That Rash Around Your Mouth Might Be Perioral Dermatitis

[ 437 ] August 22, 2012

Our most widely-read post on this blog is about a rash I had around my mouth and how I discovered what triggered it and how I finally healed it.  That particular rash was the result of an allergic reaction to propolis. But not all rashes near the mouth or on the face are caused by allergic contact dermatitis.  Sometimes they are the result of a condition called perioral dermatitis.  Differentiation of mouth/face rashes is important because the treatments for allergic contact dermatitis, acne, rosacea, or eczema can make perioral dermatitis worse.

Appearance of Perioral Dermatitis:

The most common presentation of perioral dermatitis is at the corner of the nose or along the nasolabial folds.
Copyright © 2012 Elsevier Inc.

Perioral dermatitis is a non-contagious skin condition that occurs mostly in women (typically ages 16 to 45) and sometimes in children.  The etiology and pathogenesis  is unknown according to western biomedicine.  The rash of perioral dermatitis is rather distinct though it can often be misdiagnosed as eczema (atopic dermatitis), acne, allergic contact dermatitis, or even rosacea.  Eruptions typically begin around the mouth (perioral region) in the nasolabial folds (smile lines) and can spread to the sides of the nose (perinasal region), the chin, the cheeks, or even the lateral aspect of the lower eyelid (periorbital region).  Sometimes the rash only appears at the eyelids (despite the name “perioral” dermatitis).  Tiny papules (small bumps) and small vesicles (bumps filled with a small amount of clear fluid) will appear on an erythematous (red) base.  Sometimes there is also dry scaling.  The skin may feel tight and dry with occasional mild itching or burning.  Most of the time the rash will be symmetrical – appearing on both sides of the face.

Differentiation:

This case of perioral dermatitis resembles acne.
Copyright © 2012 Elsevier Inc.

Acne: When perioral dermatitis affects the chin and the skin next to the nose, it often looks like acne at first appearance.  But you can tell that it is not acne by noticing there are no comedones (blackheads or whiteheads).

Allergic Contact Dermatitis: Allergic reactions around the mouth or lips, like from lip balms or lipstick, will also typically affect the vermilion border (the edge between your lips and the regular skin of your face).  In the case of perioral dermatitis, this vermilion border is spared and there will be a thin clear zone along the edge of the lips with no redness or papules.

This infant’s rash was initially misdiagnosed as eczema and treated with topical steroids which made the rash worse.
Copyright © 2012 Elsevier Inc.

Eczema (Atopic Dermatitis): It can be challenging to differentiate perioral dermatitis from eczema/AD at first glance.  Eczema will often appear elsewhere on the face or the body and not be confined to the region around the mouth or eyes.  Eczema/AD can be asymmetrical, while perioral dermatitis is typically symmetrical.  Blood tests for IgE levels can be helpful to determine if it is eczema/AD. Often topical steroids will be prescribed to treat the eczema but this can cause a severe aggravation of the eruptions if it truly is perioral dermatitis.

Rosacea: At the initial stages of rosacea, flushing occurs and erythema can occur without papules or pustules (though these appear at later stages).  Rosacea can also affect the forehead and nose (unlike perioral dermatitis) and is usually more wide-spread on the cheeks.  Telangiectasia (dilated purple capillaries) appears in rosacea but not in perioral dermatitis.  Rosacea is not seen in young children.

Why Does Perioral Dermatitis Occur?

Despite the name, “perioral” dermatitis can occur exclusively at lateral aspect of the eyes.
Copyright © 2012 Elsevier Inc.

While the exact cause of this condition is unknown (according to biological science), it is often triggered by the use of potent (fluorinated) topical steroids on the face or elsewhere on the body. Perioral dermatitis eruptions appear on the delicate areas of the face where drying substances (like benzoyl peroxide found in acne medications) make the skin too dry. It is believed that in individuals with constitutionally dry skin, the overuse of moisturizers causes the surface of the skin (the horny layer) to be constantly artificially hydrated, thus affecting this layer’s ability to inhibit the growth of bacteria.  This is thought to play a role in the development of perioral dermatitis.  Case studies show that the use of moisturizers plus cosmetic foundation on a daily basis contributes to an increased risk of developing perioral dermatitis.  Persons with oily skin who do not properly cleanse with water and soap (or other cleanser) are also susceptible.  Daily use of heavy sunscreens also tend to trigger this type of rash.

In the last few months I have had 8 new patients contact me regarding perioral dermatitis.  All but one of them were women who worked in healthcare (nurses, acupuncturists, and optometrists).  They all claim to have had no contact with steroid creams and they appear to wear minimal amounts of makeup (if any).  Perhaps there is a common chemical or cleanser they are coming into contact with that is triggering this?  Not an allergy but maybe a chemical irritant?  In each of these cases, the rash improves on days when the patient is not at work or when they are on vacation and it reappears or gets noticeably worse when they return to work.  I am so curious to discover the correlation here (if one exists).

How To Treat Perioral Dermatitis:

In most cases, perioral dermatitis responds quite well to treatment, though there are times where is recurs or becomes stubborn (like in the health care workers mentioned above).  Oral (internal) antibiotics are the treatment of choice in western dermatology.  Internal herbs are the treatment of choice in Traditional Chinese Dermatology.  Whether or not internal treatments are sought, the following must be considered:

  1. Stop the use of all steroid creams (on the face as well as elsewhere on the body).  If you have been using a steroid cream, your rash may get worse when you first withdraw the substance but be patient…this will clear up in most cases.
  2. Discontinue the application of all moisturizers on the face.  Even after the rash resolves, you should not apply moisturizers on the areas where the rash was or it may recur.
  3. Discontinue (or at least limit) the use of sunscreens on the face.  (But then be sure to stay out of the sun or wear a hat with a large brim).  If you must be out in the sun, choose a sunscreen that is a liquid or gel (not a lotion/cream which is oil-based).
  4. Do not use moisturizer under your cosmetic foundation.  And limit your use of cosmetics in general.
  5. Wash face with just warm water until the eruptions resolve, then use a gentle cleanser or soap to keep your face clean.
  6. Avoid using drying alcohol-based facial toners or cleansers.
  7. Avoid using drying acne medications such as those that contain benzoyl peroxide.
  8. Do not touch your face.  Seriously, don’t keep checking the feel of the rash to see if it is improving.  And try to stay of aware if you are inadvertently touching your face throughout the day (rubbing your chin in thought, scratching little itches, etc.).
  9. Make sure your pillow case is clean.
  10. Avoid spicy and/or greasy food.  From the TCM perspective these foods aggravate the energetic imbalances that lead to facial rashes of many varieties.
  11. From a western medicine perspective:
    My colleague, a nurse practitioner specializing in dermatology, suggests doxycycline 50 mg BID to clear it initially.  Follow with 50 mg daily  for 2 more weeks to assure it stays gone.  This will not prevent it from recurring, but it should clear up the current episode.

Do you have or think you have perioral dermatitis?  Share your experience with us by commenting below.  I would really love to hear from health care providers to see if there is any link to those work environments and and the development of this condition.

Tags: atopic dermatitis, contact dermatitis, dermatitis, lip rash, perioral dermatitis, rash around mouth, rash near nose

Categories: Acne, Allergies, Eczema, Facial Care, Rashes

About the Author ()

Diana Hermann is a licensed acupuncturist and board certified in Chinese Herbal Medicine. She received her Master Degree in Acupuncture and Oriental Medicine from the Oregon College of Oriental Medicine in Portland, OR and trained in China at the Nanjing University of Traditional Chinese Medicine. She is the owner of Zi Zai Dermatology (hand crafted herbal skin care products) and maintains a private practice (Acupuncture of the Rockies) in Fort Collins, Colorado.

Comments (437)

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  1. Janet says:

    I think I have this but it is only on the right side of my mouth. I’m pregnant, therefore I cannot take any antibiotics for it. I was using Cortizone (OTC) but I may use less now according to this blog. Thanks for the information. This is the 3rd break out I’ve had since I was 14 and now I’m 28. The previous ones were closer to my nose, same side, and this is the first one by my mouth so it looks like herpes to me, which I know I don’t have. Hopefully it goes away soon since I’m extremely emotional and self conscious about it, especially now with my hormones out of wack.

    • I cannot actually give medical advice here, but perioral dermatitis should not be treated with cortisone cream/ointment. Be ready for a flare-up for a few days if you choose to discontinue the cortisone. But don’t worry, it won’t stay flared forever. Good luck!

      • Clara says:

        When I was 16 years old I developed a rash around my nose that was diagnosed as perioral dermatitis. The dermatologists that I saw all prescribed antibiotics and cortisone creams. This worked for a while. But when the rash emerged again, I was always given a stronger antibiotic. Finally, I went to a specialist in Brooklyn who was well known and prescribed a cortisone cream and the same dosage of my previous antibiotic. When I asked for a stronger antibiotic the answer given was “if we gave you a stronger antibiotic, it would be the same dosage for someone with meningitis.” And so shortly thereafter began my experimentation with nutrition. I am 49. I kept the perioral ldermatitis away for all these years with a pure diet. I currently continue to not eat white food, sugar, flour, dairy etc. I am gluten free. I tried an antihistamine diet for a while. Also, I tried the candida diet for a while. The rash is kept at bey but I cannot make it go completely away. I am going to make an appointment with a nutritionist/chiropractor who is supposed to be good with rashes. We’ll see.
        What I have tried for Perioral dermatitis:
        My initial attempt was to treat this naturally.
        Using Himalaya Botanique brand moisturizer all over face Helps, doesn’t cure.
        Hemp oil helps at night, doesn’t cure.
        Taking 2 to 3 probiotics a day
        1 tsp. cod liver oil a day
        Now Omega 7’s (2 a day)
        I thought it might be too much acid in my system since the rash (though only on my face) was in spots where body fluids secrete. (I do not have rash anywhere else at all on my body) So I purchased a PH test strip roll. According to strip, it showed I had high acid in my system. The highest on chart provided. I followed advise of Health food store owner and went on a low alkaline diet. I have tried oregano oil. . .probiotics. . .Mega food multivitamins. Lemon in my water ( I already do) Apple cider vinegar Braggs ( I already do)
        NO CHANGE

        February 2014 A Naturopathic doctor said I should take (Ortho Molecular Product Natural DHIST) vitC150mg, Quercetin dehydrate 200mg, Stinging Nettles leaf200mg, Bromelain50mg, N-Acetyl-L-CysteineUSP 25mg,
        (Source Naturals Activated Quercetin) vitC646mg, Magnesium50mg,Quercetin1g,Bromelain300mg,
        NO CHANGE
        After about a year and a half of trying to treat perioral dermatitis naturally, I caved and went to see a dermatologist in April 2014. She prescribed an antibiotic cream called METRONIDAZOLE topical lotion 0.75%. I applied it on my eyes, around my mouth and on my chin. After 5 applications, I woke up to a face full of blisters. I returned to the dermatologist who said I had a reaction and gave me steroids and antibiotics. I am ending the course of these medications.
        The dermatologist wants to keep me on antibiotics for 2 months but I don’t see the point. Anywhere I have researched and my experience tells me that an antibiotic can cure the current episode but will not keep the problem away. Is there anything you can recommend that I have not tried. I am very healthy, in great shape and have not other symptoms nor am I on any other medications.

