Perioral dermatitis

Perioral dermatitis, also known as "perioral dermatitis," is a type of skin disease that primarily affects the area around the mouth, nose, and occasionally the eyes. Although the name sounds harmless, the condition poses a significant burden for many people.

Itching, redness, pustules and even slight pain are among the typical symptoms that can affect not only your appearance but also your self-confidence.

Over-cared skin, hormonal changes, stress, or a weakened immune system often play a key role. Because it develops slowly, it's often initially confused with acne, hand, foot, and mouth disease, or other skin problems. In this short guide, we provide you with all the important information.

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What are the symptoms and stages of perioral dermatitis?

The skin changes often begin subtly and can worsen over weeks or months.

Dermatologists typically observe several phases in this skin disease.

General symptoms at a glance

The symptoms and signs can vary in severity. Only a doctor can make a reliable diagnosis.

Itching: Many patients may experience itchy skin.
Dryness: the skin flakes and feels dry and tight.
Redness: In most cases, the rash occurs around the mouth, less frequently on other parts of the body.
Papules: Blisters, pimples and pustules can also appear together with the red spots on the skin

Early stage: First signs and confusion with acne

In the initial phase, the skin around the mouth is predominantly red and scaly. Small, inflammatory nodules appear on the affected skin areas. These are often mistaken for acne, blocked sebaceous glands, an allergic reaction, or a common rash. The symptoms are not constant, but appear in bouts.

Progressive stage: spread to larger skin areas

If the skin problem isn't treated early, this dermatitis can spread to larger areas of the face, for example, toward the eyelids, across the cheeks, or even up to both sides of the chin. Small papules, about two millimeters in diameter, are noticeable, often accompanied by pus-filled blisters. The affected skin areas appear irritated and react sensitively to skincare products. Many people take inappropriate measures that further exacerbate the symptoms.

Rash around the mouth? Perioral dermatitis: Causes, symptoms, and what to avoid

The exact triggers of perioral dermatitis have not yet been fully researched. However, various factors can be identified that can increase the risk or promote an outbreak.

Over-cared skin

Over-exposing the skin to too many products can disrupt its natural protective function. Ingredients containing fragrances or irritating substances are particularly problematic. The result is often an overreaction of the skin, manifesting as redness and minor inflammation.

Creams containing cortisone

Cortisone can provide short-term relief, but long-term use often has the opposite effect.

After discontinuation, the skin condition often worsens significantly.

stress

Mental or physical stress can affect general health, and the skin also reacts sensitively. Many sufferers report the first signs during such times. Therefore, a low-stress lifestyle should also be considered as a complementary measure.

Dry skin

People with dry skin often have a less stable skin barrier, which makes it easier for irritants to penetrate and cause inflammation.

Cosmetics & Make-up

Regular use of high-coverage products can strain skin pores. Certain ingredients can also irritate the skin. Avoiding all cosmetic products for a few weeks often helps.

UV radiation

Whether from the sun or a tanning bed, intense radiation dries out the skin and can aggravate existing conditions. Sensitive skin is particularly sensitive to this. Moderate exposure to UV light is therefore advisable.

Frequent facial touching

In everyday life, we often unconsciously touch our faces. This can expose dirt and microorganisms to sensitive skin. Being aware of this can make an important contribution to prevention.

Hormonal fluctuations

Hormonal changes, such as those experienced during adolescence, pregnancy, or menopause, can also affect the skin. The first symptoms often appear during such transitional phases, requiring particularly gentle skincare.

moisture

Wearing a face mask for extended periods creates a moist environment on the skin. This can promote breakouts and overwhelm the skin. Especially during the pandemic, many people reported skin irritation on the lower face.

In cases of this rash, some patients are more frequently affected than others. The disease is rarely diagnosed in children and is more commonly diagnosed during pregnancy and menopause.

Children

Mouth thrush is relatively rare in children, but medical evaluation is still advisable even at a young age, especially if a persistent rash occurs around the mouth. Observations show that the condition often first appears around the age of six. There is often a history of atopic dermatitis, asthma, or other allergies.

pregnancy

During pregnancy, existing mouth rash can worsen. Hormonal changes affect many bodily functions, including the skin. Since certain medications cannot be used without warning during this phase, treatment requires special caution. If a rash around the mouth develops while breastfeeding, any treatment should be discussed with a doctor to avoid adverse effects on the child.

Menopause

Many women also experience an increased susceptibility to skin problems during menopause. This is due to declining hormone production, which makes the skin drier and more sensitive. Many women respond by using more intensive skincare products, but this can be counterproductive. If the stratum corneum of the skin is permanently softened, it loses its natural protective function. Germs and irritants can penetrate more easily and lead to inflammatory reactions.

Perioral dermatitis: How long does it take to heal with the right therapy?

The healing time for perioral dermatitis depends heavily on the individual course of the condition and the appropriate treatment. Dermatologists typically recommend a so-called "zero therapy" first. This involves consistently eliminating all irritating substances, such as cosmetic products, creams, or fluoride toothpaste. Treatment usually lasts about six to twelve weeks. In more severe cases, the course may be longer.

Dermatology consultation

During a detailed consultation with a specialist, we analyze possible causes, such as stress factors, hormonal changes, or unsuitable skincare products. We then develop a personalized treatment plan. Comorbidities are also taken into account in the therapy planning process.

Difficult cases

Topical creams & antibiotics

In more severe cases, where dermatitis has already spread to larger areas of the face or other sensitive areas of the body, we recommend a combined treatment. This includes regular check-ups, targeted medication, and professional skin cleansing. The goal is not only to combat visible signs of the disease, but also to permanently improve our patients' skin health.

In the first step, depending on the findings, we apply topical creams with anti-inflammatory active ingredients. These soothe irritated skin areas and reduce redness, pustules, and blisters. For bacterial skin infections, we also use externally applied antibiotics to effectively contain the spread.

Chronic course

A chronic course often develops when sufferers repeatedly use cortisone-containing ointments, for example, for other skin diseases or inflamed areas of the face. These medications suppress symptoms in the short term but promote a relapse of the disease in the long term.

A vicious circle develops! If the cortisone is discontinued, the inflammation flares up; when it is reapplied, the symptoms disappear, but only temporarily. To counteract this, the medication should be discontinued carefully and replaced with appropriate treatments.

A targeted diagnosis by a dermatologist or an experienced dermatologist is essential for developing an appropriate treatment plan. Regular monitoring of skin reactions and targeted skin care play a crucial role in healing.

Why perioral dermatitis keeps coming back after cortisone

Treating perioral dermatitis naturally: Home remedies to support

Even if medical treatment is absolutely the first priority, simple home remedies can help alleviate the symptoms. Black or green tea compresses have proven particularly effective, as the tannins they contain have anti-inflammatory properties and gently dry the affected skin areas.

To use, first prepare a cup of tea and let it cool completely. Then, soak a clean cotton cloth in it and gently place it on the irritated areas. The compress should be left on for about 15 minutes; the cloth can be re-soaked during this time to enhance its effect.

This application can be repeated several times a day as needed and is perceived by many sufferers as pleasant and calming.