What are the symptoms of perioral dermatitis?
Perioral dermatitis usually appears as a red, dry, flaky or scaly patches and small bump-like lesions that look like pimples. The inflammation is sometimes sensitive or itchy but not always.
"When around the mouth area there is usually no rash or irritation near the pink boundaries of the lip," Dr Cook says. "We call this a rim of sparing around the mouth. It’s quite classic of the condition."
What causes perioral dermatitis?
The exact cause of perioral dermatatis is not understood but Dr Cook says there are a number of different triggers she's noticed in her decades of experience dealing with skin.
1. Depleting the skin barrier
Your skin barrier is essentially a combination of skin cells and lipids (a fancy word for fats) that keeps your skin healthy and functioning to protect your insides. Sabotaging your skin barrier allows moisture from your skin to evaporate easier and lets irritants to enter your body. Basically, it ain't good.
"Lack of an intact barrier function results in a loss of your skin being able to protect itself," Dr Cook says. The skin the gets chronically irritated, inflammation sets in and perioral dermatitis is one of the manifestations."
There are plenty of ways to damage your skin barrier including not drinking enough water, environmental exposure and, beauty lovers listen up, going too HAM on harsh products. Misusing chemical and physical exfoliators is a major culprit.
"Using skin care and skin treatments that compromise the skins barrier function and therefore the skin starts “acting out” like a rebellious teenage," she explains.
Hormonal changes from pregnancy can sometimes trigger perioral dermatatis. There's also evidence that hormonal birth control can play a role.
3. Misdiagnosis and mistreatment of other conditions
Often the use of steroid cream can trigger perioral dermatatis.
"People may have a dermatitis type rash," Dr Cook says. "They are given a steroid ointment that then takes the rash away (but not treating the underlying cause and fixing the skin barrier). The patient gets codependent on using the steroid cream and keeps using it. At first things go ok. Then when they stop using the steroid, the skin rebounds with really bad perioral dermatitis."
Is perioral dermatitis contagious?
No, perioral dermatitis is not contagious.
How is perioral dermatatis diagnosed?
Your GP or dermatologist can diagnose perioral dematitis with a visual assessment and medical history.
How do you treat perioral dermatatis?
1. Assess your skincare routine
"First, stop all potentially irritating products: No foaming or scrubbing cleansers," Dr Cook says. "No active ingredients."
Yep, step away from the AHAs and take it back to basics.
"Instead replace with gentle cleansing," she says. "Gentle moisturising. Morning and night. Aiming to reduce any further irritation and restore and rebuild the barrier layer.
2. Stop using steroid cream
The Australian College of Dermatologists recommend stopping the use of steroid creams if they are the suspected trigger. You're likely to see a rebound or flare-up of perioral dermatitis after you stop using the cream but don't be tempted to start using it again!
3. Prescribed medication
"The gold standard prescription is oral anti-inflammatory antibiotics," Dr Cook says. "The tetracycline family. The ones commonly prescribed are minomycin and doxycycline. If pregnant we prescribe Erythromycin."
She says a topical anti inflammatory, non steroid cream can also help.
How long does it take to get rid of perioral dermatitis?
Unfortunately perioral dermatitis won't clear over night. Expect gradual improvement over a few weeks or months.