Perioral dermatitis Information | Mount Sinai

Periorificial dermatitis

Perioral dermatitis is a skin disorder resembling acne or rosacea. In most cases, it involves tiny red pumps that form on the lower half of the face in the folds of the nose and around the mouth.

Perioral dermatitis is most common in young to middle age women. Frequently, no specific cause is found. However, there appears to be an association with fluorinated steroids. In children, dermatitis around the mouth may be associated with irritation from specific foods or other materials carried to the face on the hands.

Causes

The exact cause of perioral dermatitis is unknown. It may occur after using face creams containing steroids for another condition.

Young women are most likely to get this condition. This condition is also common in children.

Periorificial dermatitis may be brought on by:

• Topical steroids, either when they are applied to the face on purpose or by accident
• Nasal steroids, steroid inhalers, and oral steroids
• Cosmetic creams, make-ups and sunscreens
• Fluorinated toothpaste
• Failing to wash the face
• Hormonal changes or oral contraceptives

Symptoms

Symptoms may include:

• Burning feeling around the mouth. The creases between the nose and mouth are most affected.
• Bumps around the mouth that may be filled with fluid or pus.
• A similar rash may appear around the eyes, nose, or forehead.

The rash may be mistaken for acne.

Exams and Tests

Your health care provider will examine your skin to diagnose the condition. You may need to have other tests to find out if it is due to a bacterial infection.

Treatment

Self-care you may want to try include:

• Stop using all face creams, cosmetics, and sunscreen.
• Wash your face with warm water only.
• After the rash has cleared, ask your provider to recommend a non-soap bar or a liquid cleanser.

DO NOT use any over-the-counter steroid creams to treat this condition. If you were taking steroid creams, your provider may tell you to stop the cream. They may also prescribe a less potent steroid cream and then slowly withdraw it.

Treatment may include medicines placed on the skin such as:

• Metronidazole
• Erythromycin
• Benzoyl peroxide
• Tacrolimus
• Clindamycin
• Pimecrolimus
• Sodium sulfacetamide with sulfur

You may need to take antibiotic pills if the condition is severe. Antibiotics used to treat this condition include tetracycline, doxycycline, minocycline, or erythromycin.

At times, treatment may be needed for up to 6 to 12 weeks.

Outlook (Prognosis)

Perioral dermatitis requires several months of treatment.

Bumps may return. However, the condition does not come back after treatment in most cases. The rash is more likely to return if you apply skin creams that contain steroids.

When to Contact a Medical Professional

Call your provider if you notice red bumps around your mouth that do not go away.

Prevention

Avoid using skin creams containing steroids on your face, unless directed by your provider.

Dinulos JGH. Acne, rosacea, and related disorders. In: Dinulos JGH, ed. Habif’s Clinical Dermatology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 7.

James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Acne. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews’ Diseases of the Skin: Clinical Dermatology. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 13.

Last reviewed on: 8/14/2021

Reviewed by: Elika Hoss, MD, Senior Associate Consultant, Mayo Clinic, Scottsdale, AZ. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Is It an Allergic Reaction?

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Bumps on your skin can have a variety of causes, from allergic reactions to acne. However, you can tell the differences between an allergic reaction and other bumps on your face by some defining characteristics.

An allergic reaction — mainly allergic contact dermatitis — may cause small bumps or rashes that are red, itchy, and usually localized to the area contacted by the allergen.

Learning the signs and symptoms of an allergic reaction is important to help determine the possible cause of tiny bumps on your face so that you can also seek the right treatment.

In some cases, you may need to see a dermatologist to help clear up more severe rashes.

Allergic contact dermatitis has a characteristic red rash that feels very itchy. You may suspect this type of allergic reaction if you’ve recently used a new facial soap, lotion, or cosmetic and you experience a rash soon after.

This type of allergic reaction may also occur as a result of contact with plant substances and jewelry.

However, if your face hasn’t come into contact with any unusual substances, the bumpy rash you’re experiencing may not be an allergic reaction at all.