        • clara says:

          Re: Perioral Dermatitis. My decision was made for me regarding Doxycyline. I reacted badly with another rash. Diana Hermann recommended the serum for acne, toner for acne and the cleanser. She said to not expect a cure and see results in two weeks. And that is exactly what happened. It didn’t cure my dermatitis. But it looks 95% better. I am so impressed!! My teenage daughters don’t wince in compassion when they see me without makeup. They have actually forgotten that I have this condition. There was a flareup even on the serum, during my cycle. But, though expensive for me, it works so amazingly well and I’ll have to continue to use it and happy to do it. I love this product!

          • I love it when our products work even better than expected :)
            For the record, the more you use our products, the less you need to use our products. The goal of our products (and Chinese medicine in general) is to create more balance. The more balanced and healthy your skin becomes, the less outside help you need to maintain this improved state of health.

          • Stephanie LeToy says:

            Hi there – can you tell me exactly which products you used and how they were used? I’m desperate to get this at least moderately cleared up. I have it on the outer corners of my eyes and in my smile lines. It’s been this way for nearly 6 months and nothing helps!

    • HC worker says:

      I am a health care worker and have had this rash for approx. 3 weeks (small bumps in the perioral area). I obviously wash my hands frequently do to the nature if the job. I used to use minimal make-up and washed my face morning and night with soap/water and used a moisturizer. During these last three weeks I have stopped using any make-up/moisturizer/ fluorided toothpaste. I only wash my face with a liquid cleanser. I saw a physician who prescribed ketoconazole/hydrocortisone and with no improvement after the first week I discontinued usage to find a “flare up”. Since then I have tried red wine vinegar, tee tree oil, and straight ketoconazole shampoo on my face – only to leave it more irritated. I am going to try to watch what I eat and only wash with water (since cleanser seems to be drying out my skin). I am going to the doctors again tomorrow and wanted to share my story. Thanks for the article!

      • Thank you for your comment. So frustrating, isn’t it? I would recommend a very diluted soap, not just water, for washing your face. The only reason I suggest this is that accumulation of oils on the rash will make it worse. So if your skin isn’t too oily to begin with, maybe just rinsing with water will be enough, but keep this in mind if it doesn’t work. My PD just flared up, too, and I cannot figure out why. It is exceedingly dry here in northern Colorado so that may have triggered it.

      • Kim says:

        For me it was the nicorette gum causing the bumps on my face! This may not help everyone, but I felt that I would put this info out to help anyone dealing with this due to the gum. I’ve been dealing with embarrassing skin-colored non-itchy bumps around my mouth: from the corner of nose down around my chin on both sides for over a year and I found out just recently it was all caused by the nicorette gum. I quit and within a day or so it was gone: the bumps and tightness with lines! For over a year I’ve been trying to figure out what I was allergic to and never thought about the gum! Before this discovery I stopped soaps and lotions and makeup etc. I tried all natural ingredients. I quit cinnamon, fluoride toothpaste and mouthwash. I even went to the dermatologist and he thought it was perioral dermatitis. I tried special expensive lotions and nothing worked. I even tried the trustworthy cortisone cream. I hope this helps anyone with the same issue.

      • EL says:

        You have a condition called seborrhagic dermatitis or a yeast infection of the skin aka perioral dermatitis. You need to treat with Nystatin cream which is an antifungal. I had this for months and used clotrimozole with limited success. It would appear to go away and then come back. The Nystatin cream did the trick, like magic.

        • Do you mean seborrheic dermatitis? Perioral dermatitis and seborrheic dermatitis are not the same thing, though they can appear very similarly to the naked eye. There is no overgrowth of yeast in perioral dermatitis. Nystatin would not be appropriate treatment unless there is confirmed overgrowth of yeast. If there is yeast overgrowth, Nystatin may be an appropriate treatment option, but many people choose not to use unnecessary synthetic pharmaceuticals on their skin. I am glad Nystatin worked in your case, though.

  2. John says:

    I have bumps that looks like perioral dermitits in the common spot around the nose and cheeks. The bumps are mild though. The only thing is that it originated on the bottom vermilion border, the place that should not be affected if it is in fact perioral dermititis. My lips are constantly chapped and burning and the rash does not improve. Do you think this could be two different things?

    • If your lips themselves are chapped and burning, I would suspect something other than perioral dermatitis. Do you use lip balm? Toothpaste with fluoride? For a guy, those would be the first 2 things I would stop using to see if the rash resolves.

      • John says:

        Yes, I have not used toothpaste with fluoride in over 6 months but the chapped and burning still resides. I use petroleum jelly in place of lip balm for that reason. My shampoo and toothpaste I bought from an online allergenic store. Is it possible for a chemical that is not an allergen to cause a reaction of this nature? like SLS, ect..? I have just about thought of everything and have not came to a resolution. Im convinced the only way im going to solve it is through patch testing. I read online that Nickel can be a cause. Do you think if I was highly allergic to it, just as much as grabbing my keys and then touching my face could cause a reaction?

    • Annoyed says:

      I know you posted this a while ago, but I have the exact same thing! I was diagnosed with PD but it has recently developed along my lip lines as well. I was wondering if you ever figured out what was causing yours?

      • Hi Annoyed,
        Not certain if you were asking me or reader John what caused our rash. In case you were asking me, the original rash around my mouth was definitely caused by an allergic reaction to propolis (in beeswax). But I still am unclear as to what triggers my perioral dermatitis. It hasn’t reappeared in quite some time, though. John, have you figured out what triggered your rash yet?

    • Gina says:

      John, I have the exact same thing happening to me…..redness, bumps and itchy under my nose and my lips are chapped and burn….going on 2 weeks. Did you ever find out the cause and cure? Would appreciate any help that you can give me.

  3. John says:

    I thought I should also mention that I was prescribed a steroid which it reacted horrible to. The rash on the vermilion border got worse and the bumps around my nose and cheeks started appearing more frequently. When I started taking doxicycline, the bumps started clearing up but my rash on the vermilion border stayed the same with the usual burning and chappness. This is why I thought at first it might be two totally different things. Although im not positive the doxicycline had any effect.

    • Hmmm…that does make it seem possible that 2 separate things going on. Corticosteroid creams will make perioral dermatitis flare and doxycycline usually improves it. It is also possible that although the vermillion border is typically uninvolved in perioral dermatitis, you may just have a less-than-typical case. People have been known to react to SLS so be sure you are not using a facial cleanser with those harsh detergents in it. Nickel allergy is possible but I do not think touching your keys then touching your face would do it (but I am no expert in nickel allergies). Do you have any facial piercings? Do you play any musical instruments with your mouth (reed instruments, didgeridoo)? Patch testing may be quite helpful for you to figure this out. If you go, the best time is to do the testing when the rash is at its worst – you will get a more definitive reaction at the test sites (on your back).

      Here is a lost of articles about substances that tend to cause lip rashes. You may have seen all this before, but perhaps there is one helpful thing you may have missed. Good luck!
      http://search.atomz.com/search/?sp_a=sp1001e79f&sp_f=iso-8859-1&sp_q=propolis+allergy

  4. teb says:

    I HAVE HAD ECZEMA PROBLEM SINCE I WAS 18 AND WHEN I WAS FIRST DIAGNOSED BY A DERMATOLOGIST, SHE PRESCRIBED HYDROCORTISONE CREAM. THE ECZEMA STARTED OUT AS PERI ORAL RASH WHICH THEN PIGMENTS AND MY SKIN WOULD PEEL OFF SOMETIMES, ON MY FEET, LATELAL SIDE OF EYELIDS AND MY HANDS. i USED THE CREAM FOR TWO YEARS ONLY WHEN I HAD FLARE UPS. BUT FUNNY THING IS WHEN I MOVED TO EUROPE IN 2003 FROM AFRICA, I STARTED USING ONLY VICHY MOISTURISER FOR 5 YEARS AND IT WAS GOOD ENOUGH. I THEN TRIED CORTISONE CREAM THEN AND SEEM TO MAKE IT WORSE WHICH WAS STRANGE. BUT I REALISED WHEN I WAS IN EUROPE THAT MY ECZEMA WAS A COMBINATION OF SUN EXPSURE, SOAP, OESTROGEN LEVEL(FLARE UPS NORMALLY WHEN IM MENSING) AND SOME FOOD.SO COZ THE SUN IS NOT AS BAD IN EUROPE AS IN AFRICA, I STOPPED USING ANY KIND OF SOAP AND USED MOISTURISER THE HYPOALLERGENIC ONE MY PROBLEM SKIN IMPROVED. PROBLEM IS I HAVE BEEN BACK IN AFRICA AND PROBLEM STARTED AGAI. BUT THIS TIME IM USING SPF 15 TO 20 FOUNDATION, NOT USING SOAP AND I APPLY BETAMETHASONE CREAM ONLY WHEN I HAVE FLARE UPS AND USE GALLIA TEA TREE OIL FACE WASH AND ITS SEEMS TO BE UNDER CONTROL.

  5. Katrina says:

    My dermatologist thought I might have this after repeated trips to him with supposed eczema on my lips/mouth area, cheeks, and eye region. He gave me a round of antibiotics but it didn’t seem to help. Also, I once read it isn’t super itchy and mine is often very itchy. Still getting dry/itchy/flaky lips and still not sure why…also intermittent eczema around eyes and lower cheek region. The investigation continues. Through a patch test, I found out I am reactive to formaldehyde and my dermatologist mentioned nail polish so I’m wondering if there is a correlation. I don’t wear it very much (and it didn’t seem to help when I stopped altogether)-has anyone had any experience with this kind of a reaction?

    • Jenna says:

      Wow! I may have figured mine out thanks to you! I had a keratin hair treatment at a salon with formaldehyde in it and ever since then is when I’ve noticed my red bumps and never before! Thanks!

