Perioral Dermatitis: Treatment, Symptoms & Diagnosis

Monderma

Oliver Belcher

16 May 2025

Perioral dermatitis causes facial redness
It shows bumps and dryness near the mouth
Triggers include skincare and steroids
Targeted treatments help calm flares
Supported by use of Monderma

Perioral dermatitis affects comfort and confidence through redness, bumps, and dryness around the mouth, nose, or eyes. These symptoms can disrupt daily life and may be difficult to distinguish from acne or eczema.

In this article you will find clear guidance that explains symptoms, causes, diagnostic clues, and evidence based treatment options that help manage this condition.

What Is Perioral Dermatitis?

Perioral dermatitis is a facial rash that appears mainly around the mouth but may affect the nose and eyes. It shows small red bumps that can resemble acne or eczema, which may lead to misdiagnosis [1,7].

It rarely includes comedones typical of acne and does not usually show the intense itch seen in eczema [14]. It is more common in women aged 16 to 45 and may persist without tailored care [1,2,3].

Symptoms Of Perioral Dermatitis

Symptoms appear in varying intensity but follow a recognisable pattern that supports diagnosis.

Key Symptoms

Symptom	Description
Redness or rash	Erythematous rash near the mouth, nose, or eyes while sparing the lip border [1]
Bumps	Small red papules that may contain clear or pus filled content [2]
Burning sensation	Mild to moderate discomfort or burning in affected areas [3]
Flakiness or dryness	Scaly or dry skin that may worsen irritation [4]

Table 1: Typical symptoms of perioral dermatitis

These signs may fluctuate with triggers but rarely affect the lips directly, which helps differentiate it from other facial conditions [1].

Perioral Dermatitis Causes

The exact cause remains unclear, yet several factors may contribute to flare patterns. Identifying these helps reduce recurrence and guide treatment choices.

Common Triggers

Trigger	Description
Topical steroids	Linked with up to 90 percent of cases through prolonged or inappropriate use [3,4]
Skincare products	Occlusive products or harsher formulas may aggravate skin [3,6,7]
Hormonal changes	Menstruation, pregnancy, or contraceptive use may influence outbreaks [6,7]
Environmental factors	Sunlight, weather changes, and stress may provoke symptoms [3,6]

Table 2: Potential causes linked with perioral dermatitis

Diagnosis

Diagnosis is clinical, guided by symptom pattern and history. Biopsy may be used in rare unclear cases and can show perivascular and perifollicular inflammation, although findings are not specific [8].

Treatments For Perioral Dermatitis

Treatment combines reduced triggers with topical and oral medicines tailored to severity.

Treatment Options

Treatment	Description
Metronidazole	Topical antibiotic that reduces inflammation and bacteria [5]
Pimecrolimus cream	Non steroid anti inflammatory that calms skin [10,11]
Clindamycin	Topical antibiotic that targets bacteria and redness [5]
Azelaic acid	Mild anti inflammatory that reduces redness and irritation [9]
Oral antibiotics	Options such as doxycycline or tetracycline for persistent cases [12]
Gentle skincare and sunscreen	Supports barrier function and reduces triggers [3,6]

Table 3: Evidence based treatments for perioral dermatitis

Discontinuing Topical Steroids

Stopping topical steroids is essential, yet rebound may occur, so gradual withdrawal helps support comfort [3,13].

Azelaic Acid Support

Azelaic acid offers effective and gentle support, with research noting improvement in many cases within several weeks [9].

Pimecrolimus Cream

Two RCTs support pimecrolimus for steroid induced perioral dermatitis, with evidence showing significant improvement in inflammation [10,11].

Doxycycline

Modified release doxycycline supports persistent cases with fewer gastrointestinal effects than standard formulations [12].

Conclusion

Perioral dermatitis can be managed effectively with gentle routines, awareness of triggers, and treatments that help calm inflammation and restore balance. Understanding how factors such as topical steroid use and skin sensitivity contribute to flare ups supports clearer, steadier progress over time.

If you would like personalised skincare shaped around your own needs, you can explore a custom formula through Monderma.

Content is for informational purposes only. Monderma treatments are prescribed following consultation. Results and timeframes can vary. Use as directed by your prescriber.

References

Perioral dermatitis – GPnotebook.
Perioral dermatitis – VALINTERMED.
Perioral Dermatitis | Doctor. Patient.info.
Answer: Can you identify this condition.
Perioral Dermatitis. StatPearls.
Perioral Dermatitis: Managing the Healing Phases.
Wikipedia. Perioral dermatitis.
Biopsies of Facial Dermatoses Made Simple.
Jansen T, Melnik BC, Schadendorf D, et al. Steroid induced periorificial dermatitis in children.
Oppel T, Pavicic T, Kamann S, et al. Pimecrolimus cream efficacy in perioral dermatitis.
Schwarz T, Kreiselmaier I, Bieber T, et al. Pimecrolimus cream in adult perioral dermatitis.
Del Rosso JQ. Management of papulopustular rosacea and perioral dermatitis.
Diehl KL, Cohen PR. Topical steroid induced perioral dermatitis.