It’s worth asking your dermatologist what could be causing the rash, though, as you can develop an allergy to a product you’ve used for a long time without problems.

Other possible causes of bumps on your face include:

• Acne. You may see comedones and sometimes inflammatory lesions, such as cysts and pustules, or they may appear as red bumps on the skin.
• Eczema. Also known as atopic dermatitis, eczema causes red rashes that are extremely itchy.
• Folliculitis. This is a term for infected hair follicles, which is often seen in people who shave.
• Hives. These are welts that may be caused by a medications or a recent illness. In many cases, the exact cause can’t be determined.
• Medication allergies. Some people have allergic reactions to a medication they take. In most cases, it’s an exanthematous drug reaction and may be harmless. In other cases, it can be very serious, such as a condition called drug reaction with eosinophilia and systemic symptoms (DRESS) or Stevens-Johnson syndrome.
• Milia. These are small cysts that develop as a result of keratin proteins getting trapped underneath the skin, and are harmless.
• Rosacea. This is a long-term, inflammatory skin condition that causes flushing skin and red bumps.

Allergic contact dermatitis on the face can cause a large, red rash. It may also contain small red bumps along with dry, crusty skin.

If you develop this type of allergic reaction, it’ll occur along the parts of your face that have come into contact with an irritating substance.

Allergic contact dermatitis appears as a red rash that can be itchy and uncomfortable. There may also be tiny bumps within the rash. It may resemble a burn on the skin, and severe cases can cause blisters.

As the skin heals, the rash may become dry and crusty. This is a result of dead skin cells shedding from the epidermis.

Symptoms of allergic contact dermatitis may be similar in babies and young children. You may see a red rash that’s extremely dry, cracked, and swollen. Your baby might be fussy due to pain, burning, and itchiness.

Allergic contact dermatitis is caused by your skin coming into contact with a substance to which you have a sensitivity or allergy.

Oftentimes, you may not know you have a sensitivity to the offending substance ahead of time — the resulting rash is a sign that it ought to be avoided again in the future.

Irritant vs. allergic

Contact dermatitis may be further classified as either irritant or allergic.

Irritant contact dermatitis develops from exposure to irritants such as bleach, rubbing alcohol, water, and detergents. Other irritants include pesticides, fertilizers, and dust from fabrics.

Reactions from severe irritants occur almost immediately after skin contact, while prolonged mild exposure, such as repeated hand washing, may not display a significant irritant contact dermatitis for days.

On the other hand, allergic contact dermatitis is caused by an immune response your body produces when your skin comes into contact with a certain substance.

Dyes, fragrances, and plant substances are possible sources of allergic contact dermatitis. Other possible causes for this reaction on your face include nickel, formaldehyde, and Balsam of Peru.

Unlike irritant contact dermatitis, allergic contact dermatitis can take 1 to 3 days to develop. This can also make it more challenging to identify allergens that are causing your rashes.

Babies and young children may also be prone to allergic contact dermatitis on the face. Some common causes are fragrances, sunscreens, and certain chemicals in baby wipes.

Treatment for contact dermatitis is largely preventive.

If you develop a rash on your face after using certain skin care products, cosmetics, or other substances, you should stop using them immediately. The same applies to baby wipes and other children’s care products for young children.

If you do start to develop a skin rash from an allergic reaction, gently wash your skin with gentle soap and cool to lukewarm water. Treatment focuses on identifying the substance and avoiding it.

Some rashes may result in oozing and crusting. You can help protect your skin by applying wet dressings to the area. Petroleum jelly (Vaseline) or a mixture of petroleum jelly and mineral oil (Aquaphor) may also help soothe the skin and protect your face from cracking.

However, using any ointment on the face has the potential to cause acne, so apply these products with caution if you’re prone to acne. You may want to consider using a hypoallergenic product like Vanicream, which doesn’t have some of the substances that can cause allergic contact dermatitis.

Shop for Vaseline, Aquaphor, and Vanicream online.

