Perioral Dermatitis - Diagnosis and Treatment

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

Perioral dermatitis is usually diagnosed from its appearance. There is not much else that looks like it, but there are a few other conditions it can be mistaken for:

Tests are usually not needed unless perioral dermatitis does not improve with treatment and one of these other conditions needs to be ruled out.

Without treatment, the condition may last for months or years. The following treatments can usually help to clear the rash. However, it may take some time for the treatment to work.

Stop using anything on your face

Firstly, your doctor is likely to advise you to stop using any cream, ointment, cosmetic, etc, on your face. In particular, your doctor may advise you to stop using any topical steroid. If you have been using a topical steroid, the rash will worsen for several days before it gets any better. You need to anticipate and accept this. Whilst the rash is present, just wash your face with water only. Some doctors advise not using toothpaste that contains fluoride.

Even when the rash has gone, it is best not to use any cosmetics or creams on the affected area, as the rash may reappear. And use only a bland liquid face cleaner to wash your face, rather than bar soap.

Antibiotic medicines

Your doctor may prescribe an antibiotic tablet in the tetracycline group. Doxycycline or tetracycline topical antibiotics are sometimes used in milder cases. The course of treatment is usually for six to twelve weeks. You may not notice any improvement for the first few weeks of treatment. However, there is an improvement in most cases within two months after starting antibiotic treatment. So, do persevere if an antibiotic is prescribed. The way antibiotics work in this condition is not clear. It is not a simple skin infection. However, tetracyclines and some other antibiotics have an action to reduce inflammation in addition to killing germs (bacteria) and this may be why they work.

Other treatments

Other treatments are sometimes used for perioral dermatitis. These include pimecrolimus cream. This cream works to reduce skin inflammation. It seems to be particularly effective in perioral dermatitis that has been caused by using topical steroids.

If you suspect you have perioral dermatitis you should stop putting all ointments and creams on your face. This alone may improve the condition. However, it's best to see a GP as soon as the rash starts in case it's one of the other conditions mentioned above. Also, your doctor may want to prescribe antibiotics or another type of treatment.

Further reading and references

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