If you have a stubborn rash of small red bumps, flaky skin, and a mild burning sensation around your mouth and nose, you may be dealing with perioral dermatitis.
What it looks like
Perioral dermatitis typically shows up as clusters of small red bumps, flaking, and a burning or tight feeling. It usually appears around the mouth and nose, and sometimes around the eyes. It's most common in women in their 20s to 40s, though anyone can get it.
Common triggers
The exact cause isn't fully understood, but these are frequent culprits:
- Topical steroid creams, including hydrocortisone
- Nasal and inhaled steroids
Heavy, occlusive moisturizers and cosmetics
- Fluoride toothpaste, especially strongly flavored (cinnamon or mint) formulas
- Alcohol-based mouthwashes
- Lip products with heavy waxes, fragrance, oils, or menthol
- Over-washing, over-exfoliating or friction against the skin
- Hormonal shifts
Hormonal shifts
Hormones can play a big role. Flare ups are often linked to times of change, such as puberty, pregnancy, your menstrual cycle, or starting or stopping birth control or hormone replacement therapy (HRT). Hormonal shifts alter the skin barrier, leaving the area around the mouth more reactive to triggers and prone to inflammation.
Lifestyle factors that can make it worse
Anything that may cause inflammation in the body may contribute. Many people notice flares with:
- Dairy, gluten, alcohol, or high-sugar foods (triggers can vary from person to person)
- High stress levels
- Gut imbalances
Physical friction and heat
- Scrubbing, over-exfoliating, or rubbing skin with a washcloth
- Wearing a face mask for long periods
- Hot water (wash with lukewarm instead)
Why it's easy to make worse
Perioral dermatitis can look like acne, eczema, or rosacea, so many people reach for hydrocortisone or a thick cream. Steroids may calm it temporarily, but can make the condition worse when you stop.
What helps
- Simplify your routine. Stick to a gentle cleanser, a light moisturizer, and a mineral sunscreen. We like Hale & Hush Quiet Wash, Bio Relief Powder, Hush Hydrate Mask, and Face Reality Omni Clear Mist.
- Slowly discontinue topical steroids on the area, ideally with a doctor's guidance, since it may flare before it improves.
- Switch your lip balm to plain Aquaphor or Vaseline, and skip waxy, fragranced, oily, or mentholated balms.
- Swap your mouthwash for an alcohol-free one, and consider a fluoride-free, mild-flavored toothpaste.
- Cut back on heavy products. Avoid layering thick makeup, occlusive moisturizers, and ointments around the affected area.
- Manage what you can. Prioritize sleep and stress relief, and pay attention to foods that seem to trigger flares. Keeping a food journal may help to identify which foods trigger your symptoms.
- Be patient. Improvement usually takes weeks to a few months.
Perioral dermatitis is common, non contagious, and treatable. The best first step is often to do less: simplify your skincare and remove triggers.
If you have any questions, please reach out to either Krystal or Melissa. They will help answer any questions you may have and get you on the proper homecare.
