While derms agree there's no magic cure for perioral dermatitis, the skin condition is still treatable.

By Emilia Benton
April 17, 2020
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You might not know perioral dermatitis by name, but chances are, you've either experienced the scaly red rash yourself or know someone who has.

In fact, Hailey Bieber recently shared that she deals with the skin condition. "I have perioral dermatitis, so certain products irritate my skin, giving me a horrible itchy rash around my mouth and eyes," she told Glamour UK in an interview.

But perioral dermatitis causes can sometimes include more than just the wrong skin-care routine. Here's what you need to know about perioral dermatitis and how to treat it.

What is perioral dermatitis?

Perioral dermatitis is a skin condition that results in a red, bumpy rash, most commonly around the mouth and sometimes around the nose or eyes, says Rajani Katta, M.D., a board-certified dermatologist, clinical professor at Baylor College of Medicine and the University of Texas Health Science Center at Houston, and author of Glow: The Dermatologist's Guide to a Whole Foods Younger Skin Diet. (BTW, even though the two seem similar, perioral dermatitis isn't the same as keratosis pilaris.)

"A lot of my patients describe it as 'bumpy and flaky,' because the rash usually has red bumps, on a background of dry, flaky skin," explains Dr. Katta. "And most patients will describe it as tender or prone to burning or stinging." Ouch, right?

The severity of perioral dermatitis can vary from person to person. For instance, while Bieber described her experience with the skin condition as "a horrible itchy rash," CBS Miami anchor Frances Wang—whose Instagram post about her struggle with perioral dermatitis went viral back in September 2019—said in an interview with People that her rash was so painful, it hurt to talk or eat.

While rash around the mouth, nose, and eyes is most common, perioral dermatitis can also appear around the genitals, according to the AAD. Regardless of where it appears, though, perioral dermatitis is not contagious.

What causes perioral dermatitis?

TBH, dermatologists don't know exactly what causes perioral dermatitis, says Patricia Farris, M.D., a board-certified dermatologist at Sanova Dermatology in Metairie, Louisiana. It affects women far more than men, but experts say there are a lot of unanswered questions about potential triggers, as they can vary from person to person.

One of the most common perioral dermatitis causes is steroid cream (including prescription meds and over-the-counter hydrocortisone creams and ointments), explain Drs. Katta and Farris. Many people make the mistake of using these creams on perioral dermatitis because they think it will help clear up the rash, but it can actually make it worse, say the derms.

Overdoing it on night creams and moisturizers could lead to perioral dermatitis as well, especially if the products contain fragrances or certain ingredients you're sensitive to (much like Bieber noted in her experience with the skin condition), add Drs. Katta and Farris. Using fluoride toothpaste and occlusive ointments such as petroleum jelly on your face may play a role too, notes Dr. Farris. For some women, hormonal changes or genetic factors may be related to perioral dermatitis as well, says Dr. Katta. (Related: Could Your Sensitive Skin Actually Be ~Sensitized~ Skin?)

Some doctors have seen cases of perioral dermatitis in people who have a poor skin barrier, something that can make the skin more prone to inflammation in general, notes Dr. Katta. Researchers have also studied bacteria and yeast obtained from this rash, but they haven't been able to determine if they're actually the culprit, or just hanging out with the rash as other unwelcome visitors.

Interestingly, there are some theories that dairy and gluten may be contributing factors in perioral dermatitis, but there isn't sufficient research to back this up, says Dr. Farris.

"Additionally, other conditions can sometimes look very similar to perioral dermatitis," notes Dr. Katta. For example, allergic contact dermatitis, an allergy to certain ingredients in skin-care products, or even certain foods, can trigger a similar red, flaky rash, she says. Sometimes foods like cinnamon or tomatoes can trigger this kind of allergic rash, which can be mistaken for perioral dermatitis if it shows up around the lips and mouth, she explains.

What is the best perioral dermatitis treatment?

Unfortunately, experts say there's no "cure" to get rid of perioral dermatitis overnight. Many perioral dermatitis treatment routes include trial and error with different medications before finding something that works. So, the best thing you can do is see a dermatologist for a proper diagnosis and treatment.

In many cases, the most effective perioral dermatitis treatments are prescription medications that are either antimicrobial or anti-inflammatory, says Dr. Katta, adding that she typically prescribes medicated creams to start. But keep in mind: It can take weeks to months for the skin to improve, notes Dr. Katta. She says she usually advises patients to try a prescription medicated cream for eight weeks before re-evaluating. Flare-ups are common, so it's important to stay in touch with your derm and schedule follow-up visits in case you need to re-treat it or switch to another medication, she explains. In more severe cases, oral medications may be necessary.

As for your skin-care routine, using too many thick, greasy products may be a trigger for some people, which is why it's important to always remove your makeup at night, says Dr. Katta. If you struggle with the stinging and burning that's common with perioral dermatitis, avoiding fragrances would likely help as well, says Dr. Farris.

"I also always recommend continuing to cleanse your face, even if it looks dry," explains Dr. Katta. She suggests using a hydrating cleanser like Cetaphil Gentle Skin Cleanser (Buy It, $10, ulta.com) or a gentle foaming cleanser like Cerave Foaming Facial Cleanser (Buy It, $12, ulta.com). "I also recommend applying moisturizer while the skin is still damp, to help strengthen the skin barrier, as it may be helpful to prevent outbreaks, although it's not a key part of treatment," she adds. (Related: The Best Moisturizers for Every Skin Type)

Perioral dermatitis can definitely be frustrating, not to mention downright painful in some cases. But the good news is that it isn't bad for your overall skin health (or general health). "[In] the long-term outlook, most people will get better with treatment and then do well for a period of time," says Dr. Katta. "But it's fairly common to have a reoccurrence of the rash at a later time. I always add the caveat that even if you're doing everything right, you may still experience perioral dermatitis."

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