Persisting facial rash could be perioral dermatitis

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Perioral dermatitis is a facial rash that causes bumps to develop around the mouth. In some cases, a similar rash might appear around the eyes, nose, chin or forehead.

While this condition can happen to anyone, it is most commonly seen in women (90 percent of cases), but it can affect men as well.

Q: What causes this condition?

A: The exact cause of perioral dermatitis is not known. However, it might appear after topical steroid creams are applied to the face to treat other conditions.

Other causes may also come into play such as:

  • Makeup, cleansers and cosmetics applied to the area affected on the face. It could be that certain ingredients of cosmetics may act as the trigger.
  • Physical factors such as strong winds and ultraviolet (UV) light.
  • Fluorinated toothpaste has been suggested as a possible trigger.
  • Yeasts and germs (bacteria) that live on the skin and in hair follicles have been suggested as a possible trigger. (However, perioral dermatitis is not just a simple skin infection.)
  • Hormone factors might play a part.
  • Oral contraceptives might be a factor in some cases.

Q: What are the symptoms of perioral dermatitis?

A: Perioral dermatitis results in bumps around the skin of the mouth, and a rash may appear around the eyes, nose, forehead or chin. These symptoms often resemble those of rosacea or acne, but it is not either of these conditions.

Often the skin just next to the lips is not affected, so it appears that the rash almost forms a ring around the mouth.

The severity of the rash can vary from a few minor spots that are barely noticeable, to a definite and obvious lumpy rash around the mouth.

The rash is not usually painful; however, some people report a mild burning or itchy feeling. Others report that the affected skin feels tense.

The rash is not serious and is not associated with any underlying disease. However, it can be unsightly.

Q: How do I know if I have perioral dermatitis?

A: You should consult a dermatologist who will likely make a diagnosis based on your skin's appearance. No tests are usually done. In some cases, a culture for bacteria might be needed to eliminate the possibility of infection.

Q: How is perioral dermatitis treated?

A: To treat perioral dermatitis, discontinue the use of all topical steroid medications and facial creams.

Oral antibiotics, used as an anti-inflammatory drug might also be prescribed.

If you have a persisting rash, call a dermatologist to schedule an appointment.

Dr. Oswald Lightsey Mikell, certified by the American Board of Cosmetic Surgery, is the owner of Dermatology Associates of the Lowcountry.

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