Topical corticosteroids may reduce redness and inflammation. Such ointments and creams may also help with itchiness. However, corticosteroids should only be used on the face for a short-term basis only, usually less than 2 weeks, and shouldn’t be used around the eyes.

The best form of treatment for a child’s allergic contact dermatitis is first identifying what’s causing the reaction. Sometimes it can be difficult to do this. In those cases, it’s important to take a minimalist approach to skin care.

To do so, avoid using body washes and laundry detergents with fragrances, and switch to baby wipes for sensitive skin, such as Water Wipes. Be sure to moisturize often with a hypoallergenic cream. If the rash persists, make an appointment with a dermatologist.

Shop for Water Wipes online.

New cases of contact dermatitis — be it allergic or irritant — may be aided by the advice of a dermatologist. They can also rule out other possible causes of a skin rash on your face.

As a rule of thumb, you should see a dermatologist if you suspect irritant or allergic contact dermatitis on your face and it fails to resolve within 3 weeks.

If allergic contact dermatitis is to blame, you might undergoing allergy testing, especially if you have recurring cases of dermatitis without an obvious cause. This is done via patch testing.

You should also see a doctor if your skin starts showing signs of infection. This can cause increased inflammation as well as pus from the rashes. An infection may also cause a fever.

If you don’t already have a dermatologist, you can browse doctors in your area through the Healthline FindCare tool.

Any new rash on the face can be a cause for concern. While allergic and irritant contact dermatitis can be uncomfortable, they’re not considered serious or life threatening.

The key is to prevent recurring cases of contact dermatitis rashes on your face. Stop using any products that could have contributed to the rash, and see your doctor if your symptoms don’t clear up after a few weeks.

symptoms, causes and home treatments

What are pimples (acne, pimples)? Why acne appears, how dangerous they are, and how to get rid of them. Mild, moderate and severe acne. Treatment at home.

Pimples on the face – what it is and why it appears

Pimples are minor skin blemishes that appear in most people and usually go away on their own. Most often, teenagers complain about acne during puberty, but they can appear for various reasons in both young children and adults.

The affected area is most often the face, but can be any area of ​​the skin except the soles of the feet and palms.

The cause of acne is not always, but most often associated with clogging of the hair (follicular) channel with sweat and dead skin cells. As a result, an environment is created on the skin for the development of fungal or bacterial organisms.

In a mild form, without inflammation, pimples do not pose a threat and go away on their own, with good hygiene.

There are several varieties of acne, differing in appearance and severity of complications.

Non-inflammatory pimples – comedones

• Black pimples (in English “black heads”) – open comedones. They have a small size of non-inflamed pores. The dark color – from yellowish to black – is formed due to the oxidation of the contents of the pore with oxygen.
• White small pimples (in English “white heads”) – closed comedones. The sebum is clogged and has no free exit. It looks like a small white subcutaneous tubercle (milium). Most often they develop into a classic red pimple – a papule.

Comedones are formed when the mouths of the hair follicles are blocked. The content of the duct contributes to the development of opportunistic flora for which it is a nutrient medium. If you do not follow the rules of hygiene, acne progresses to the inflammatory stage.

Inflammatory pimples and subcutaneous formations

• Papule – red pimple. It is an inflamed comedone. Has no obvious purulent content.
• Pustules – purulent pimple with a white head over irritated skin. Occurs when inflammation is mixed with a bacterial or fungal infection.
• Nodules (or nodules) – hard subcutaneous lumps of flesh or red color. Darken with complication.
• Cysts are the most advanced form and may require surgery to treat. A soft seal (which is different from hard knots) in the skin filled with purulent contents. The skin at the site of the cyst may be white or red.

The medical name for pimples is acne or “acne”.

Comedones are mild acne. Papules and pustules – to a disease of moderate severity. Nodules and cysts are a serious skin disease.

Acne and inflammation can be caused by both bacterial infections (Propionibacterium acnes, Streptococci and Staphylococci) and fungal infections. Much less often, a tick or parasite can be the cause.

