Perioral dermatitis is a rash that most often affects the skin around the mouth.

Perioral dermatitis is a rash that develops around the mouth and tends to be bumpy or scaly.

The bumps generally do not affect the skin right next to the mouth but appear a short distance away from the lips. They may form a ring around the mouth.

Sometimes the rash can appear around the nose or eyes. It can occasionally appear around the genitals too, but this is rare.

The cause of perioral dermatitis is unknown; however, long-term use of topical steroids for minor skin alterations of the face often precedes the manifestation of the disease. Some causes are as follows:

Drugs: Many patients abuse topical steroids. No clear correlation exists between the risk of perioral dermatitis and strength of the steroid or the duration of the abuse. Perioral dermatitis has also observed after the use of nasal steroids and steroid inhalers.

Cosmetics: Fluorinated toothpaste; skin care ointments and creams, especially those with a petrolatum or paraffin base, and the vehicle isopropyl myristate are suggested to be causative factors.

Physical factors: UV light, heat, and wind worsen perioral dermatitis.

Microbiologic factors: Fusiform spirilla bacteria, Candida species, and other fungi have been cultured from lesions.

Miscellaneous factors: Hormonal factors are suspected because of an observed premenstrual deterioration. Oral contraceptives may be a factor.

Treatment should be adapted to the severity and extension of the disease. Stopping the use of topical steroid creams or nasal sprays, containing steroids, if possible. Doctor will determine treatment based on the severity of condition. In some cases, using mild soaps and discontinuing the use of heavy skin creams and fluorinated toothpaste may ease symptoms. Medications may also speed healing.

Medications include:

• topical antibiotic medications, such as metronidazole and erythromycin
• immunosuppressive creams, such as pimecrolimus or tacrolimus cream
• topical acne medications, such as adapalene or azelaic acid
• oral antibiotics, such as doxycycline, tetracycline, minocycline, or isotretinoin, for more severe cases

Diet and lifestyle

Lifestyle changes are a part of treating perioral dermatitis that can help prevent it. Consider the following:

• Get rid of harsh face scrubs or perfumed cleansers. Instead, use only warm water during flare-ups. Once healed, only use mild soap and don’t scrub skin.
• Avoid steroid creams.
• Stop using or reduce use of makeup, cosmetics, and sunscreen.
• Frequently wash pillow cases and towels in hot water.
• Limit overly salty or spicy foods. They can irritate skin around the mouth.

Consult a dermatologist to evaluate provoking factors and to determine the individualized treatment.

It’s important to speak with doctor before discontinuing any medications.

• Oxford hand Book of medical Dermatology
• ABC Of Dermatology
• Roxburgh’s common skin diseases
• Andrew’s Diseases of the skin