Perioral Dermatitis: How to Care for Your Child

Perioral (pair-ee-OR-ul) dermatitis is a rash that can form around the mouth, nose, or eyes of children and young adults. Doctors think that steroid medicines are one thing that can cause it.

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 cause mild burning or itching, but it usually isn't very bothersome. Perioral dermatitis (also called periorificial dermatitis) usually gets better a few months after starting treatment.

For children using steroid medicines

• If your child uses an over-the-counter or prescribed steroid that is put on the skin (a topical steroid), your health care provider will tell you to stop using it or slowly wean your child off of it.

  • The rash will not go away until use of the steroid medicine stops. At first, the rash may get worse after stopping the steroids.

• If your child uses prescribed steroid medicines taken by mouth, sprayed up the nose, or inhaled, continue using them as prescribed. These can sometimes get on the skin and cause perioral dermatitis, so:

  • If any inhaled or nasal steroid medicine gets on the skin, wipe it off right away. 

  • If your child uses a mask for an inhaled steroid (such as Qvar® or Flovent®), ask your health care provider if your child can switch to a spacer without a mask or another type of device that will keep steroids off the skin.

Cleansing and moisturizing

• Your child should:

  • Avoid soaps, lotions, lip products, or makeup that can irritate the rash areas. 

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

  • Use a fragrance-free moisturizing cream twice a day.

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 cheek or eyelid. 

What else causes perioral dermatitis? Skin irritation or too much bacteria or yeast on the skin also can cause perioral dermatitis.

Who gets perioral dermatitis? Boys and girls of any age can get perioral dermatitis. Many children who get it have had eczema or asthma because steroid medicines are used for these conditions.