The main causes of acne

The appearance of acne is closely related to the excessive production of sweat by the sweat glands and the presence of dead skin cells.

Causes of excessive sweating:

1. – Rest or work in uncomfortable (poorly ventilated) clothing.
2. – Hormonal surges in the body (age or emotional).
3. – Environmental conditions (high temperature, dryness).
4. – Unbalanced diet (high carbohydrate, fatty food).
5. – Specific diseases and medicines.

In case of excessive sweating, the removal of dead skin cells is difficult, which contributes to clogging of hair pores and creating conditions for the appearance of acne.

In addition, the use of cosmetics, thick ointments and greasy creams can also contribute to the appearance of acne on the skin of the face: forehead, cheeks, neck, chin.

In addition to the reasons described, the appearance of acne can be caused by some other circumstances. For example, an allergic reaction.

In order to determine the cause of acne for sure, the doctor takes an anamnesis, that is, collects all the information about the situation, time and conditions under which acne appeared.

How to quickly get rid of pimples

Getting rid of pimples by squeezing is the wrong step. When extruded, an open wound is formed. Even if the infection is treated in a timely manner, wound healing will not happen soon.

Not to mention the severe form of acne on the face, which is not recommended to be treated at home. Among other things, picking and “opening” pimples can lead to scarring and scars for the rest of your life.

Why you shouldn’t pop pimples yet – because of the bacteria that can be found under the skin and become an additional problem.

Instead of squeezing pimples, the following advice may help get rid of pimples:

• Wash problem area with mild cleanser;
• Dry skin with a clean towel;
• Apply a spot treatment to help dry out the pimple.

What are the best remedies to use to fight acne?

Dermatological preparations and acne ointments usually contain one of the substances:

Acne treatment takes from several days to several weeks. The course can be adjusted in case of deterioration of the situation or lack of positive dynamics.

How to get rid of acne and prevent it from reappearing

It is rare to get rid of acne quickly. It is much easier to prevent its occurrence by adhering to simple rules.

The following tips can help fight acne:

• Create a comfortable microclimate around.
• Switch to a balanced diet.
• Avoid mental and physical overload.
• Practice regular walks.
• Wear comfortable clothing.
• Avoid aggressive environmental influences (including the sun).
• Maintain good hygiene by washing your hands and face with mild cleansers at least morning and evening.

Pimples on the face [acne] – causes of rashes on the skin

Pimples are inflammatory formations on the skin caused by excessive production of sebum (sebum), which leads to clogged pores and multiplication of bacteria. Acne occurs mainly in areas of accumulation of sebaceous glands: the T-zone of the face, shoulders, chest, upper back. Let’s find out why acne appears on the face, and how to care for skin that is prone to imperfections.

The main causes of acne on the face

Only a specialized specialist (dermatologist) can determine the exact cause of acne on the face after collecting an anamnesis, tests and other data. Acne can be related to hereditary predisposition, hormonal problems and even stress factors. Consider the main causes of acne on the face in adolescents and adults.

Stress

Increased production of stress hormones increases sebum production and causes breakouts. If the skin is prone to imperfections, then severe stress and chronic fatigue will aggravate the situation. It cannot be said that nervous overload causes acne, but it can be argued that they exacerbate it.

Improper nutrition

If acne is not caused by hormonal and genetic factors, then the cause of acne on the face may be a lack of important macro- and micronutrients. In particular, protein, healthy fats, zinc, vitamins A and E, as well as group B. The predominance of sugar and trans fats in the diet can also cause rashes on the face.

Hormonal imbalance

The appearance of acne in adolescents is associated with a transitional period during which the level of androgens in the blood rises. The sebaceous glands are sensitive to sex hormones, which is the main cause of acne on the face during puberty.

In adulthood, an imbalance of sex hormones can also lead to rashes. For example, at the end of the monthly cycle in women, the skin produces more sebum, causing acne and blackheads.