  6. Cynthia Bradford says:

    I have been to a local dermatologist before for this rash that is hard to clear up. After reading I think mine might be triggered by a moisturizing cream that I have used off and on. It’s been about 4 years ago since my last outbreak. The dermatologist gave me an antibiotic that really messed up my vision. I called and they had me come back in and gave me another antibiotic and a cream. I only used the cream for fear of side effects from the pill and my face cleared up. Any idea what that might have been? I have had this breakout for 2 1/2 months now and it gets better then worse.

  7. Betty Forwick says:

    A dermatologist once told me that kleenex has formaldehyde in it, which can cause/exacerbate perioral dermatitis. I buy mens handkerchiefs when I get a rash around the nose.

  8. eleanor says:

    health care worker, same rash, is it possible that our blue health gloves might have some kind of irritant? I am thinking that after we remove them we may inadvertantly touch our face and whatever is on the inside of the gloves gets onto the face area? I have only started using these gloves, used the plain untreated ones before and never saw any kind of rash!

  9. Patty says:

    I am a 55-yr-old female, and been having strange lip border issues for quite some (quivering, tightness, dryness) until just about a month ago I started seeing a few red, itchy bumps going uo from my lip towards my nostril. My derm had been treating the lip issue with Protopic, which would often clear up my issue, but I didnt feel comfortable continuing with it, so I stopped it all together about 2 mos. ago. Them boom, one day this rash just exploded! It’s all around my “muzzle” area. I was dx’d by an allergist to have perioficial dermatitis. I have been on doxycycline 100mg twice a day for about a week. Not better. Some days ok, some days awful. Its the redness that really bothers me. I am self-conscious going out now. Tried apple cider vinegar, etc. So distressed. Does it take awhile for the antibiotics to work? Its not quite as bumpy but its still bad, especially in the morning! Help!

    • If it truly is perioral dermatitis it probably will respond to antibiotics, but it may take a few weeks. Give it another week before going back to your dermatologist. If it is perioral dermatitis, resist the urge to apply a topical steroid cream to address the redness – this will make it worse. Often, hormonal changes will trigger or exacerbate perioral dermatitis. If you see an acupuncturist or other holistic practitioner, you may want to have them treat you to balance your hormones. If it is not perioral dermatitis, then it is back to the drawing board. You may have to do a little detective work to see if you perhaps have an allergy. Be sure to read our other posts (and the comments below them) for helpful tips that may benefit your skin:

  10. After reading this post, I think that the cyclic sporadic rash that I’ve been afflicted with lately may be perioral dermatitis. I do have eczema on my body, but this rash on my face doesn’t seem like eczema – it doesn’t itch and doesn’t respond well to typical steroid creams (although I’ve stopped using those).

    I don’t have a rash around my lips per se, but I get a rash above my lip (under the nose area) and then under my lip, and then around my eyes. Lately the rash has been sporadic at coming and going, but when it’s in a full on flare, it’s around both eyes like a raccoon mask (except under my right eye), down the whole left side of my face/cheek, and then on my neck on the left and in the center. I have pictures if there is interest. It’s completely odd that the right side of my face is relatively unaffected and the skin on that side is pretty good. It’s completely maddening as it’s gone through about 4 cycles of getting mostly clear for a day or two and then coming right back. I HAVE suspected beeswax in my chapsticks and have totally phased those out and just use a little vaseline or olive oil when my lips feel really dry.

  11. Rachel says:

    I have been reading alot about different rashes lately mainly perioral dermatitis and seborrheic dermatitis. My rash started out around June or July and has gotten worse month after month. First it appeared around one side of mouth then the other. It then progressed to the sides of eyes, sometimes on eyelids and finally a bit on one side above my nose close to eyebrow. It is horrible, burns itches bumpy sometimes scaly very red and retracts me from wanting to go out. I am a stay at home mother of 2 boys, 3 years and 10 months. My family and I moved 3 hours north to Sauble Beach, Ontario in August and therefore have been looking for a new doctor. We are on a waiting list and I can’t wait to see our new doctor about this issue. I started using a topical corticosteriod in August when it wasnt as bad and it seemed to work at first but the rash has pregressively gotten worse with continued use since then. This medication was actually diagnosed to me when I was pregnant with my second son for a rash that had developed on my legs.So today I have not used the cream used a shampoo that does not contain SLS- Sodium Lauryl Sulfate, no cover-up, and will be buying toothpaste without flouride. I used dove soap on face and mosturizer, skin was dry, I work out almost everyday so I need something other than water to wash face or I break out? I will continue to not use cream and do whatever I can to get rid of this problem and share my results and would very much appreciate any more suggestions that may help?

    • Betty Forwick says:

      There are two prescription drugs that I was prescribed by my doctor. The first Finacea (15%) didn’t work that well but the second Protopic (0.03%) helped.

    • Theresa Egler says:

      My perioral dermatitis seems to not be irritated by Sophyto pH Optimizing Restorative Toner. It can be used as a cleanser with cotton pads and doesn’t leave you dry. I am just beginning to realize that i may be over moisturizing and using too much sunscreen. I am going to stop everything and try just the Sophyto. A friend of mine who is allergic to sunscreen only uses Sophyto and has perfect skin. Hope this helps you!

  12. Rachel says:

    Well it has been two days since stopping the steriod cream and my rash like you said has exploded. It is very irritating itchy and burning. The rash is in the same places as I listed above but has gotten severly worse. So, I am going to be heading to the hospital seeing as my family and I are on a waiting list for a new doctor in the area. Hopefully I can get some answers and some medication for this issue!!

  13. Rachel says:

    Hello all, been to hospital and back the doctor there has perscribed to me both metronidazole cream and tetracycline which is taken orally. I was advised to choose one but not take both at same time. Pharmacy in town is not open today but will be tomorrow. I am first going to try tetracycline..will follow-up again on page of results. Funny thing is the doctor told me to mosturize alot!!??

  14. Charissa Cirts says:

    I am 12 I have had this for around 6-7 months now, I have noticed after I was playing sports. I thought it might go away. But it didn’t I told my parents they said use a steroid cream so I did but when I stoppe it didn’t help. It did help when I was using it. But that was like 3 months after I really started to get annoyed by it! So I wanna get rid of this! It’s embarrassing and annoying!

    • Why after sports? Do you wear sunscreen for outdoor sports? Is the rash in a skin fold where sweat might accumulate? Do you use equipment like a mouth guard or does something come into contact with your skin where the rash is? How long does the rash last once it appears?

  15. micky says:

    thanks for finding out what my doctors could not.

    ive stopped using my chap stick and the pain and swelling is almost gone leaving me with a flakey mouth and that i can handle i was afraid i was picking up a reaction from Red Wine.

  16. Rachel says:

    The last week I have been through hell and back. Things are getting better. As I have been researching different sites I have found one that I think is imperative for everyone to read!!!!! ITSAN.ORG. If you have been perscribed any type of steroid cream please go to this website it could save your skin!! I made the mistake of self medicating myself with a potent steroid cream on my face ( a huge mistake). For four months I did this to my face because I thought the steroid cream was actually helping, but what I didnt know was that my skin had become very addicted to steroid cream. The site will further explain what steroid addiction is. My hope is to help someone who visits this site or has!

    • I am not a fan of using steroid creams on the face unless absolutely necessary. Their use tends to make the original rash flare up much worse once the steroid use is stopped. I would recommend trying to treat facial rashes without the use of steroid creams, even though they are so tempting.

    • Brittany says:

      I’ve been using a topical steroid cream on my face for about 7 years. Not knowing what to do, I’ve just continued to use it because it’s at least better than if I stop using it altogether. How long did it take it to clear up once you stopped cold turkey?

  17. Hello :)
    Not sure if I have Perioral Dermatitis, but so far the symptoms seen correct.
    For the past 4-5 months I have had redness, slight burning when agitated, dry flaky skin, & small clear fluid fill bumps under my nostrils.
    At first I thought it was from having a cold & irritation from blowing & wiping my nose (happened before) but since it has persisted, I wasn’t sure anymore :(
    Then the same irritation popped up on one side of my chin a few weeks ago & a week ago a smaller patch on the other side of my chin has appeared.

    It is nowhere as bad as it was a few months ago, so I seem to be keeping it at bay/healing it.
    Not as red, sore, dry, & the bumps are smaller, if not almost nonexistent.

    I’ve been keeping my face clean & treating it separately from the rest of my face.
    I wash my face twice daily with antibacterial soap & warm water, then treat the areas with rubbing alcohol on qtips & let dry, then with a Qtip, apply a thin layer of triple antibiotic ointment.
    I still use hydrocortisone cream on the rest of my face, avoiding the affected areas, but might refrain until it clears up. Also once to twice a week I use an avocado clay face mask & it seems to leave it in even better condition than before.

    It seems to work & only reddens or gets sore if I accidentally scratch it or after wearing makeup.

  18. Jil Croker says:

    I believe I have perioral dermatitis under both of my eyes. Interestingly during my first semester in nursing school mid point into clinicals it first appeared under one eye. It went away for awhile then popped up in the other eye. Now I have it in both eyes. On another note it went away during the summer only to pop up again when second semester clinicals began. Steroid topical cream keeps it at bay but if I stop using it it comes back with a vengence.

    • So interesting – all my patients with this who are healthcare workers tell me it goes away when they are off of work for a while and returns as soon as they go back to work.

      • Jil Croker says:

        I had a feeling it had something to do with the hospital but felt I had maybe contracted it from one of my patients. Interesting indeed! I felt relieved to find this site because my PCP has been puzzled by this condition and has now suggested I see a dermatologist. Thankfully I have some information to share with her regarding treatment of it. I thank you so much for this!

  19. Jil Croker says:

    I am interested in the traditional Chinese herbal therapy you mentioned. Can you elloborate?

    • We basically give internal herbs that are both antibacterial and treat what we call Spleen Damp Heat (TCM diagnosis – too much to explain here). I have given a combo of herbal pills that seemed to work well, but usually I give a custom prescription of herbs in granule form (you mix the “powder” with hot water and drink – like tea). I just emailed you to find your location, but for other readers, if you would like to find a TCM practitioner near you, visit our Practitioner Referral Page.

  20. Noemi says:

    My doctor told me that I have perioral dermatitis today and gave me an oral antibiotic to take and a hydrocortisone cream (2.5%) but reading all these posts I am not quite sure that this is what I have. I don’t really have a strong rash, it’s mostly itchy and flaking around and on my lips as well as a lot of swelling of my lips in the morning. My doctor originally told me I just had chapped lips and had me use vaseline and carmex but it continued to get worse. He doesn’t think it is an allergic reaction to the chapsticks. Is it possible that perioral dermatitis only affects the lips and right around the mouth?

