Perioral Dermatitis - Causes

Authored by Dr Laurence Knott, 13 Sep 2016

Patient is a certified member of
The Information Standard

Reviewed by:
Dr Helen Huins, 13 Sep 2016

The exact cause is not clear. However, in many cases the rash seems to be triggered by one or more of the following:

  • Steroid creams and ointments are a main trigger. See below for details.
  • Make-up, cleansers and cosmetics applied to the area affected on the face. It may be that certain ingredients of cosmetics may act as the trigger. For example, one study found that make-up foundation seemed to be a particular provoking factor.
  • Physical factors such as strong winds and UV light.
  • Fluoridated toothpaste has been suggested as a possible trigger.
  • Yeasts and germs (bacteria) that live on the skin and in hair follicles have been suggested as a possible trigger. (However, perioral dermatitis is not just a simple skin infection.)
  • Hormone factors may play a part, as some women find that the rash becomes worse just before a period.
  • The oral contraceptive pill may be a factor in some cases.

Recently, a study has found that some sun creams used on the face may be a trigger for perioral dermatitis in some children and adults. A liquid, gel or light milk sunscreen may be the best to use.

There is a well-known link between using a topical steroid (steroid creams, gels, ointments, etc) and developing perioral dermatitis. Many cases develop soon after using a topical steroid on the face for another condition, such as mild eczema. Without realising you are doing so, you may even rub some steroid on your face if you are treating another part of your body with a topical steroid. For example, you may scratch the treated area of your skin (say, your elbow) and then, without realising you are doing so, rub the finger used for scratching on to your face.

Topical steroids can also clear a mild patch of perioral dermatitis temporarily. Some people will have tried a steroid cream, which can be bought at pharmacies, to treat what they think is mild eczema. However, as soon as the rash clears and the steroid is stopped, the rash reappears, only even worse. This can become a vicious circle as they may then put more steroid cream on to clear the new rash, which may clear again. They may stop the steroid again, only for the rash to come back yet again and even worse, etc.

Further reading and references

I have always had mild eczema and dermatitis but it has got worse over the last 6 months. I now have eczema all on my back, hips and legs (and eye lids) it's annoying but I have been dealing with it...

vickilouise
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