Perioral dermatitis causes small red bumps around the mouth, nose, and sometimes eyes. It’s common, especially in women, and often triggered by topical steroids or heavy face products.
What it looks like
- Clusters of tiny red or skin-colored bumps with mild flaking.
- A narrow strip of normal skin often borders the lips.
- Can burn or feel tight; less itchy than eczema.
Common triggers
- Topical steroids on the face (even low-strength hydrocortisone).
- Fluorinated toothpaste, heavy or occlusive moisturizers, makeup primers, sunscreens with heavy silicones, facial oils.
- Inhaled steroid sprays that contact skin; masks/occlusion.
First steps at home
- “Zero therapy” for 2–4 weeks:
- Stop face steroids; if used daily, taper off to avoid rebound (your clinician can guide).
- Simplify skincare: gentle cleanser, light non-comedogenic moisturizer, mineral sunscreen (zinc/titanium) if needed.
- Avoid heavy creams/oils, thick occlusives, and harsh actives (AHAs/BHAs/retinoids) during healing.
- Switch to SLS-free, mild toothpaste; avoid spicy/cinnamon flavors that can irritate.
Effective medical treatments
- Topicals: metronidazole, azelaic acid, ivermectin, erythromycin, or pimecrolimus/tacrolimus in some cases.
- Oral antibiotics for moderate/severe or widespread cases: doxycycline or minocycline for 6–8 weeks (anti-inflammatory dosing), or azithromycin/erythromycin if tetracyclines aren’t suitable.
- Expect improvement in 2–4 weeks; full clearance can take 6–8+ weeks.
Prevention and maintenance
- Avoid routine steroid use on the face unless specifically prescribed; if needed, use the weakest for the shortest time and avoid perioral area.
- Choose lightweight, non-occlusive skincare and mineral sunscreens.
- Reintroduce actives slowly once clear.
When to see a clinician
- If worsening or not improving after 2–4 weeks of gentle care.
- If the area around the eyes (periorbital dermatitis) is involved.
- If severe burning, pain, or significant redness develops.