Perioral Dermatitis: A Guide to Triggers and Treatment

Perioral dermatitis is a facial rash that often flares around the mouth and may spread to the nose or eyes. Common triggers include topical steroids, fragranced skincare, fluoride toothpaste, and hormonal shifts. First steps: simplify your routine, avoid heavy occlusives, and patch-test. Gentle, fragrance-free care may help; persistent cases need clinician-guided treatment.

Perioral dermatitis is also referred to as periorificial dermatitis and facial dermatitis. It is a skin condition characterised by red, flaky skin around the mouth, but can also present near the eyes, nose, cheeks, or jawline. Although common, it is frequently misunderstood and can be mistaken for other skin ailments. In this article we explore the condition, what can contribute to it, and gentle treatment options. We also outline how factors such as pregnancy and skin tone can influence presentation and care.

Close-up of mild perioral dermatitis around the mouth with small red bumps.
Perioral dermatitis often appears as small clustered bumps around the mouth.

In this article:

  1. What is Perioral Dermatitis?
  2. Perioral Dermatitis causes and triggers
  3. Who does Perioral Dermatitis affect?
  4. Where it appears on the face
  5. Perioral Dermatitis treatment
  6. Perioral Dermatitis in pregnancy
  7. Perioral Dermatitis in people of colour
  8. Conclusion
  9. Related articles

Symptoms (what it looks/feels like)

  • Small red or skin-coloured bumps around the mouth (may spread to nose/eyes/chin).
  • Fine scaling or flaky patches; skin can feel tight.
  • Stinging, burning, or mild itch (often worse after products).
  • Looks like acne but usually no deep, painful nodules.
  • Darker skin tones: redness may be subtle; brown/grey/purple marks (PIH) can linger after flare-ups.

Here’s the Common triggers section in plain text (copy/paste into the Visual editor to replace your current block).

Common triggers

  • Recent or repeated topical steroid use on the face; nasal/inhaled steroids.
  • Makeup: friction/occlusion can aggravate; keep coverage light and breathable.
  • Skincare, moisturisers, sunscreen: harsh ingredients or overuse can irritate; thick, oily occlusives may exacerbate PD.
  • Fluoride toothpaste: can irritate perioral skin in some; avoid contact with the surrounding skin.
  • Chewing gum: certain ingredients, saliva, and friction may aggravate the area.
  • Hormonal shifts: menstruation, pregnancy, contraceptives.
  • Stress and poor sleep.
  • Friction/occlusion: masks, scarves, frequent face touching.
  • Weather/extremes: wind, cold, UV; over-cleansing; hot water.
  • Infants: drool/pacifiers (constant moisture on perioral skin).

Do / Don’t (quick routine rules)

Do

  • Pare back to a gentle, fragrance-free cleanser and a light, non-occlusive moisturiser.
  • Patch-test anything new; introduce one product at a time.
  • Use daily SPF suitable for sensitive skin.
  • Keep toothpaste off the surrounding skin; rinse and wipe corners of the mouth.
  • Change pillowcases/towels often; hands off the rash.
  • If using steroids on the face, seek clinician guidance before stopping.

Don’t

  • Don’t use thick occlusive balms/ointments on the rash area.
  • Don’t use fragrance, essential oils, scrubs, or harsh acids/retinoids while flaring.
  • Don’t layer multiple actives or test many products at once.
  • Don’t cover heavily with occlusive makeup; choose breathable, minimal options.
  • Don’t self-treat long-term with facial steroids without medical advice.

What is Perioral Dermatitis? — An Overview

Perioral dermatitis (also called periorificial dermatitis) is an inflammatory skin condition characterised by clusters of small, red or skin-coloured bumps and scaling around the mouth, sometimes affecting the nose and eyes. It can sting or burn, and is distinct from acne or eczema. Diagnosis is clinical; management focuses on trigger control and gentle care.

Given the number of potential triggers, protective habits and a simplified routine can help reduce the likelihood of flare-ups or support recovery.

Read about Bragan Skincare’s snail mucin products, including skin treatments, hair care, hand cream and beauty products: https://braganskincare.com/snail-mucin-in-skincare/

Who does Perioral Dermatitis affect?

PD can affect anyone—men, women, and children. It’s reported most often in women aged 16–45, with cases peaking in the 20s–30s. Hormonal changes (pregnancy, contraceptives, menstruation) and higher exposure to cosmetics/complex routines may contribute. Strong cleansers and harsh actives can disrupt the skin microbiome and barrier, increasing sensitivity. A gentle cleansing routine is a practical prevention step.

Our snail mucin range suits people aiming to protect—or repair—their skin barrier:
https://braganskincare.com/snail-range/cleanser-for-sensitive-skin/

Men can also experience PD, though some may be less likely to seek care. Symptoms are similar: red, flaky, itchy skin around the mouth.

In children, girls are affected more often than boys. Pacifiers and drooling can maintain constant moisture around the mouth, triggering irritation. Infants may be more prone to granulomatous PD, where bumps can appear orange rather than red.

Read more about PD in infants: https://braganskincare.com/infant-perioral-dermatitis/

Where it appears on the face

Perioral Dermatitis treatment

Because PD is often mistaken for acne or eczema, some well-intended remedies can worsen it (e.g., heavy occlusives). A simple, low-irritation routine usually helps.

