What is perioral dermatitis?
Perioral dermatitis (“clown eczema”) is a common skin condition around the mouth, with red, itchy spots a few millimetres across. The skin directly bordering the lip is often not affected. Sometimes the lesions cause a burning or stinging pain, and the skin often shows some scaling.
Who can get it?
People with an oily skin type in particular have a greater chance of developing perioral dermatitis, especially if cosmetics are regularly used on the facial skin. Women are affected more often than men. The typical small papules and pustules are located around the mouth and beside the eyes.
How does it develop?
The complaints can be triggered by applying cosmetics in the area around the mouth, such as day and night creams; blocking of the pores plays a role in this. There is a clear relationship between applying corticosteroid (“hormone”) creams to the face and the development of perioral dermatitis. When a doctor mistakes the signs for “ordinary” eczema and prescribes even stronger corticosteroid creams, the complaints can worsen further. Besides around the mouth, the lesions also occur on either side of the nose and around the eyes, so the term “perioral” (around the mouth) is not always correct. The condition has more features of acne and rosacea than of eczema.
How is it treated?
The use of cosmetic creams should be stopped. If corticosteroid creams are being used on the affected area, it is important to stop them; when fairly strong corticosteroid creams are being applied, it is wise not to stop abruptly but to wean the skin off by first using weaker corticosteroid creams. In many cases stopping the cosmetics or corticosteroid creams is enough to cure the perioral dermatitis. If it does not resolve, the doctor can prescribe a course of antibiotics (for example tetracycline). Topical antibiotics (in cream or gel form, such as metronidazole or clindamycin) have sometimes also proved effective.
How do I prevent perioral dermatitis?
- Do not use cosmetics that “seal” the skin; if needed, use a mild, soothing cream.
- Clean the skin well every day with water and a skin-friendly cleanser.
- Do not use strong corticosteroid creams on the face.
When to see a doctor
See a doctor if a red, bumpy, scaly rash around the mouth, nose or eyes persists or worsens, especially if it flares when you stop a facial cream, so the right treatment can be started.