Perioral dermatitis is a common facial skin problem that mostly affects adult women. It rarely occurs in men or children. Groups of itchy or tender small red papules (bumps) appear most often around the mouth. There can be mild redness and irritation of the skin. They spare the skin bordering the lips (which then appears pale) but develop on the sides of the chin, upper lip and cheeks. The surrounding skin may be pink, and the skin surface often becomes dry and flaky. Often the skin around the nose is affected, and occasionally around the eyes (periocular or periorificial dermatitis).
The exact cause of perioral dermatitis is not understood. Some dermatologists believe it is a form of rosacea or seborrheic dermatitis. Use of topical steroid creams appears to be the most frequent cause of perioral dermatitis. The more potent the steroid cream, the more rapid and severe the perioral dermatitis.
Luckily perioral dermatitis responds well to treatment. If you are using a topical steroid, there may be a brief flare-up when the creams are stopped. An oral antibiotic, such as tetracycline or doxycycline, is the most common treatment for perioral dermatitis. For milder cases or pregnant women, a topical antibiotic cream may be used. Azelaic acid may be of benefit, and may be used during pregnancy.