General practitioners or dermatologists may recommend:

  • Topical/oral antibiotics: for example, metronidazole cream or gel (topical antibiotic), as advised by a clinician.
  • Azelaic acid: often suitable for sensitive or barrier-impaired skin (cream/gel/serum).
  • Sulfur-based creams or face washes: can reduce bacteria and visible inflammation while being gentle.

Over-the-counter options include gentle cleansers and bland, fragrance-free moisturisers. Finding the right routine can take time; many people improve within 4–12 weeks.

Gentle, fragrance-free routines and simplified skincare are a common way to manage perioral dermatitis and reduce flare-ups.

Prescription and over-the-counter options can help some people. A gentle, low-irritation routine aims to support the skin barrier over time. Always speak with a healthcare professional to choose what’s appropriate for you. Bragan Skincare’s snail mucin Atopic Cream is “specially crafted to soothe redness, calm irritation and restore balance to sensitive skin.”

Read more about our Atopic Cream and why it’s a dermatology-informed, gentle option for those managing perioral dermatitis:
https://braganskincare.com/perioral-dermatitis-cream/

When to see a clinician

  • Symptoms persist beyond 8–12 weeks despite routine changes.
  • Eye involvement (pain, swelling, vision changes).
  • Severe burning, rapid spread, or recurrent flare-ups.
  • You’re using (or stopping) facial steroids—seek guidance.

Perioral Dermatitis in pregnancy

Pregnancy can increase skin sensitivity and the likelihood of flare-ups due to hormonal shifts, stress, and routine changes.

  • Hormonal changes: fluctuating oestrogen may increase oil production and reactivity, prolonging flare-ups.
  • Stress: lifestyle changes can raise cortisol; stress may slow recovery.
  • Immune/skin microbiome: changes can increase sensitivity to everyday products.
  • Topical steroid withdrawal: stopping facial steroids abruptly can worsen symptoms; seek medical guidance.
  • Change in skincare routine: switching products can temporarily unsettle the barrier.

Our Atopic Cream is formulated to soothe redness and support the skin barrier. If you’re pregnant or breastfeeding, check ingredients with your clinician first. Read more or purchase:
https://braganskincare.com/snail-range/atopic-cream-50ml/

Perioral Dermatitis in darker skin

Skin conditions can look different across skin tones. Limited representation in dermatology images can contribute to under- or misdiagnosis for people of colour.

PD can present differently on darker skin due to melanin levels and post-inflammatory changes. Redness may be less visible; brown, purple, or grey hyperpigmentation can linger after flare-ups. Gentle routines and sun protection help reduce PIH risk.
More: https://braganskincare.com/perioral-dermatitis-on-dark-skin/

People with darker skin often benefit from simple, fragrance-free routines that minimise irritation. Read about our natural remedies for dermatitis on the face:
https://braganskincare.com/natural-remedies-for-dermatitis-on-the-face/

Conclusion

Perioral dermatitis is common and often misunderstood. It can affect anyone, and its appearance on darker skin may differ. Effective care usually starts with trigger control and a gentle, simplified routine; medical treatments can help when needed. Bragan Skincare’s snail mucin products—particularly our Atopic Cream—are formulated to soothe visible redness and support the skin barrier with low-irritation care.

FAQ — Perioral Dermatitis

How long does perioral dermatitis take to clear?
It varies. Many people improve within 4–12 weeks once triggers are removed and a gentle routine is followed. Some need prescription treatment. Always speak with a healthcare professional for personalised advice.

Should I stop topical steroids suddenly?
Don’t stop facial steroids without guidance. Withdrawal can temporarily worsen redness and burning. A clinician can advise whether to taper and what to use instead.

Can fluoride toothpaste trigger perioral dermatitis?
For some, yes. Switching to a non-fluoride or low-foaming toothpaste and avoiding contact with the lip skin can help. Keep toothpaste off the surrounding skin and rinse thoroughly.

What gentle skincare routine helps perioral dermatitis?
Keep it simple: a mild, fragrance-free cleanser; a light, non-occlusive moisturiser; and daily SPF suitable for sensitive skin. Avoid heavy occlusives and strong actives. Patch-test anything new.

Is pimecrolimus (Elidel) available over the counter?
No. Pimecrolimus (Elidel) is prescription-only. Over-the-counter options include gentle cleansers, bland moisturisers, and some zinc/sulfur washes. Ask a pharmacist or clinician for guidance.

How does perioral dermatitis present on darker skin tones?
Redness may be less obvious. Brown, purple, or grey patches (post-inflammatory hyperpigmentation) can linger after flare-ups. Use a gentle routine to reduce irritation and PIH risk; sun protection helps.

Is perioral dermatitis contagious?
No. It’s an inflammatory skin condition, not an infection, and cannot be passed from person to person.

About This Article
Author: Kieran Corley — Founder, Bragan Skincare
Bio: Kieran leads Bragan Skincare in County Monaghan, focusing on gentle, fragrance-free routines powered by snail mucin. He writes clear, evidence-informed guides to help people manage sensitive and dermatitis-prone skin.
Last reviewed: 23 September 2025

Extra Reading

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