Redness, swelling, fine scaling and inflammatory acne-like lesions around the mouth, often involving the chin and nasolabial folds, accompanied by burning, itching and a feeling of tension…this describes perioral dermatitis (peri = around, oral = the mouth). A closer look usually reveals a zone free of lesions immediately adjacent to the red of the lips.
The underlying cause of perioral dermatitis is a hypersensitivity of the skin, oftentimes due to excessive use of cosmetics, complex care routines and/ or too aggressive cleansing. To alleviate occurring symptoms, corticosteroids or antibiotic creams are quickly used. However, especially when discontinuing these products, symptoms flare up. Thereupon, frequency and intensity of care and cleansing products are increased again, which finally creates a vicious cycle.
Follow these steps to clear perioral dermatitis:
1. Stop applying any corticosteroids (including mild, over-the counter treatments such as hydrocortisone creams)
2. The rash may flare up when stopping corticosteroids. Although it’s tempting, don’t start using it again! It will only bring temporary relief.
3. Change your skin care routine: mild, fragrance-free products if any. Zero therapy in acute phase (no washing gels, care products or make-up).
4. Only use lukewarm water to cleanse your face and carefully dry your skin with a fresh towel. Dabbing, no rubbing.
5. Patience. Expect gradual but slow improvement (weeks to months to clear completely)
6. To alleviate tension and burning, apply black tea dressings: briefly dip a tea bag in hot water, allow to cool completely, soak dressings, place directly on the affected areas for 10 minutes. The tea should be organic and unflavored (For example, no early gray tea)
7. Deal with it openly. Perioral dermatitis cannot be overlooked, especially since it should not be covered. Instead of skipping events or meetings, just tell your colleagues and friends what’s up. It is more common than you might think and everyone will understand.
8. Consult a board-certified dermatologist or functional doctor in cases of persistence and severe presentation.
What you probably didn’t know about perioral dermatitis:
It can also appear around the eyes or nose
It is not contagious It is not chronic and leaves no scars
It is not an allergy. However, due to the disrupted skin barrier, allergens can potentially penetrate the skin much easier
References: Searle, T., Ali, F.R. & Al-Niaimi, F. Perioral dermatitis: diagnosis, proposed etiologies and management. J Cosmet Dermatol (2021) Tempark, T. & Shwayder, T.A. Perioral dermatitis: a review of the condition with special attention to treatment options. Am J Clin Dermatol 15, 101-113 (2014) Hafeez, Z.H. Perioral dermatitis: an update. Int J Dermatol 42, 514-517 (2003) Witte M, Krause L, Zillikens D, Shimanovich I. Black tea dressings - a rapidly effective treatment for facial dermatitis. J Dermatolog Treat 2019; 30: 785-789