Periorbital dermatitis

Your Complete guide to Treating Perioral Dermatitis

Perioral means “around the mouth”.
Periocular means “around the eyes”, and dermatitis means “skin inflammation.

Are you struggling with a persistent red rash around your mouth?

Is your skin excessively dry, flaky, and itchy?

Then, chances are you’re dealing with perioral dermatitis.

This condition is often confused with eczema or seborrheic dermatitis.

Here at NC, we’ve dedicated years to researching and helping people heal from PD.

We’re here to help you understand the condition and its features; we even wrote an ebook about it.

So join us as we look at how to decode and overcome your peculiar rash.

Understanding perioral dermatitis

Perioral dermatitis is a recurrent inflammatory condition with various facets:

Perioral Dermatitis on the Face: If you’ve noticed a rash encircling your mouth or nestled within the folds of your nose, perioral dermatitis might be the culprit.

This manifestation is associated with dry, flaky skin and appears as clusters of tiny 1-2 mm papules or pustules hugging your lips, mouth, or nose creases.

Granulomatous Periorificial Dermatitis: Yellow pimples may signal a granulose infection, possibly linked to invasive treatments like microneedling.

Periorbital Dermatitis Around the Eyes: Redness at the corners of your eyes may indicate you have PD of the eyes, which can extend to your eyelids.

Periorificial Dermatitis: This condition relates to irritation and rashes affecting your chest or groin area.

Additional telltale signs include skin irritation and a burning sensation.

If you can relate to these symptoms, Chloe’s journey with periorbital dermatitis may provide valuable insights.

Unraveling the origins of PD

The precise trigger of perioral dermatitis remains shrouded in mystery, and there are several theories:

  1. Follicular Fusiform Bacteria: Some studies (1) suggest that rod-shaped bacteria nestled within skin lesions may incite perioral dermatitis. Notably, the symptoms appeared to reduce when participants resorted to antibiotics.
  2. Parasites: These are potential culprits. Elevated Demodex follicular mites were present in the skin of perioral dermatitis sufferers. Interestingly, even those treated with topical steroids exhibited mites on their skin. Another study (2) found substantial symptom relief among participants who applied an anti-parasite cream to afflicted skin.
  3. Barrier Dysfunction: An impaired protective barrier or a disrupted skin microflora, responsible for maintaining the delicate acid mantle, may contribute to PD.

When treating this condition, it is important to recognise that the underlying cause is very individualistic and differs from person to person.

Possible triggers for perioral dermatitis

Perioral dermatitis is a complex condition with various potential triggers, including:

  1. Excessive stress
  2. Immune dysregulation
  3. Harsh skincare ingredients
  4. Excessive caffeine consumption
  5. Poor dietary choices culminating in skin inflammation
  6. Prolonged use of nasal steroids, oral steroids, or steroid inhalers
  7. Utilising fluorinated toothpaste or mouthwash
  8. Pregnancy, oral contraceptives, and hormonal fluctuations
  9. Concealed food sensitivities, particularly to sugar and gluten
  10. Gut dysbiosis, resulting in a bacterial and fungal imbalance
  11. Usage of occlusive skin creams, petroleum jelly, or paraffin-based products
  12. Laundry detergent, potentially serving as a trigger; consider switching to a hypoallergenic alternative
  13. Application of steroids or anti-inflammatory medications: Approximately 9% of long-term steroid cream users develop PD
  14. Certain spices and salty foods may cause skin reactions. For example, one study observed the development of perioral dermatitis after consuming bay leaves, marjoram, and cinnamon, with significant improvements upon discontinuation.

We are often asked if perioral dermatitis is contagious. Please take it from us: you did not catch PD from someone else; it is not infectious.

Treatment options available

Navigating the challenges of perioral dermatitis may seem daunting, given the various triggers and factors discussed above, but by taking a proactive approach, you can get your condition under control.