    • Perioral dermatitis does not affect the lips themselves. If your lips are swelling, chances are it is not perioral dermatitis (or it is not ONLY perioral dermatitis). Please understand that I cannot diagnose you in this forum. But if I were you, I would not overlook the possibility of an allergic reaction. I would suggest you see a dermatologist before using the steroid cream. (I am assuming the doctor who prescribed your meds was a general practitioner?) You may want to read the following posts (AND all the comments listed below them) for additional educational information that may be helpful to you:
      Beeswax Allergy
      Healing a mouth/lip rash

  21. Susana says:

    Hello,
    I am a sufferer of perioral dermatitis.
    It had my first mild break out of this around 15. Researched through my pharmacy record, I used METROGEL and at the time, I recall it going away as I never used it again.

    I am 23 years of age now and for the past year or so, I was perscribed with BETADERM and even renewed my perscription. It is no surprise that I had reoccuring breakouts of the dermatitis more often than not, following this perscription. Concerned, I recently hoped to find new information and was perscribed with HYDROCORTISONE. Knowing it was a milder steriod, I looked for more help. Now, 1 week ago, I have been perscribed with METROGEL for my apparent adult acne and rosacea. Based on images I have seen and the location of my issue (symmetrically situated under the lower of my eye and around my mouth) I know this is not what I have. The metrogel seems to be minimizing the problem but the area particularly around my eyes, is not really making the breakout go away. The around around my mouth is definetly a lot better than before, but the underlining redness, itch and dryness is still occuring.

    It is itchy, certain air causes a burning feeling (particularly around my eyes), and the skin in this area, due to the metrogel, is particularly dry.

    I have quit my job, dropped out of University, so yes there is a level of stress. However, I have had random breakouts of this while working as well. Please note, I hated my job and that is why I quit therefore there is a correlation with the stress level. I have a kind and wonderful boyfriend, so that emotional bit of myself is very happy.

    I use oilfree makeup products (smashbox concealer, sephora brand face powder, benefit cheek stain for blush, sephora brand bronzer, Dior maskara, and eyeliner only on special ocassions) I know this sounds like a lot, but I generally have very clear skin and only put a small amount of these products on to even skin and give a brighter complexition. I use organic cleansing products and creams (Suki balancing day lotion up until last month, I have been using green beaver face cream, goats milk soap for cleansing, and dessert essence tea trea face wash, but I use it for my arms and back to avoid break outs, I haven’t used it on my face for several months). I use burts bees lipchap, pure vitamin e oil is used on my face in only particular places after a pimple to reduce scarring, as well as rosehip oil. Up until 3 weeks ago, I was also using suki under eye balm. I take thorne multi-cap with iron vitamin, twice daily, zinc in the evenings to heal my skin, billberry twice daily for my eye care, and fish oils, 1 table spoon daily.

    **Please note, for a period of 8 weeks around 4-5 months ago I was using an eye lash growth product, LATISSE. I did notice during the use I would have very minimal spouts of this dermatitis around my eyes. I would us bataderm mildly, and it would go away – temporaily, then come back again. I have stopped using this product since that time.

    I hope this helps in your understanding.

    Thank you for your effort to help indiviudals who have this problem, it is very much appreciated. Never stop your great work.

    Kindest and sincerest regards,

    Susana

  22. O jacks says:

    Hey, I think I might have this. I have had this problem with dry, tight, red skin since I was in like the 6th or 7th grade. But, it is not always constant. It will go away for awhile but then suddenly it comes back. I’ve tried everything. Some sites I’ve been to say to use hand sanatizer but I’m not sure if that will work for what I have.

  23. Sara says:

    I am a 55 yr old woman in great health. I had this condition over a year ago. It took about 3-4 times at the clinic with different MD’s to finally get the right diagnosis. I was treated with antibiotics (can’t remember which), and it cleared up. Now I have it again. I am going to the doctor tomorrow and will make sure I tell HER what it is I have…It is a frustrating thing, and I cannot figure anything out that I have done or not done, or have done that I had done during that period when I had it the last time.. It just seems to crop up at random.

  24. Gisele says:

    i seem to have this too, only mine is only on my eyelids and near the outer parts of the eye, very few spots around my mouth. I went to the clinic yesterday and was prescribed “protopic” 0.1% ointment. It seems to be clearing up the spots quite well, however, i feel more pain on my skin than before…. Any advice/comments/suggestions?

    • Jil Croker says:

      Hi Gisele. Like me do you touch around or rub your eyes often? Perhaps use skin cleansers like soap, or alcohol based solutions often those areas? When did this first occur? Does your skin issue look like the pictures posted on this site? My PCP prescribed me steroid cream which appears to do the trick however, when I stop using it the bumps come back times 2 or 3. It’s important (but not easy) to try to remember what you may have handled with your hands then touched your mouth or eye area with…what kinds of creams, soaps, solutions have you put on those areas that you may be allergic to or are too harsh for your skin…

    • If you are having pain in your skin you should tell your dermatologist or doctor as this may not be simple perioral dermatitis. I wish I could advise you directly but legally, I cannot do that unless you are my patient. Check back in with your doc and tell them about the new symptom. Good luck!

  25. Kallie says:

    I’m going to second the person that mentioned NAIL POLISH. It’s crazy, but if I get my nails done (just painted — at a salon or at home) in about 24 hours, I will develop a red, rash in a semi-circular shape just under my lower lip and above my chin. It’s itchy and unattractive. Applying moisturizer seems to make the situation worse, so I try to just keep the skin dry. Over the next 3-4 days, the rash “dries up” and the skin begins to heal and flake away. (Also, not attractive.) Within a week, it clears up and I will not get another rash until I paint my nails again. Seriously. I went a year with natural nails and no under lip rash. Then, I was in NYC visiting a friend and we decided to get manicures. (So cheap in NYC!) And, on the train back to DC the next day – BOOM, the signs of a rashy, red lower lip were back. I switched from OPI to the “natural” line by Zoya, but it still causes a rash when I use it.

    Am I doomed to natural, unpainted nails for the rest of my life? I hope not.

    Seemingly unrelated: I’m 30 and have always had dry, pale skin, but suddenly I started developing patches of psoriasis! (Beautiful, no?) I took my woes to Google and found some people that remedied their scaly patches with boosting their zinc intake. I’ve been following a Paleo diet for over two years to help cure my adult acne (Yes –I’m just as surprised as you that I’m not a complete troll with all these unsightly afflictions…) so, I opted to enjoy a half dozen raw oysters in lieu of a pill. INCREDIBLY (!) the patches started to heal and I stop developing new ones. I started going to raw oyster happy hours, but eventually broke down and bought a bottle of Zinc supplements; just a small dosage of 15mg a day each morning. Now only did my psoriasis not return, but my acne REALLY improved (Paleo never cleared me up completely) and my dry skin was becoming softer… as we are heading into winter (!?) What gives? Was it the zinc? Back to the Google sea of knowledge! I cast my line and came back with a generic condition called “Pyroluria Syndrome”, which is a [not entirely uncommon] blood disorder that prevents your body from absorbing zinc and B6! Zinc apparently enables the absorption of a whole host of other vitamins and minerals, so in it’s absence you become deficient in more than just zinc — most notably A, which is huge for skin! (And has a Paleo nutrition follower, I was eating liver on the regular, so I was getting plenty of A, but with diminished zinc, I couldn’t metabolize it!) What’s the connection here? Well, I caught a tiny blip that zinc deficiency creates a whole host of skin maladies AND can result in a sensitivity to metallic elements, like… in NAIL POLISH.

    The hypothesis now becomes: If I do have (and have had for years…) Pyroluia Syndrome, and if zinc supplementation helps to remedy my deficiency, will I then no longer be sensitive to the metallic components in nail polish?

    I’m going to paint my nails JUST before my birthday next weekend. (That way, any rashes that may can happen after-the-fact) and my personal experiment means I get to have flashy colored finger tips for the celebration.

    Stay tuned…

  26. Jil Croker says:

    I feel strongly the dermatitis around my eyes is connected to the anticeptic hand gel I use in the hospital. The first occurance and subsequent occurances would have to be entirely too coincidental otherwise. What I found during my research is just about anything can cause dermatitis but by being a nursing student with limited contact to chemicals, medications etc.. the one thing I use frequently throughout the day when in the clinical setting is anticeptic hand gel. I do tend to touch my glasses, rub my eyes often. Perhaps I am allergic to a chemical in the gel or I’ve disrupted my normal skin flora to the point that bacteria around my eye have the ability to flourish. Maybe, both? In any case, the skin around my eyes improves while I am away from the hospital. My situation is somewhat unique in that I am only at the hospital once a week and am able to rule out may things like handling patient medications for one. There are also some scholarly articles and evidenced-based information regarding healthcare workers and chronic dermatitis citing possible links to anticeptic hand gels. Food for thought!

    • Another health-care victim says:

      I just recently had a small rash appear on the corner of my nose and it appears to look and be described as the above. I was so happy to find this site when Googled my symptoms. After my first trial and error I am now taking the doxycycline after I fwd this to my Dr. In a attempt to resolve this asap and so far it’s working knock on wood! So my situation started with me thinking At first if it was MRSA and was treating with mupirocin. It was going away until like the others said I returned to work. I myself work in the health-care industry, however I am just the receptionist at a very busy office so I come into contact with everone and thing. Now I am starting to think it may be from anticeptic hand gel as well. I don’t think it’s correlated with the gloves, but I am constantly washing my hands and putting the anticeptic hand gel on them. Secondly recently with my allergies my nose runs crazy and I’m constantly using a tissue so maybe that could be it as well, as someone else mentioned. Lastly my final thought is its from using a spf moisturizer every day and when I wear makeup which is maybe 3 out of the 7 days of the week. I wear the spf under my makeup, but in the past that has never bothered me unless it’s the new foundation im using. So obviously it’s hard to come to a conclusion but if I had to choose 1 that seems to be most relevant at least for the health-care ladies and gents I’m going to go with the anticeptic hand gel! hopefully we can find peace with this irritating problem.

  27. Sara says:

    I went to the MD and was prescribed the Z-pak….I have taken it for 4 days, and it already seems to be helping. I am not in the medical field, however…so can’t give any input. I discovered that the last time I had it was 2 years ago, but can’t seem to find any correlation, that I can think of…

    • Jil Croker says:

      Well you know, I was thinking, an outbreak could come from literally anything your face touches. Say you use a new laundry detergent on your sheets and you have a reaction to it. Our skin, especially our hands come into contact with so many things, like a shopping cart that has been touched by many different people. Some have very sensitive skin that will react to the slightest intrusion of a foreign substance.

      My skin, at least in the past, has never been exceedingly sensitive. Everyone’s make-up varies and I guess we have to make peace with it somehow. Perhaps as I am getting older my skin isn’t as easy-going as it once was.

