There are many potential causes and triggers of perioral dermatitis, some of which are simply theories. These include: the application of topical steroid creams (which may initially calm the rash down, but ultimately results in a flare), fluoride in toothpastes, certain skin care products, UV light, hormonal factors (worsens during premenstrual phase), and bacteria.
The most common treatment of perioral dermatitis is antibiotics. Moderate to severe cases are typically treated with prescription oral antibiotics such as tetracycline, doxycycline or minocycline for a period of weeks to months. Topical prescription medications such as antibiotics (metronidazole gel, erythromycin gel), pimecrolimus cream, and others may also be used in combination with oral agents or as solo therapy for milder cases.
OTC Treatment Options
Vanicream Gentle Facial Cleanser for Sensitive Skin - AM & PM
Vanicream Lite Lotion for Sensitive Skin - AM & PM
The Ordinary Azelaic Acid Suspension 10%- PM
AM: Apply gentle skin cleanser generously to wet skin, lather, rinse, and pat dry with a towel. Follow with application of a moisturizer for sensitive skin, then sunscreen.
PM: Apply gentle skin cleanser generously to wet skin, lather, rinse, and pat dry with a towel. Follow with application of The Ordinary Azelaic Acid Suspension, then moisturizer for sensitive skin.
Over-the-counter treatments for perioral dermatitis are not well studied. Some skin experts endorse OTC acne medications such as benzoyl peroxide and adapalene to treat perioral dermatitis. Such medications can, however, cause significant skin irritation and therefore are generally not recommended. The most useful over-the-counter approach to perioral dermatitis is avoidance. Simplify the skin care regimen to a gentle hypoallergenic cleanser & moisturizer.
The most useful over-the-counter approach to perioral dermatitis is avoidance. Avoid hydrocortisone creams. Avoid excessive sun exposure. You may choose to temporarily avoid fluoridated toothpastes, tartar control agents and cinnamon flavored dental products. Consider changing toothpaste to non-fluorinated Tom’s of Maine toothpaste. Avoid use of excessive skin care products, including cosmetics. A hypoallergenic sunscreen such as Vanicream Broad Spectrum SPF 50 or Elta MD Physical may be helpful (more on sunscreens).
Perioral dermatitis can be a persistent & frustrating problem. Consultation with a physician is recommended if symptoms persist.