Conventional medical treatment

  1. Topical Antibiotics: Dermatologists often prescribe antibiotics like erythromycin, sodium sulfacetamide, or doxycycline for short-term relief. However, it’s essential to complement these antibiotics with natural approaches and lifestyle adjustments to prevent relapses upon discontinuation.
  2. Steroids: Corticosteroids are commonly used to manage symptoms, but overuse can have negative consequences. Misuse of topical corticosteroids has been linked to perioral dermatitis. Gradually tapering off steroid use is advisable, especially if stopping suddenly results in a severe flare-up.
  3. Antifungal Agents: In some instances, dermatologists may recommend antifungal creams and immunomodulators like pimecrolimus to address this condition.

Natural treatment

When dealing with perioral dermatitis, you can take a holistic approach that doesn’t necessarily start with a dermatologist.

  1. Stop Steroid Use: The first step is discontinuing steroids, which is crucial for recovery.
  2. Switch to Natural Skincare Products: Transition to natural skincare products to avoid potentially aggravating your skin condition.
  3. Fluoride-Free Toothpaste: Opt for fluoride-free toothpaste to prevent triggering perioral dermatitis.

For a more detailed natural treatment plan, our comprehensive guide on perioral dermatitis treatments provides a holistic protocol to help you address this condition from both inside and out.

Why can’t I get a correct diagnosis?

You’re not alone if you struggle to comprehend what’s happening with your skin. Perioral dermatitis is often misdiagnosed or left undiagnosed, leading to confusion and frustration.

In our clinic, many clients initially mistake PD for other skin conditions, such as acne. Identifying the actual cause of your skin condition can be challenging and often requires a trained eye.

To assist you in obtaining a more accurate diagnosis, we’ve compiled the following comparisons:

  1. Acne: PD typically causes inflamed bumps without pus. Acne breakouts, however, often contain pus or fluid and are rarely accompanied by itching.
  2. Seborrheic Dermatitis: This condition can affect similar facial areas. It is caused by Malassezia yeast and may result in oily skin in some regions. Due to the close relationship between these conditions, a precise diagnosis from a dermatologist is important.
  3. Steroid Rosacea: This condition is induced by steroid use; it manifests as extensive facial papules, pustules, or broken capillaries, especially around the nose area.
  4. Rosacea-like Dermatoses: If you are experiencing facial flushing, skin thickening (particularly around the nose), and acne-like symptoms, you could be dealing with rosacea. This condition typically occurs around the nose and cheeks rather than the mouth.
  5. Eczema: Both perioral dermatitis and eczema can cause a red, irritated rash. Eczema is characterised by thick, scaly patches and severe, painful bumps that may ooze liquid and crust over when scratched. Eczema can appear anywhere on the body, which is not typical of perioral dermatitis.
  6. Impetigo: This contagious skin infection is more common among young children and spreads quickly. If you have an oozing rash or sores around your mouth or nose, impetigo may be the culprit.

If you are confused about your condition, we strongly recommend scheduling an appointment with a dermatologist, who will perform a thorough consultation.

They will consider factors like the location and distribution of your skin condition to provide you with an accurate diagnosis.

To conclude. The naked truth

In summary, addressing perioral dermatitis is a multi-faceted journey that calls for a holistic approach.

This condition can manifest as a persistent red, flaky rash around your mouth, nose, or other facial areas, and its causes can vary among individuals.

The precise cause of perioral dermatitis remains unclear, but it is thought to involve multiple factors such as bacteria, parasites, and disruptions in skin barriers.

Triggers can include stress, caffeine, dietary choices, and steroid usage.

Perioral dermatitis is a warning system for your body, signalling underlying imbalances that need attention.

You have two main paths to tackle this issue: a medical approach involving antibiotics or steroids, which may offer temporary relief but could lead to flare-ups when discontinued.

Alternatively, a natural approach is recommended, considering factors like hormonal fluctuations, stress, product choices, and even fluoride toothpaste that can trigger recurrences.

Patience and a thorough understanding of your condition and its causes will empower you to make informed decisions for effective management and recovery.


  1. Density of Demodex folliculorum in Perioral Dermatitis
  2. Topical praziquantel as a new treatment for perioral dermatitis: results of a randomized vehicle-controlled pilot study

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