      • Sara says:

        Right! I agree 100% about skin changing. I had never had particularly sensitive skin at all, but my mother does. Now that I am 55 all kinds of new things are happening! Not all bad, but changes, nonetheless…

  28. Jenna says:

    I would like to know what some of the eastern medicines are for PD like which herbs are suggested.

  29. Sara says:

    I wrote 2 comments above…and I was thinking; I work with children, and also exercise at a gym, and I am always using hand sanitizer. Just wanted to add that. Happy Holidays!

  30. Jenny says:

    I first experienced this 2-/12 years ago. I’ll never forget the first time it occurred. It was a Sat. morning and I had just gotten into a bubble bath when I noticed a tingling sensation at the corner of my mouth. From then on I experienced bouts that would range from mild to explosive. Extremely red skin around the mouth, sometimes with blisters or flaking skin, sometimes with white patches, most time it tingles with a burning sensation but not exactly itchy. It can last anywhere from a few days to a few weeks.

    I went to a derm. doc. and they gave me sample sample meds that I’ve been milking all this time because there were so expensive.

    The worst occurrence happened on my way up to MN from WI to attend a U2 concert over a year ago. An hour from my destination I felt it coming on and realized I’d forgotten my meds. By the time I got to the concert, the span of about 3-4 hours it was a complete Bozo the Clown blowout and everybody was staring at me.

    I’d always thought it was stress related because my body goes through an 18 month cycle of handling stress differently. One year it was dry skin around my navel, one year it was a small bald patch on my scalp, one year it was a little bump on the side of my finger, etc., etc.

    Sometimes it wouldn’t show up for months, like this past summer when it went away for almost 4 months. I thought I was finally rid of it but the fall brought it back again. My neighbor suggested I try aloe vera, I’ve got a plant in my house. It seemed to work but I felt the tingle coming on just before bed time last night and even though I knew I should have done something about it I ignored the warning and woke up to a breakout.

    Nice to know there are some answers to my questions about this and it’s not just stress related. I wish there was a total cure but at least I can try something different now and hopefully be able to manage it better.

    Thanks for the information and hope!

  31. Jennifer says:

    I have perioral dermatitis and was told by a coworker to wash the area with a popular dandruff shampoo and then apply triple antibiotic patrolatum based ointment on the area. Has anyone heard , or triedI of this type of treatment? The area around my mouth, nose and chin is very tight and uncomfortable. It is Christmas weekend and my Dr’s office is not open. I think this appeared due to wearing lotion with spf under foundation and using a new facewash and new toothpaste. I have had it before but used antibiotics to clear it up. Again, my Dr’s office is closed for 3 morewks days. PLEASE HELP!!!

    • Topical antibiotics (ointment) are not often effective for PD. I think a dandruff shampoo may irritate the facial skin, especially if there is fragrance and SLS in it (sodium lauryl or laureth sulfate – cleansing agents). Can you moisturize the healthy skin near the dermatitis? That may help alleviate some of the tightness.

  32. Kate says:

    I have a large rash around my mouth which I think is perioral dermatitis. It seems to be getting worse every morning which I wake up. Iv’e had it for the last 3 days and the rash is spreading very fast. There is also dry pieces of skin which are orange all around my mouth. Iv’e tried hot water with salt, no moisturizers/lip balms and holding ice packs on it but none of it seems to be working. I really don’t want it to keep spreading and the doctors are closed because of christmas holidays. Is there anything you would suggest to help it?

    • Sorry for the delayed reply. Have you been in to see a dermatologist yet? I would definitely see a doctor, as this could be something other than perioral dermatitis. The orange crust makes me think of impetigo which is contagious. Remember, I cannot diagnose, I am just informing you so you seek the proper care.

  33. Ruth says:

    I have a rash around the mouth that usually starts with severe burning sensations even though the area is clear of the rash, and after a few days later the rash begins. Its a redding and peeling rash at the corner of the mouth and under the mouth. It dries up especially in the morning with tightening feels. It flakes and leaves a map around the affected area. Regular touching leaves blisters on the affected area. Its seem to have turned into a monthly problem. I’m 36 years old and a GERD patient. Any help.

    • Well, I am sorry but I cannot diagnose via this forum. But I wonder – does is blister if you DON’T touch it? It almost sounds more like herpes considering the burning, the monthly reappearance and blistering. I would definitely see a dermatologist for diagnosis, that way you know what you are dealing with and can treat it properly. TCM can be an excellent treatment for chronic viral infections like herpes, if that turns out to be the case. Good luck.

  34. awboj says:

    I have this on one side in the crease leading down from my mouth. It is a red patch about 2cm long and 0.75cm wide and at various stages of flare-up it can have 4-5 ‘pimples’ that break and disappear, then re-appear the next day. My GP diagnosed skin cancer and wanted to cut it out! I declined and got a referral to a derm, my appointment isn’t until April. After reading this blog and other info, went back to my Doc and insisted on a doxycycline prescription which I started yesterday. I also find putting on Ella Bache Creme Intex No 2 at night really settles the rash down, but am hoping the antibiotics will do something towards a cure. BTW I actually saw a different doctor at my practice yesterday and he wanted to prescribe a steroid cream. I told him I thought it was PD but he wasn’t convinced. He looked up a medical website while I was in the office and there was a picture of a case that looked exactly like mine in the same location near the mouth and everything. I pointed to the pic and said ‘that’s it’ but he still looked at me sceptically and again indicated I should try steroid cream. I argued, well what if it IS this condition (which I know it is), it says steroid creams are the worst thing you could do, and basically had to beg for the prescription, but the main thing is I got it. I’m hoping I will see an improvement before I see the derm. I don’t think general practitioners are very well-equipped to diagnose this, they must just be trained that whenever they encounter a rash on the face they go for steroid cream.

    • I agree most GPs are not well trained to spot these types of conditions. But I also want all my readers to be aware that many skin ailments look alike to the untrained eye and one should not assume that just because the rash you have LOOKS LIKE a photo that you have the same condition as the person in the photo. What made your doc think skin cancer? Are there any other dermatologists you can get in with sooner than April? That is too long to wait for a second opinion.

      • awboj says:

        What he actually said was that it could be pre-cancerous. He wasn’t concerned even when he knew I didn’t have an appointment until April. Also, it’s not just the appearance that is similar, it’s the whole description, and I have read a lot about it, not just this blog. He already tried Keflex antibiotics and a topical anti-bacterial cream which did nothing. I have had this for a few months now, and when I think back, I briefly had a stint with a steroid inhaler which I had to stop,due to nausea, but the rash would have appeared around that time also, not sure if there is a link there. Anyway as the doc wasn’t concerned about my delayed appointment I’m not worried about it. I am on the cancellation list so may get in earlier, but there are no others in my area. Also the Doxy is not going to kill me either, even if it turns out not to be effective.

      • awboj says:

        So it’s been 3 weeks on the doxy and I continue to put my zinc-based cream on at night and there have been no ‘pimples’ for at least a week and the red area has faded a lot, although still noticeable. The dermatologist rang with a cancellation so I went yesterday. It’s not skin cancer, lucky I didn’t let the GP cut my face! Because of the rather benign appearance of the rash now the derm at first said it could have been folliculitis, however that’s what the initial GP said which was why he gave me Keflex antibiotics and a topical antibiotic cream which did nothing. It was when I went back to him after the ineffectiveness of that treatment that he mentioned the possibility of skin cancer. (I live in Australia and there is a high incidence of skin cancer here so doctors are very aware of any spot etc that might be cancerous, perhaps a little too aware in my case.) So when the derm saw that I’d Hosea course of those antibiotics he said it was probably PD which if so, the doxy would be helping. He took a photo of my face (wish I had done that myself earlier on), asked if I had enough repeats to stay on the doxy for 2 months and advised me not to put anything else on my face and keep my make-up light. I told him about the zinc and he said I could continue that.

        So not cancer. And thankfully I didn’t listen to the second GP and use a steroid cream either.

        • Glad to hear it is not cancer. PD can be stubborn but it will resolve eventually if that is what it is. Two months of antibiotics is a long time. Be sure to take probiotics (like liquid Kefir) between meals (and NOT at the same time you take the antibiotics). I have my patients follow a protocol to restore their healthy gut flora after taking antibiotics, so you may consider doing something similar after the 2 months. Let us know how it goes!

      • awboj says:

        Thanks for the advice, I’ll do that.

  35. Anne says:

    I am in nursing school and I think I have perioral dermatitis as well (I’ve made an appointment with a dermatologist to confirm). I have VERY sensitive, pale skin (I’m English, Irish, Scottish, and Swedish) that gets red very easily with any irritation. I’m not sure if it’s related, but I also have Raynaud’s disease, and I have a family history of rosacea. Anyways, over the past few months, my face has developed a red, bumpy rash with mild peeling that has become worse in the past two weeks. It began as a small spot on my chin and nose creases….now, it’s on my chin, around my mouth area, and around my nose creases (not on my nose). It also expanded a bit to my cheeks where I have a few red bumps. At first, I thought it was acne and that it would go away because I am prone to the occasional small breakout on the T-zone, but I am 30 years old, and I’ve never experienced acne like this before. There are some pus-filled bumps, but no whiteheads or blackheads. Then, I thought it may be rosacea due to my family history and mild rosacea symptoms (flushing and bright red skin when exposed to heat). As did many of you, I made the mistake of trying hydrocortisone cream on the rash thinking that it would reduce the inflammation. I don’t know exactly what caused the breakout, but I DO know that moisturizers on my face make it much worse. Also, it got better while on vacation in Barbados, then worsened again when I returned home. I’m interested to see what the dermatologist will say and what will be prescribed — I’m thinking I may need an antibiotic at this point.

    • Interesting that you mention a family history of rosacea and that you have Raynaud’s – clinically I see this combo often and also with the occasional addition of perioral dermatitis. Let us know what the dermatologist says and if you have success treating it. I still cannot find an answer as to why so many healthcare professionals develop PD.

      • Anne says:

        Thank you very much for your reply. The link between healthcare professions and PD is really interesting! The only thing I can think of that may contribute to healthcare professionals being more prone to developing PD is our very, *VERY* frequent use of alcohol-based anti-bacteria hand soaps. They are great in a hospital setting to reduce the risk of spreading infections; however, perhaps by using it so frequently on my hands….and then touching my face… it is disrupting my skin’s natural balance. After all, anti-bacterial soaps kill 99% of ALL bacteria — this means the good gets killed with the bad. So, maybe the anti-bacterial soap is killing the normal flora on my skin and giving the opportunistic bad bacteria a chance to replicate. Just a thought.