Hyperkeratosis

Insufficient exfoliation of the skin can also cause purulent and other pimples on the face. Dead skin particles clog pores, preventing sebum from escaping. As a result, acne, closed and open comedones and pustular rashes occur.

Improper skin care

Many girls wonder what causes acne on their face, not even suspecting that their favorite cosmetics may be involved in this. Some cosmetic and skin care formulas contain comedogenic ingredients that lead to blockage of the sebaceous glands. Insufficient cleansing, lack of exfoliation, incomplete make-up removal – all this negatively affects the skin condition of girls. At the same time, excessive cleansing, too frequent peeling and mechanical scrubbing of the skin also thins the protective barrier, provoking compensatory activity of the sebaceous glands.

Genetic predisposition

The sensitivity of sebaceous gland receptors to sex hormones is an innate property and the main cause of acne on the face. Skin type is not necessarily inherited, but if one of the parents had acne, then the likelihood of its occurrence in the child increases.

What else causes acne? Risk factors are considered autoimmune, endocrine and gastrointestinal diseases. Also, the influence of lifestyle should not be excluded. For example, a lack of activity leads to oxygen starvation of tissues, slowing down blood circulation, and as a result, skin problems.

Types of acne on the face

Having determined what causes acne on the face, we proceed to the analysis of their types. The type of rash directly affects the strategy of treatment and care. So, what are and what do acne on the face mean?

• Open and closed comedones are non-inflammatory formations that are hair follicles clogged with sebaceous secretion. In the case of open comedones, the sebum oxidizes under the influence of air, turning into black dots. Closed comedones look like non-inflamed bumps on the skin. With the development of infection, comedones turn into inflamed and even painful acne on the face.
• Papules – inflammatory lesions with severe swelling and redness of the tissues. In this case, a seal appears under the skin, but there may be no purulent contents. In place of papules, traces of post-acne often appear, especially in the case of deep inflammation of the tissues.
• Pustules – purulent, inflamed pimples with white contents. They can “come out” on their own, and their opening often provokes an inflammatory process, as a result of which blue and red stagnant spots can also remain.
• Nodules – subcutaneous pimples on the face, caused by an inflammatory process in the deep layers of the skin. Such formations are often painful and cause discomfort. The cause of painful acne on the face is acne, provoked by various factors.

Regardless of where pimples appear from, they require timely treatment and preventive measures. Proper skin care can help prevent and reduce facial breakouts.

Care for problem areas with acne

Many people are interested in the causes of rashes on the face by zones and the corresponding treatment. Let’s take a look at why breakouts appear on the forehead and lower face, what to do if you notice blackheads on your nose, and how to deal with blackheads all over your face.

• Nose – there are also many sebaceous glands here, and therefore black dots and closed comedones appear on the bridge of the nose and on the nose. Treatment is the same as in the previous paragraph – proper care with the use of seboregulatory and anti-inflammatory drugs.
• Chin – the chin area is included in the T-zone, along with the nose and forehead. Comedones, papules and pustules are not uncommon here, especially with hormonal problems. If acne appeared at the bottom of the oval of the face, then it is recommended to visit an endocrinologist.
• Whiskey – the appearance of a rash on the temples is also associated with a violation of the gastrointestinal tract and the excretory system of the body. You should make an appointment with specialized doctors and choose a restraining and corrective cosmetic care.
• Lower jaw – on the U-zone rashes appear due to systemic disorders in the body, as well as diagnosed with acne. For treatment, first of all, you need to visit a dermatologist, who will refer you to other specialists if necessary.
• Cheeks – disruption of the endocrine and digestive systems are the main causes of acne on the cheeks. But other risk factors cannot be ruled out, especially if there are not too many rashes.
• Forehead – in this area there is an accumulation of sebaceous glands, and therefore the spread of acne often starts from here. In addition, acne on the forehead is a symptom of problems with the gastrointestinal tract and indicates malnutrition. To get rid of rashes in this area will help stabilize the diet and corrective skin care.

