Perioral Dermatitis: How to Care for Your Child

Perioral (pair-ee-OR-ul) dermatitis is a rash around the mouth. Treatment includes stopping any steroid ointments or creams since this may be a cause of the condition. Other treatments may include antibiotics (by mouth or in ointment form) or a cream to calm down inflammation (redness and swelling).

Although the rash sometimes gets worse after stopping the steroid ointment or cream, it usually clears up completely within a few months.

For children using steroid medicines:

• Stop any steroid ointments or creams as recommended by your health care provider. If your child is using a strong steroid ointment or cream or they have been using it for a long time, you may need to slowly wean them off the medicine. 

• Continue any steroid medicines taken by mouth, sprayed up the nose, or inhaled unless your health care provider tells you otherwise.

• To protect the skin from steroid medicine:

  • If your child uses steroid medicine sprayed up the nose, wipe the area with a tissue right after using it to remove any medicine that may have gotten on the skin.

  • If your child uses a spacer (a hollow tube that attaches to the inhaler on one side and a mask or mouthpiece on the other), ask your health care provider if your child can use the type of spacer that has a mouthpiece (instead of the mask).

Skin care:

• Your child should:

  • Use water or a gentle fragrance-free soap or a non-soap cleanser to wash their face.

  • Use a fragrance-free moisturizing ointment when needed for dry skin.

  • Avoid using lip products, acne treatments, or makeup on or near the rash.

  • Use sunscreen only on or near the rash if absolutely needed.

• Once the rash gets better, your child can start using their skin products and makeup again. They should add only one product at a time and use it for a week to make sure the rash doesn't come back.

Other treatments:

• Your health care provider may prescribe other treatments, such as:

  • An antibiotic ointment (such as metronidazole gel) or an anti-inflammatory cream (such as Elidel® cream)

  • An antibiotic by mouth, if the rash doesn't get better with skin creams

• The rash gets worse even after using medicines for 3 weeks.

• The pain or burning gets worse.

• The itching gets worse.

• You notice swelling of your child's lips, cheek, or eyelid.

What causes perioral dermatitis? The exact cause isn't known. It may be related to a breakdown in the skin barrier or the use of steroid creams or ointments in the area.

What are the symptoms of perioral dermatitis? Usually, the rash has many small red, pink, or skin-colored bumps that come close to the lips but aren't on them. The rash can also appear around the eyes and nose. Sometimes the rash causes mild burning or itching.