  36. LuAnne says:

    I’ve been recently diagnosed with PD. It started about a month ago but then it just looked like red skin with no bumps. After a few weeks, the bumps started to appear and I decided to see my dermatologist about it. I was prescribed Doxycycline but I had an allergic reaction (severe itching all over my body) so the doc switched me to Minocycline which I’ve been taking for a few days with no itching. However, the rash seems to have gotten worse since but it may be because I had been self medicating with steroid creams and now I’ve stopped that. My doctor has also prescribed Clinagel, which I haven’t received yet because it is very expensive and I had to submit it to my mail order pharmacy program to get the cost down a little bit. I’ve been doing a lot of online research since I found out what I have. I’ve seen multiple posts on various websites by people saying they have seen improvement by using organic apple cider vinegar topically on the rash. Can you comment on this?

    • If your rash is PD, then the exacerbation from stopping steroid creams makes sense and it should improve after a week or 2 on the antibiotics. So be patient in that regard. Keep in mind that even if it heals this time around it may return. I myself used RosacaHerbal Facial Toner (apple cider vinegar-based) on mine and it reduced the redness and kept it in check and eventually it healed with no additional treatment. Was it the ACV or just time? I cannot be certain.

  37. LuAnne says:

    I forgot to ask in my previous post but some of the same people who said they used ACV also said they applied coconut oil to moisturize. Would that be ok? Thanks!

  38. BJ says:

    I suffered from perioral seborrheic dermatitis for about 15 years. My condition involved a red-as-a-beet “muzzle” appearance around my nose, mouth and chin, caused by my skin constantly peeling, regrowing, and peeling again non-stop. I saw a few different dermatologists about it, but no medication that they gave me cured it. I decided to have a “Fraxel” lazer treatment for acne scaring and wrinkles. It wasn’t cheap! And no mention of my dermatitis condition was mentioned, except that I did mention that I had it. To my happy surprise, the lazer treatment totally cleared my dermatitis, and it hasn’t returned and it’s been about 3 1/2 years so far. I had my whole face done, but you can just have certain “areas” done. It hurt, but some people that have had that treatment said that it didn’t hurt them that bad. I think that the doctor that performed my treatment waited too long before starting and the numbing medication that was applied to my face had almost gone away by the time he got about 1/2 way done. But, considering the fact that it did totally cure my condition, I’d go through it all again in a minute, and will if it comes back! I sure hope this helps someone because I looked for answers for years and there is no answer, but this lazer treatment sure worked for me!

  39. Jessica says:

    My doctor diagnosed what I thought was contact dermatitis as perioral dermatitis. I’ve had it for 3 months now, and it’s really starting to wear me out emotionally. I just took Doxycycline for 2 weeks with barely any improvement. But as I was finishing up the antibiotics, I left for Mexico, and spent a week in 80 degree weather. Even though I was constantly slathering sunscreen on my face and laying out in the sun, as the week passed, the rash slowly started looking better. By the end of the week, it had almost no flakes, was way smaller, had almost no pain/itchiness, was pinkish instead of red, and I could finally throw a dash of makeup over it without my skin freaking out. For the first time, I was finally starting to look/feel like a normal person again!

    I then arrived back home in cold NY weather at nighttime, and by the next morning, the rash was horrible all over again. Redness, blisters, painful crust all over…in just one night!!! Either this rash is extremely sensitive to cold weather, or I am allergic to something in my house…but does that mean I should take another dose of Doxycycline as my doctor suggested to me today? I don’t see how antibiotics could help something that seems to be very closely related to my external environment, and the first round really didn’t help much in the first place.

    My doctor also told me to use Desonide cream. I’m afraid that it won’t be kind to my skin, but she insisted that it’s “safe”. I’m still weary, though, and not sure where to go from here (although if I could, I’d head back to Mexico for a few more weeks :P).

  40. Lisa Flood says:

    I discovered that my perioral dermatitis was triggered by peanuts, and have also found I am sensitive to tree nuts. Because I don’t have a life threatening allergy I sometimes “accidently” eat a peanut product, and sure enough, I will have an eruption. I also was plagued with frequent tonsil inflammation and since avoiding peanuts this has also subsided.

  41. LuAnne says:

    I was diagnosed with PD about 2 weeks ago. I’ve been on Minocycline and, while I was waiting on my prescription for Clindagel to arrive from my mail order pharmacy, I did some research and found info on people who have used organic apple cider vinegar and others who have used a yogurt mask to help cure it. I started with the ACV right away and, when I found out about the yogurt, I started using that (it’s been about a week for the yogurt). When I started with the yogurt, I would apply the ACV after washing off the yogurt. By the time my Clindagel arrived last Thursday, I was already seeing much improvement. I did start the Clindagel but have also kept up with using the yogurt mask every day (I stopped the ACV) and my PD has almost disappeared. I’m very happy that it has cleared up so quickly since I’ve been reading that it takes much longer for a lot of people. I feel confident that, even without the Clindagel, it would have cleared up with the yogurt and ACV because it had improved so much with just those two remedies (not sure if I would have needed the Minocycline or not but I’ve been on that the whole time).

  42. Kelli says:

    I think I have this. It started 7 months ago. I began I get a rash like bumps around my mouth. I soon went to the doctor after it started to spread! They gave me an antibiotic and steroid cream, the results were amazing! Just after a week, it reduced dramatically. Yet, it did not fully go away. Now it would reduce to a little rash on the corner of my mouth and then sometimes it would bloom all across my chin, nose, lower cheek, etc. Now, reading some things online about the steroid cream. I discontinued it about a week ago, hoping it would get worse and then slowly reduce by itself after 3-4 days. (I am currently still taking the Antibiotic) and also discontinued facial scrubs and just used a natural ingredient bar of soap. And now it’s even worse, it’s all over my eye lid, reaching farther up my check and my entire face feels like its being attacked and I don’t know what to do anymore! After 7 months of struggling with this, I want answers to get this away immediately. :/

  43. ash says:

    Has anyone found a link to perioral dermatitis and gluten intolerance OR dermatitis herpetiformis (the rash of celiac disease) being misdiagnosed as perioral dermatitis?
    My dermatologist diagnosed me with pd and initially prescribed a steroid, which has made it much worse after stopping. I am currently 1 week into a topical antibiotic but I also saw a naturalist for a second opinion. There is more to the conditions surrounding the start of my face rash but she thinks I may have a gluten and/or dairy allergy. Does anyone have a similar story… with a successful outcome?

    • Lisa Flood says:

      As I mentioned in an earlier post, my perioral dermatitis is from a nut sensitivity, which I discovered through an elimination diet. I definitely think it is worth going through the elimination process. I still sometimes have a mild case if I have inadvertantly eaten a peanut or tree nut product, but it clears up in a few days. And I ate peanut butter almost daily for years, this didn’t become an issue until I was in my 20s. I’m now 54 and this condition has been managed through diet.

      • ash says:

        Thank you for the response, I am definitely continuing with the diet changes. I also have eaten everything/anything my entire life (and have had clear skin) and it wasn’t until now, at 25, after a 30 day cleanse have I had this problem once I returned to eating everything. However, I might add, I have had a horrible immune system my entire life and became severely anemic a few years ago. I find it quite sad that when I went to my doctor and asked about the role of food allergies in my health and skin, she claimed that food has “no effect on my skin” and I have adult acne… so frustrating!!!
        Anyways, I am wondering how you managed to get rid of the pd? It has slowly gotten worse over the past 4 months and has now “exploded” after stopping steroids. I was trying to avoid the antibiotics but the current state of my skin is putting a hold on my life. Do you mind sharing if you did anything other than the elimination diet?

        • I can’t recommend this enough: see a TCM practitioner. Find one near you that specializes in skin conditions here:
          http://www.zizaidermatology.com/blog/find-tcm-specialist/
          Or if there was no one on that list near where you live, check here:
          http://www.nccaom.org/find-a-nccaom-certified-practitioner
          Any TCM practitioner can help you balance your immune system and improve your health. And I would fire any doctor who is ignorant enough to say that what you eat does not effect your skin. That is someone who really does NOT understand the human body.

        • Lisa Flood says:

          I didn’t do anything but the elimination diet, but when I have a flare up I wash the area with an antibacterial soap, like Dial, and avoid using any kind of moisturizer on that area. Which is hard because my skin is dry and that area will become sort of white and flaky. Every night I’ll apply hot compresses to any little blisters, usually there are only 1 or 2. After about 3 days (if I haven’t eaten any nut products!) it will be clear enough that I can cover it with cover stick and foundation until it is completely gone, about 7 days total. I do have other skin issues too, exzema on the nape of my neck and in my ears, but they don’t show and it comes an goes. Don’t lose hope! I was initially treated with a long course of antibiotics too, and while it worked in the short term it always came back.

          • I do not recommend antibacterial soap on the face. The main active ingredient is in those soaps is triclosan which can be an allergen (though this is not very common). Recent studies have shown that when triclosan reacts with chlorinated tap water, it can form chloroform (a human carginogen) and it may also have a negative effect on hormones and the endocrine system. Also, soaps like Dial brand can be very harsh to delicate facial skin. When the skin is stripped of its natural oils and emollients, it becomes more susceptible to irritants and this can lead to additional rashes and irritation.

          • Lisa Flood says:

            Perhaps, but I don’t have chlorinated water and I have been using Dial soap most of my life. I don’t use it on my whole face (I use Neutrogena soap), and this is what works for me when I have a flare up.

      • Just FYI, if your rash was in response to an allergy, we would classify this as allergic dermatitis, not perioral dermatitis.

  44. Chris says:

    Hi, i have had perioral dermatitis for 6 years but only officaly got diagnosed a week ago. I have being useing diprosne ointment ever since i first got the rash which the doctor prescribed for me. I only went and seen a dermatoligist because the rash has taken over my whole face which he said that the steriod in the cream has done. He gave me antibiotics and a week later without using the cream it has flared up emensley and is very dry, itching,burning and even blistering sort of. I dont go back for another two weeks for a check up, is there anything i can use to stop this burning feeling and bring the inflamation down

    • LuAnne says:

      I don’t know if it’ll work for you but putting yogurt on the rash twice a day really calmed mine down. I was also on oral antibiotics while I was doing this. I used Greek yogurt because it’s thicker and it stays where you put it. Put it on and leave it for about 30 minutes than wash it off. I still have the PD but it’s greatly improved and I think the yogurt helped.

  45. Lauren says:

    I woke up this morning with 4 little bumps all conjoined together in a square very close, this appeared on my chin in the very middle, dead center of my chin. I felt it and got scared because I really hardly get acne especially not on my chin. I’m 14, turning 15 next month. But after I felt the bumps and got worried I proceded to try and pop them when I looked in the mirror. When I popped them it was clear puss coming out and then the bottom two got even redder and it’s really dry now. So I looked up any possible things it could be and I found perioral dermatitis, the images seem simular but my case is not nearly as bad, yet. I don’t want it to spread so could you help me figure out as to what is on my face?

