Perioral Dermatitis Healing: Look for These Signs

Medically reviewed by Brendan Camp, MD

Perioral dermatitis is a red, scaly rash with bumps around the mouth that can extend up to the nose. There may be mild itching and burning. It can be caused by a topical steroid cream (hydrocortisone), inhaled corticosteroids, cosmetics, moisturizers, or fluoride toothpaste.

When related to topical steroid use, the perioral dermatitis rash may worsen when you stop using the cream before it gets better. This can be troublesome to those with the skin condition as it seems like it is not healing. This article will discuss the healing stages of perioral dermatitis, its causes, and treatments.

How to Tell If Perioral Dermatitis Is Healing

Perioral dermatitis can be triggered by long-term topical steroid use, both over-the-counter (OTC) and prescription. One of the first steps to treating it in these cases is to stop using topical steroids. However, this often causes a rebound effect, which is a worsening of symptoms when treatment is discontinued.

In rebound cases, there can be more redness, scaling, and bumps. Symptoms can worsen for a few days or weeks. After the worsening phase, symptoms should subside, and the skin will heal.

If your perioral dermatitis is related to topical steroid use, your healthcare provider may recommend reducing the strength of the cream or how often you use it rather than discontinuing it completely. This may help reduce or avoid a rebound flare.

If perioral dermatitis develops due to a different irritant (such as a cosmetic or moisturizer), it should begin to heal when the use of the irritant is stopped.

Signs of Worsening Perioral Dermatitis

Perioral dermatitis due to topical steroid use can be a difficult-to-treat skin condition. The possible rebound effect of worsening before getting better can lead people to believe that they are not making any gains.

Outside the rebound stage of perioral dermatitis, there are signs that the skin is not healing properly. This can be due to an infection or another skin condition occurring simultaneously with perioral dermatitis.

Any new signs of an infection, like swelling or discharge from sores, would indicate that there may be a bacterial infection that needs to be treated. Talk to a healthcare provider if you have these signs.

Ways to Get Rid of Perioral Dermatitis

To get rid of perioral dermatitis it's important to identify what is causing the rash and remove it. For many people, this is topical steroids, nasal steroids, heavy cream moisturizers, or fluoride toothpaste.

Once all topical steroids and other irritants have been stopped, those with mild perioral dermatitis may be treated with topical antibiotics like metronidazole and clindamycin. Healing generally takes three to eight weeks.

Those with moderate to severe perioral dermatitis not responsive to topical treatment may need oral antibiotics. Treatment may take four to eight weeks.

What Affects Perioral Dermatitis Healing?

Perioral dermatitis healing can be affected by not following a healthcare provider's treatment directions or having a concurrent additional skin condition.

Since perioral dermatitis can worsen when topical steroid cream is stopped, some people have difficulty seeing their face get worse and restart the steroid cream. This continues the cycle and hinders healing.

Triggers like heavy face moisturizers, makeup, face oils, and hormone changes can also affect healing.

Finding a Management Plan for Your Symptoms

The best management plan for perioral dermatitis symptoms should come from a healthcare provider. They will be able to customize a plan for your unique circumstances and symptoms. Parts of the plan can include prescription medications, and avoiding topical steroids and skin irritants.

Skin Care and Sun Protection

At-home self-care techniques to manage perioral dermatitis symptoms include:

• Gently wash your face with warm water and no soap.

• Do not scrub your face.

• Avoid using face creams and makeup.

• Use hats to cover your face when out in the sun.

• If you will be in the sun, use sunscreens for more sensitive skin, such as mineral sunscreen.

Summary

Perioral dermatitis is a skin condition that causes a rash around the mouth. Topical steroid cream use, toothpaste, heavy facial moisturizers, or other skin irritants can cause it. Treatment is focused on removing the trigger and, if necessary, treating it with an antibiotic.

Perioral dermatitis due to topical steroids can get worse when you discontinue the use of them before it gets better. Contact a healthcare provider for specific treatment guidance for fast healing.

Read the original article on Verywell Health.