You’ve tried everything: hydrocortisone cream, moisturizers, cutting out products. But that angry, red rash around your mouth won’t budge. It flakes, it burns, it shows up in every Zoom meeting—and it’s driving you nuts.
If you’re dealing with a persistent red rash around your mouth, nose, or eyes, you might have perioral dermatitis—a chronic, inflammatory skin condition that often gets misdiagnosed as acne, eczema, or an allergic reaction.
Let’s break down what perioral dermatitis is, how to tell if you have it, what causes it, and the exact steps you need to finally get rid of it.
What Is Perioral Dermatitis?
Perioral dermatitis is a facial rash that typically appears around the mouth, nasolabial folds, and sometimes the eyes or nose. It shows up as:
- Redness and scaling
- Tiny red or flesh-colored bumps or pustules
- Burning or stinging
- Dry, irritated, tight-feeling skin
Despite its appearance, it’s not acne, and it doesn’t respond well to acne treatments. In fact, the wrong treatments—especially topical steroids—can make it worse.
What Causes Perioral Dermatitis?
The exact cause is still unclear, but several triggers are strongly linked to this condition:
- Topical steroids – Even over-the-counter hydrocortisone can trigger or worsen PD
- Heavy or occlusive skincare products (thick moisturizers, oils, balms)
- Fluoridated toothpaste
- Hormonal fluctuations
- Inhaled corticosteroids (e.g., asthma inhalers)
- Overwashing or aggressive exfoliation
- Microbiome imbalance on the skin
It’s most common in women aged 20–45, but can occur in men and children too.
How to Tell If It’s Perioral Dermatitis
Here are a few clues that point to PD:
- The rash is concentrated around the mouth, nose, or eyes
- It burns or stings more than it itches
- It doesn’t respond to hydrocortisone, or improves briefly then comes back worse
- You’ve been using topical steroids (even occasionally)
- It resembles acne but doesn’t respond to acne treatments
If this sounds like you, don’t worry—PD is common and very treatable, but it requires the right approach.
How to Treat Perioral Dermatitis
1. Stop All Topical Steroids
This is critical. Even if they seem to help temporarily, steroids ultimately worsen PD. Stopping them can cause a temporary flare (withdrawal reaction), but it’s necessary for healing.
2. Simplify Your Skincare
- Use only a gentle, non-foaming cleanser
- Moisturize with a light, fragrance-free lotion (avoid heavy creams or oils)
- Avoid exfoliants, toners, or actives (AHAs, BHAs, retinoids)
Look for formulas labeled non-comedogenic, minimal ingredient, and barrier-friendly.
3. Switch Toothpaste
Choose a fluoride-free, SLS-free toothpaste during your flare (hello, hello charcoal or Tom’s of Maine).
4. Start Medical Treatment
A dermatologist can prescribe:
- Topical antibiotics like metronidazole or clindamycin
- Oral antibiotics like doxycycline or minocycline (especially for widespread or stubborn cases)
- Topical calcineurin inhibitors (e.g., pimecrolimus) in sensitive areas like the eyes
Most people see significant improvement in 4–8 weeks, though it can take several months for skin to fully reset.
What Not to Do
- Don’t try to scrub it away. That damages your barrier and worsens inflammation.
- Don’t layer on multiple actives. Vitamin C, retinol, acids—they’re too harsh during a PD flare.
- Don’t keep switching products. Simplicity and consistency are key.
- Don’t ignore it if it spreads. It often creeps from mouth to nose to eyes if left untreated.
Long-Term Prevention Tips
- Avoid unnecessary steroid creams on your face—even for eczema or irritation.
- Keep your skincare routine simple and gentle.
- Watch for new flare-ups during periods of stress, hormonal shifts, or after trying new products.
- Introduce actives slowly and patch test everything.
You Can Get Clear Again
Perioral dermatitis can be relentless, but it’s not forever. With the right diagnosis and a dermatologist-backed treatment plan, your skin can heal. The bumps will fade, the redness will calm, and you’ll get your smooth, even-toned skin back.
Just take a deep breath, simplify your routine, and give your skin time to recover.
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Zehn Skin and Health 
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