    • Hi Lauren, I cannot diagnose via this website. Also, skin stuff can be tricky, even with photographs. But maybe I can still offer a little help. First, don’t freak out. Maybe it is PD, maybe not. Don’t touch it and don’t pop the little vesicles (fluid-filled bumps) – that will certainly make it worse. Does it itch at all? Is there any burning or pain? It could be a little allergic reaction to something, or it could be a minor bacterial infection. I would suggest applying an over-the-counter antibacterial cream (like Neosporin) and see how it changes in the next 24 to 48 hours. If it is spreading, that is rapid and you should see a dermatologist. Impetigo is a highly contagious (but not serious) skin rash that often occurs on the face where it gets touched (around the nose, mouth, chin). It typically develops yellow crust, so it doesn’t sound like what you have, but I want you to be aware of it. Read more about it here:
      http://www.dermnetnz.org/bacterial/impetigo.html
      If you are worried, see a dermatologist. But this may just be a minor reaction to something that touched your skin (eating a mango, coming into contact with some other allergen). Keep us posted, please.

  46. Angela Roberts says:

    Zi Zai….can you tell us what you used to clear your perioral dermatitis. I have a mild case and have kept it mild with ACV and tea tree oil. I clear the spots in a few days but get new ones. It is not overly red either. I absolutely want to avoid antibiotics. Curious what you used. Thanks

  47. Hayley says:

    I believe after much research that this is exactly what I have underneath my nose and all over my chin. Since the day I became pregnant I have has this terrible rash irritating my skin. I had switched to a brand of cleansers and moisturizers that was paraben, sulfate and fragrance free when I knew I was having a baby, because working in cosmetics myself I have noticed it us alot healthier for the baby. The rash seems to get better when left untouched and when cooled down with a cold towel.To anyone going through this, I would say that a major thing that you should not try is to pop the blisters. It is painful and only seems to irritate and make the skin worse and hot. I unfortunately on first impression thought these were pimples and so I think I made it worse for myself, because even though they are thought to not be contagious, mine spread from my nose to my chin within a week of touching them. I will say it must have something to do with hormone imbalance because as I am nearing the end of my pregnancy, the bumps seem to have gone and instead I now have dry scaly face gradually just turning to red.Thank you for reading, I will try going off moisturizers etc. and will write again when something changes.

  48. Nelson says:

    Hello, I have had a rash on my lower bottom corners of my lip for about 1 and a half years. I could not figure out what it was. Switched every product, but it was still irritated and red. So about a month ago I finally was able to allergy tested and it turns out i am allergic to Balsam of Peru and Benzoyl Peroxide. I am aware that Balsam of Peru is in a lot of different artificial and natural flavorings, but most labels just label their flavorings as “artificial” or “natural” without any guidance to what ingredients make up the flavoring. When looking online, they list the types of foods that contain balsam of peru but the lists are fairly broad. Is there anyway you can expand on the types of foods or even certain brands that contain ingredients that make up BOP? Also, my dermatologist prescribed me Desonide about 6 months ago and I reacted horribly to it, or so I thought. I am wondering if applying desonide gel on the rash while coming in contact with the irritant will strengthen the allergic reaction? Do you think if i applied the Desonide now, knowing that I am avoiding exposure to BOP or benzoyl peroxide, it will improve it? It scared me a whole lot the first time I applied it and the rash got way worse. I have applied the desonide to my forearm for two weeks, two times a day and have not had a reaction BTW. Thanks for a response, dont worry if you cant answer the questions thoroughly, what you are doing on this site is awesome and you are helping a lot of people in dire need of dermatology advice. Thanks

    • If your rash is an allergic contact dermatitis, avoiding the allergens topically and internally should allow the rash to resolve fully on its own. But be patient as it can take a few weeks for the skin to heal fully. If the Desonide irritated the rash I would most definitely avoid using it. Perioral dermatitis and contact allergic dermatitis do not require anything topically for the healing to happen. So just leave it alone if possible. I would add fish oil (in capsule form) to your diet to help your body better handle the inflammation. If you can get to a TCM practitioner near you, they can prescribe internal herbs that will help this rash heal much faster with no side effects. Here is more info on Balsum of Peru allergy: http://www.dermnetnz.org/dermatitis/balsam-of-peru-allergy.html and here is more about Benzoyl Peroxide: http://www.dermnetnz.org/treatments/benzoyl-peroxide.html

  49. Jerilyn says:

    I was recently diagnosed with peri-orificial dermatitis (01/24/13). I originally saw my primary care physician last April due to the rash on one side of my mouth and around my nose. He prescribed an anti fungal / steroid topical cream, which I have been using for 10 months twice a day. The cream seems to help, but I noticed after I would use a shower that had soft water I would flare up, and using a shower without soft water wouldn’t bother it. I am a nursing student and spend once a week in a hospital setting, this also makes me flare up. I do have a latex allergy, but I try extremely hard to avoid touching my face while I am at the hospital even though the gloves are latex/powder free. Something there irritates my face. That is why I saw a dermatologist a few days ago. He said that the cream I have been using should never be used on my face because of the potency. So I have discontinued that cream and he prescribed a topical antibiotic, Clindamycin. Since I have started this medications, my face has flared up the worse its been in months. I understand that stopping the steroid cream may have the potential of a flare up. I never wore foundation until I started getting these flare ups, now I don’t dare go without it because I am self conscious of the rash. Also, I would like to mention that I initially had this rash come out of no where 6 years ago and the only significant reason I can come up with is I moved into a house that my roommate had soft water, I saw a dermatologist and was diagnosed with adult acne and prescribed acne medications to be taken orally. I had a bad reaction to this and my face become extremely worsened with a rash and acne and had unbearable itching. I discontinued that medication and moved back to my parents house and the rash cleared up on its own. Never had the problem until last year. Now the rash is located around my mouth, down my chin, and jawline, around my nose, and above my eyebrows. My skin is tight and irritated, but I am assuming it is from the medication changes. Also, the dermatologist stated it may take 2 weeks to clear up and since there is no known reason for why periorificial dermatitis occurs, I may have to use the medication each time there is a flare up but not continuously for the rest of my life because it thins the skin.

    • Jerilyn says:

      I would also like to add that I use Dove Unscented Soap to wash my face. Cleansing facial wipes by the brand Simple. I have also purchased hypoallergenic facial towelettes by Yes to Cucumbers (which I have not tried yet). Cetaphil daily facial moisturizer (but I do not put this on the rash areas ever). Nighttime moisture infusion by Aveeno (also I do not use on the rash ever). Retinol vitamin eye gel (under the eyes at night). Maybelline NY dream smooth mousse cream whipped foundation. Tom’s Toothpaste (recommended by my previous dermatologist visit by the RN). None of these seem to irritate my face. I would be up for suggestions on cream foundations or makeup brands that are free of chemicals.

      • cathy says:

        I also use Dove unscented soap. I was surprised to see the ingredients are not as benign as you would think. I started researching if other people use Dove after seeing someone else on another website said they use Dove too.

  50. Jurgen says:

    I was diagnosed with perioral dermatitis arouns the nasolabial folds. The antibiotics dididnt work and i had it for months.

    Then I came to the doctor regarding another disease and the blood tests showed Vitamim B and D-defiency. To my big surprise, the rash resolved within a week with high doses of vitamin D and B. It was a pure miracle for me.

    Of course, I cannot say for sure that it was thanks to the vitamins. And i cannot say that i wasnt misdiagnosed. But vitamin B-defiency can cause nasal rash and mimic perioral dermatitis. So its good to keep in mind.

    Jürgen
    Dortmund, Germany

    • Wonderful! Thank you SO much for sharing! Yes, nutritional deficiencies are definitely the cause of some skin ailments. I also recommend people take omega 3 fatty acids daily for the general health of their skin to keep inflammation down. Keep in mind, however, that folks with acne should pay attention when taking Vitamin B supplements – Vit B6 can sometimes exacerbate acne.

  51. emma says:

    I think I may have this as I have a rash on either side of my nose (in my smile lines ) and around the corner of my eye. I’m not able to see my Dr for a few months now because I am away working, will this go away by itself if I cut out cleansers and moisturizers?
    I’m a 21 year old female and this is really knocking my confidence ):

    • Don’t stop cleansing your skin, just be gentle and wash only twice per day. Over-accumulation of oils can make the rash worse. Be sure to remove all makeup before you go to bed (this goes for all women everywhere – leaving makeup on overnight is terrible for your complexion). I would be sure to eat very well – lots of veggies and cut out greasy fatty foods. Supplement your nutrition with some Vitamin D and Vitamin B6 and Vitamin B12 as well as omega 3 fatty acids (fish oil capsules). Apply moisturizer to the rest of your face, but again, don’t overdo it – do not layer the stuff on your face: moisturizer AND liquid foundation AND pressed powder is all too much. Avoid applying moisturizer to the rash area.

  52. Jamie says:

    Thank you so much for all the useful information. I also have PD and it’s good to know I’m not alone … It’s terrible and makes you feel very self conscious. I’ve been to the dermatologist and even-though I said the hydrocortisone cream made it worse he said that was impossible? Really? How do they not know about this. He also gave me benzFoam which I’m using now but haven’t seen any improvement, seems worse to me…going on two months and I feel like its taking over my life ugh! I tried tea tree oil, it initially burned but it did take some of the itch away. During the day while at work, I started to use o-live cream which does help with the dryness and burning. Tonight I’m going to start with ACV and yogurt. I’m also going to look into the herbal facial toner you mention. Thanks again for all the information :)

    • Usually cortisone/steroid creams don’t make it worse while they are being used…it is the withdrawal of the steroid that makes the inflammation flare. And I cannot vouch for the efficacy of using yogurt topically, but it can’t hurt. Let us know how it goes for you.

  53. DermaG says:

    I think that I have this issue. It has been on going now for about 6-8 weeks. Not sure how it started, however I ended up using a cortisone cream / and an antifungal cream. It seemed to clear up but then came back worse. This rash is around my chin and mouth area. Previous to this starting I had it around the base of my nose, which became very flakey! I had it once as a kid and it seemed to take forever to clear up.. After reading this, I now realise that the cortisone cream was a bad idea. I really have to get rid of it quickly as I have a big event in 1 week :(

  54. Diane says:

    I’ve had this off and on for about 35 yrs. Tried all the above. Finally a doctor prescribed Doxycycline Hyclate (or similar ) 100 mg… one tablet 2 times a day for about 2 weeks and this WILL make it disappear. The 4 doctors I have been to since do not know what causes this but thank goodness do give me the prescription. Usually happens once every year or every other year and once it was 5 years between rashes.
    I noticed my younger sister had it when she was about 30. Her doctor had been trying everything, but nothing worked until I told her about Doxycycline. My youngest sister is 49 and I noticed her rash over Xmas….she’s at the doctors at this moment. Reason I decided to google this. This is her first time with this rash. We call it “the Chin Rash” in my family as my 22 yr. old daughter started with it last yr. and my 28 yr. old neice also gets it occasionally. What causes it we have no clue! Good luck as I know how annoying it can be.