Read more about acne on the forehead in the article https://www.vichyconsult.ru/vmag/pryshchi-na-lbu-prichiny-vozniknoveniya-i-metody-korrekcii

We have analyzed the main areas of acne on the face, and also identified guidelines for care. If the whole face is covered with acne, it is recommended to consult a dermatologist, since in this case complex measures are necessary.

Vichy’s Top 3 Skin Care Products

French pharmacy cosmetics brand Vichy launches a successful line of products to combat imperfections. Introducing the best products of the range, which are ideal for step-by-step care for problem skin.

Normaderm Phytosolution Cleansing Gel

Cleansing gel with minerals and probiotics reduces skin oiliness, regulates sebum production and restores the protective functions of the skin.

Ingredients:

• Salicylic acid – has an antibacterial effect, gently exfoliates;
• Probiotic Bifidus – restores the hydrolipid mantle of the skin;
• Oligoelements – prevent inflammation;
• Vichy thermal water – strengthens and normalizes Ph.

Result: matte and deeply cleansed skin without feeling tight, imperfections are reduced.

Normaderm Face Cream

Corrective cream for problematic skin that promotes regeneration and reduces inflammation and post-acne marks.

Ingredients:

• Salicylic acid complex 1.5% and LHA – anti-inflammatory, antibacterial and exfoliating;
• PhE-Resorcinol – enhances skin regeneration at the cellular level and helps to reduce traces of imperfections;
• AirLicium – regulates sebum production and reduces shine.

Result: hydrated and rejuvenated skin without signs of imperfections or oily sheen.

Normaderm Phytosolution Facial Fluid

Anti-blemish corrector with anti-inflammatory, sebum-regulating and mattifying effect.

Ingredients:

• Salicylic acid 2% – prevents inflammation, promotes skin renewal; ● Hyaluronic acid – retains moisture in the skin cells, regulating hydrobalance;
• Probiotic Bifidus – supports immunity and protective properties of the skin;
• Vichy Thermal Water – strengthens and protects against harmful environmental factors.

Result: hydrated, smooth skin with an even relief and tone without pronounced imperfections and traces of them.

Prevention of acne

Before moving on to preventive measures, it should be noted that a lot of acne does not always indicate acne – a skin disease. If you have seen a photo of acne on your face, you can distinguish acne from periodic rashes. Acne is treated under the supervision of dermatologists, and rashes can be dealt with on their own, including with the help of preventive measures.

1. Proper care will help prevent pimples and blackheads. This is especially important for oily and problematic skin. Choose quality care with corrective properties from trusted brands of pharmacy cosmetics.
2. Hygiene is an important point in the fight for clear skin. Avoiding touching your face throughout the day, removing makeup, changing pillowcases more often, and using paper towels are some of the tips you can follow to achieve beautiful, healthy skin.
3. A healthy lifestyle promotes good blood circulation and oxygenation, which means better skin condition. Exercise, eat right, drink plenty of water, and break bad habits if you want perfect skin.

For problematic skin, experts recommend step-by-step care: cleansing-toning-correction, moisturizing and sun protection as needed. This approach will help maintain the health of the skin of the face at any age.

Answers to frequently asked questions

In the end, we will answer the most common questions regarding imperfections and dealing with them.

Is it possible to sunbathe with acne?

Ultraviolet rays “dry” imperfections, which over time causes an increased response from the sebaceous glands. As a result, they begin to produce even more sebum, and the number of acne increases. Therefore, with problematic skin, it is recommended to always use sunscreen on the beach and in the city.

What to do with painful pimples on the face?

Causes of patients with acne on the face may be systemic disorders in the body or exacerbation of acne. If acne causes discomfort, then they should be treated with anti-inflammatory drugs and antibacterial corrective agents, possibly with local action. If the measures did not help, it is recommended to consult a dermatologist.

Can scrubs be used if there are pimples on the face?

In the presence of inflammatory imperfections, it is not recommended to use mechanical scrubs in order not to spread the infection.