Perioral dermatitis (POD) is a common skin concern that can occur around the mouth, nose and eyes. Perioral dermatitis around the mouth is quite characteristic with dry, flaky red rash around the mouth often with tiny bumps which many might consider to be dry skin or winter dry skin.

Perioral dermatitis symptoms

As the name implies, a red rash that circles around your mouth is the classic symptom of POD. The skin may be dry, flaky, often with swollen lumps, called papules, which do not extend to the lips. Perioral dermatitis may also occur around the cheeks, nose, and eyes, often accompanied by burning or itchy sensation. POD is different from eczema, rosacea, acne and dry skin, although there may be an overlap of symptoms.

Causes of perioral dermatitis

POD occurs in all sexes, ethnicities, and ages but it is more common in women between the ages of 16 and 45

Whilst the exact cause of POD remains unknown, there are several possible causes which may be involved, and these include:

• Use of steroidal creams and nasal spray which may break down the top layer of skin.
• Use of heavy skin moisturisers or cosmetic products that stop skin from breathing.
• Fluoride and Sodium Lauryl Sulphate may be triggers of POD.
• Hormonal changes as POD clearly affects more women than men.
• Breakdown in the skin barrier function and dehydration of skin
• The presence of demodex mites, bacteria, and fungi on skin.
• These are most likely causes of POD however stress and anxiety may also cause inflammation leading to the symptoms of POD.

Perioral dermatitis treatment

The treatment of POD may involve using over-the-counter products, steroid creams or antibiotics available on prescription if mites or bacteria are thought to be the cause.

Whilst steroid creams can suppress inflammation and provide initial improvement, the rash will flare up after you stop using the steroid cream and the symptoms may be worse because steroid creams are known to thin skin. It is for this reason that I prefer a different approach.

The successful outcome of perioral dermatitis treatment involves a minimal treatment approach. Consider stopping all topical steroids and steroid inhalers and speak to your GP about changing to a different type of medication.

Stop using all skincare products, makeup and sunscreens. Often skincare products can be pore clogging or occlusive with a variety of ingredients that may be irritating. Stop using toothpastes with fluoride and consider changing to Green People’s Peppermint and Aloe Vera Toothpaste until the rash clears.

There are a few skincare products that are not occlusive and certainly do not clog pores. I suggest keeping skincare very simple and would recommend using:

DoSe Daily Cleanser – this rinse-off facial cleanser is fragrance-free and cleans skin without stripping it, which can cause dehydration and dry skin. Additionally, this mild daily cleanser is pH balanced which means it does not breakdown the skin's barrier nor affect its function.

Dose Daily Moisturiser – this is a lightweight fragrance-free face moisturiser suitable for use both in the morning and evening. It does not clog pores, allows skin to breathe, and contains two types of hyaluronic acid compounds for surface and dermal hydration.

DoSe Azelaic Acid 10% Serum - azelaic acid is often prescribed by dermatologists for perioral dermatitis. Azelaic acid has been the subject of numerous studies for a variety of inflammatory skin concerns¹. It is a skin-friendly chemical exfoliant that fights inflammation and reduces redness. In addition, it displays powerful antibacterial properties helping to reduce the numbers of mites and fungi should they be responsible for POD. Use Azelaic Acid Serum in your evening regimen after cleansing and let skin breathe overnight.

How long before my perioral dermatitis symptoms clear?

The symptoms of perioral dermatitis may linger for weeks or months, so it is important to be patient even with the right treatment.

Can perioral dermatitis recur?

Perioral dermatitis can return after treatment so continue with the treatment for a few months to prevent it from recurring. If your skin does not improve then it would be prudent to see a dermatologist.

REFERENCES

1. T. Jansen, Azelaic acid as a new treatment for perioral dermatitis: results from an open study, British Journal of Dermatology, Volume 151, Issue 4, 1 October 2004, Pages 933–934, https://doi.org/10.1111/j.1365-2133.2004.06202.x