Peri-Oral Dermatitis and Rosacea

In the treatment of rosacea, one sometimes sees a rosacea-like eruption around the mouth area. This is known as peri-oral dermatitis, peri-oral refers to the facial area around the mouth while dermatitis pertains to inflammation, redness or irritation of the skin. In addition, there are usually small red bumps or even pus bumps and mild peeling as the skin is extremely aggravated. This condition may be wrongfully thought of as acne while others believe it to be a manifestation of their rosacea. Peri-oral dermatitis is often aggravated by fluoridated or tartar-control toothpaste, chapstick, the ingredients in lipstick, and mouthwash. Peri-oral dermatitis is a common skin problem that mostly affects young women, however, occasionally men and children are affected by it.

The easiest first step for improvement is the prevention by eliminating those factors mentioned above so that the affected perioral dermatitis area may heal. Peri-oral dermatitis occurs primarily among women between the ages of 15 and 40. It may be described as small red papules or pustules without the occurrence of spider veins. Peri-oral dermatitis symptoms characteristically involve the mouth area, but generally do not affect the lips themselves. You may also notice flaking of the skin at the site of occurrence. Many times if the flaking is isolated to the lip area it may be mistaken for chapped lips. Often the skin around the nose is affected too, and sometimes it can affect the area under and around the eyes.

When peri-oral dermatitis expands to include the eye area, it should more correctly be termed “peri-ocular”, or even, “peri-orificial” dermatitis. Peri-ocular dermatitis consists of similar flaking and redness with or without the appearance of small papules or pustules.

The most common causes of peri-oral dermatitis are topical steroid use and fluoridated and/or tartar control toothpaste. According to the International Rosacea Foundation, discontinuing the use of fluoridated or tartar control toothpaste for six months may help reduce the symptoms of peri-oral dermatitis.

Sufferers of peri-oral dermatitis tend to have oily skin. Some people are more susceptible to peri-oral dermatitis than others, and recent research indicates the occurrence may be related in part to a proliferation of bacteria in the hair follicles.

Peri-oral dermatitis tends to be aggravated by the following conditions or circumstances:

  1. Cleansing the facial skin with the wrong type of soap. A soap-free cleanser such as Dove or Neutrogena is recommended. Avoid harsh scrubbing of the area.
  2. Facial scrubs or acne treatments may cause or worsen the condition.
  3. Applying face creams regularly to the area bounded by the cheek folds and chin, or around the eyes in the case of peri-ocular dermatitis. These creams include moisturizers, anti-wrinkle creams, cream cleansers, make-up foundation, and sunscreens. Many of the moisturizers and creams currently on the market contain sunscreens or ingredients that can cause or worsen the peri-oral condition. Anti-wrinkle or anti-aging creams contain retinols, citric acids, beta-hydroxy acids or alpha hydroxy acids which increased facial redness and skin irritation.
  4. Applying topical steroids to the facial area. The more potent the steroid cream, the more rapid and severe the occurrence of the peri-oral dermatitis.
  5. Lip balms, glosses and lipsticks that extend over the actual lip area can also aggravate the condition.

It can take many weeks for the condition to clear. In severe cases treatment may consist of application of a steroid cream, which you then taper off of by using less, or a weaker strength of in the following days.