Perioral Dermatitis
Red, bumpy rash around the mouth and nose - often triggered by topical steroids. Common in women aged 20-45.
What to look for
Side-by-side comparison
Normal face
Clear around mouth
Perioral dermatitis
Bumpy rash around mouth
Perioral dermatitis is a facial rash characterized by small red papules, pustules, and mild scaling distributed around the mouth, nose, and sometimes the eyes. It predominantly affects women aged 20-45, though it can occur in men and children.
A hallmark feature is the sparing of a narrow zone immediately adjacent to the lip border - the rash stops a few millimeters from the lip edge, creating a characteristic clear strip.
The most common trigger is the use of topical corticosteroids on the face (prescription or OTC hydrocortisone). Other triggers include heavy occlusive moisturizers, fluorinated toothpaste, inhaled corticosteroids (when used around the mouth), and possibly cosmetic products.
Treatment involves: (1) stopping all topical corticosteroids on the face - this often causes a temporary flare before improvement; (2) switching to a gentle, minimal skincare routine; (3) topical metronidazole or azelaic acid; and (4) oral antibiotics (doxycycline or minocycline) for moderate-to-severe cases. Most cases resolve within 2-3 months with appropriate treatment.
Quick self-check
Does this look like perioral dermatitis? Answer 2 questions.
Is there a bumpy rash around the mouth with a clear strip right at the lip edge?
Have you used steroid cream on your face or changed facial products recently?
Risk factors
- Women aged 20-45
- Use of topical corticosteroids on the face (most common trigger)
- Heavy or occlusive facial moisturizers
- Fluorinated toothpaste
- Inhaled corticosteroids
- Nasal steroids
When to see a dermatologist
- ⚠Persistent bumpy rash around the mouth that does not resolve with simple skincare changes
- ⚠Worsening rash despite stopping suspected triggers
- ⚠Rash around the eyes (periocular dermatitis)
Often confused with
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Full ABCDE check →Frequently asked questions
Why does stopping steroid cream make it worse before it gets better?
Topical steroids suppress inflammation, so stopping them allows the underlying condition to flare temporarily (steroid withdrawal or rebound). This flare typically lasts 1-2 weeks before improvement begins. Pushing through this phase is essential - restarting steroids perpetuates the cycle.
Is perioral dermatitis the same as rosacea?
They are separate conditions, though they share some features and can coexist. Perioral dermatitis is focused around the mouth and nose with characteristic lip sparing. Rosacea primarily affects the cheeks and central face with persistent background redness and visible blood vessels.