    • DermaG says:

      Hi Diane,
      I am new to this blogg as I have been having issues with perioral dermatitis. It was extremely bad days ago and I did some research and found some products and have tried them out. I have now noticed a MASSIVE IMPROVEMENT.
      1. Natural yoghurt with all the cultures. (leave on for 20 minutes)
      2. Apple Cider Vinegar (apply topically – does burn a bit, but then I put the yoghurt on afterwards and it cools it down)
      3. I have also been taking a bit of Apple Cider Vinegar with water once a day (drinking it)
      4. Tea Tree Oil – similar to the Apple cider Vinegar in the respect that it does burn a bit.
      5. Flaxseed oil – ingesting a tablespoon a day.
      6. Zinc tablets.
      7. Last but definitely Not least “Pure Organic Coconut Oil”

      I have gone out and purchased all of these items and I have to say, that the yoghurt and the coconut oil is the best! The coconut has amazing properties in it, that give you great relief from the tightness and redness.

      I suggest looking up “coconut for perioral dermatitis” and do the same for all the other products. I am only writing this, because it has helped me greatly in the last 2 days alone! last week and on the weekend I was absolutely dreadful! Now I can see a light at the end of the tunnel. :)

  55. DermaG says:

    Just to add to my last comment. Apple Cider vinegar (ACV) must be organic and have the “mother – plant” with it. If it doesn’t mention “mother” on the packaging… Dont use it!
    Cheers.

  56. Cafe says:

    I am having my second outbreak of perioral dermatitis. I too work in the healthcare field.

  57. hlbebe11 says:

    My face is a mess right now! I can honestly say I am 99% at fault, I did some pretty dumb things out of desperation. I think I might have perioral dermatitis but I’m not completely certain. About a year ago I went to a dermatologist and was prescribed Spironolactone (oral pills) and Ziana (topical gel) for my occasional cystic acne. I used it for about two and a half months and didn’t notice any changes, if anything my outbreaks were worse. The cystic acne appears monthly right after my menstrual cycle.
    A couple weeks ago I started to notice signs of cystic acne developing by my chin so I decided to give the antibiotic another try. I took it twice a day for about ten days, my acne got worse and became quite painful and unbearable. I noticed a few other regular outbreaks as well near my mouth. I spoke with a friend and she suggested I try doxycyline, I took one pill, the first day with milk (not knowing it wasn’t recommended) and another pill on the second day on an empty stomach with water. The second day is where I think I went wrong. I had been having trouble cosmetically covering my cystic acne so I tried a “cosmetic cocktail” I found on Pinterest after reading many raving reviews. The cocktail/ “miracle primer” consists of; liquid foundation, daily face cream, and wait for it… monistat chafing gel (I know, what was I thinking?). About four hours after applying my makeup and the concoction I started to notice a burning sensation around my upper lip, however I was photographing a wedding and couldn’t really do much about it. When I got home that night I immediately took a shower, followed my regular facial regiment; MURAD THREE STEP system and the Clarisonic exfoliating electric handheld brush!! (not a good idea). When I got out I felt a burning sensation around my mouth and eyes. My skin was rough, red, and slightly swollen. The cystic acne which had been present deep beneath my skin for over ten days had now come to the surface along with a couple other small zits, that’s when I thought OH NO I over moisturized. I changed my pillowcase, applied some chapstick and went to bed. When I woke up the next morning my whole face was swollen and bumpy. I noticed three outbreaks right on the edge of my lips and a few flaky/peeling areas as well. I called a doctor and she said to take benedryl and to discontinue the doxycyline. I didn’t notice any changes in the swelling of my face or the burning sensation after two days of taking benadryl every four hours.

    The swelling has gone down a tiny bit. Swollen areas: my throat, checks, under my eyes and chin. Today was the fourth day since I used the crazy cosmetic cocktail. On a side note a few years ago I used almond oil to remove eye makeup and noticed little white bumps under my eyes, I’ve also had a couple acne outbreaks after using heavy facial lotions and anti-aging creams, I stay away from those products now. What do you recommend? I have stopped everything basically, I’ve been using warm water to wash my face, I’ve gone makeup free for the past three days, no chapstick, no lotion, and I’ve been drinking lots of water.

    HELP ME PLEASE :)

    • C. says:

      I myself have cystic acne/ polycystic ovaries as well as my sister our dermatologist put us both on metformin and birth control. It has been such a blessing! I hope maybe it can do the same for you, at least worth a try!

  58. Oliver's mum says:

    Thank you for such a wonderful article. I think my son who is 15 month old has this condition. He was treated with hydrocortosone, then anti-fungal, and now anti-eczema creams (double base, oliatum) – none of which helped at all! In fact it is getting a little bit worse as it is spreading to the nose. My question is, how can this be treated in a child? And do we stop anti-eczema creams? Thank you, Oliver’s mum

    • If the eczema creams have steroids in them (cortisone, hydrocortisone) do not just stop their use – this could cause a serious exacerbation of the rash. Wean him down from frequent use. I would take the information you learned in this post and inquire further with whichever doctor prescribed these meds for your son. I cannot tell you to take your son off any mediciation, as he is not my patient, but you can discuss this with his doctor. This perioral dermatitis is easily misdiagnosed and that may be the case for your son, but perhaps he really does have eczema or seborrheic dermatitis and should be treated according to diagnosis. Will you keep up posted?

      • Oliver's mum says:

        The creams that he had just recently – did not have steroids in them. We have a doctor appointment on Monday for a review and we will discuss what this could be. It is not itchy, not bothering him, it is not improving with anything. We stopped using fluoride toothpaste to see if he has any reaction to fluoride. My daughter has eczema, and it is very classical – itchy, flares up, skin creases on wrists and back of knees, responds well to topical treatment and bath oitment. It always improves! My son, however (the doctor diagnosed also eczema and hence anti-eczema treatment), is not improving at all, this rash has been there for at least 3-4 months, not itchy, nowhere else on his body. So of course I am questioning the diagnosis at this point. I just want my son to have the right diagnosis and the right treatment. Will keep you posted. Thank you!

        • If your son is not scratching much (meaning it is not very itchy) it could still be seborrheic dermatitis. PD, Seb Derm and atopic dermatitis can be challenging to differentiate in infants. Let’s see what the derm says. Good luck! And if you would like to try our herbal ointments for this, visit: http://www.zizaidermatology.com/Eczema-Herbal-Products.html. They are totally safe for babies (and pets, too!) – you can eat them, they are not toxic and the herbs are the same ones we use internally.

  59. Deanna says:

    I think I have perioral dermatitis. It is only on the right side of my mouth and is gradually traveling up toward my nose. I have always had great skin so this is really bothering me. It seems like I may have had a mild case 10yrs ago that healed on it’s own. I have been taking fertility medication recently and wonder if that can be a contributor.

  60. Elizabeth says:

    I am a 39 yr old female, healthcare worker, with first time ever rash that I think is perioral dermatitis. It started about 5 months ago at the base of my nose when I started using retinA and then got a cold at the same time. Maybe the combo of retinA plus the runny nose, plus the kleenex (that may have formaldehyde in them), plus dry skin to begin with, triggered this. There were no major stressors at the time; I had changed jobs about one year prior (new gloves, non-latex). I thought at first it was just irritated dried skin, stopped using retinA and acne cleansers. Started using just vanicream cleanser and/or norwex skin cloths. Then tried OTC cortisone, then tried antifungal, to no avail. Now it is spreading to the nasolabial folds and can be very itchy at times. I don’t want to use oral antibiotics for a month so I am putting off an appt with my PA/derm. Have used essential oils for my son’s dry skin and thieves oil for its germ killing propterties, wondering if some other oil may help with this? Also now wondering about cutting out fluoride toothpaste, cutting out dietary dairy and cutting down wheat/sugars (as this could contribute to inflammation). Thoughts? Suggestions? Thanks!

    • frustrated101 says:

      I used AHA for (2 yrs or so) and once I stopped the tiny pimples started showing up. I went back to the AHA but found it was getting stingy. I then went on an prescribed anti fungal steroid cream (lotriderm). This made everything 10 txs worse and later was prescribed retinA (too painful to use) and oral antibiotics. I didn’t want to take the antibiotics either so I didn’t. I kinda wish I did back then since that was over 5 years ago and I still struggle with the mystery rash.: PD mixed with rosacea??

      PS I also work with medical disinfectants, alcohols and gloves.

      I FIND SUNSHINE MAKES THE RASH ALMOST DISAPPEAR BUT THEN RETURNS IN THE LATE FALL. ANYONE ELSE EXPERIENCES THIS??

  61. DaphneWoods says:

    I believe I HAD this rash. For almost over 10 months. I believe I cured it. It started as an itchy rash just below my eye on the side of my nose. At the same time of onset I also had an unusual bout of pink eye and a nasty respiratory infection. Also at the time I was a long term substitute teacher in a very poorly cleaned (no germ/virus killing cleansers ever used due to some misguided notion about Montessori homeyness even though this was a public school. The often soiled bathroom floors (which were shared by many classrooms) insured a constant transmission of germs to the rug work areas where most of the learning activities occurred.
    I very soon developed the stubborn rash as described by most others in this thread. It started at the right side of the nose and then slowly migrated down one side to the skin around the nostril and then around to both sides and then to just the left side. It never covered the nose but I did feel it irritating the inside of the nose. It had intense itching which sort of stung it I ever itched. At times it had fluid filled bumps. It was reddish. I looked at the fluid under a microscope and thought I saw long things that made me wonder about some weird worm?? But I don’t have any really knowledge there, just guesses.
    I thought it was at times a fungus (athletes foot, candida, ringworm), a bacteria, a virus, a staph?
    I tried neosporin (nada), amoxicillin (which worked 1/2 way on a 10day course but then came back), clotrimazole (worked for a while then came back), miconazole nitrate, bactroban (nada), tea tree oil (very irritated!), Ray’s ointment (tar/sulpher Cayce remedy), Myrrh, steroids: clobetasol propionate, triamcinolone acetonide, cloderm. The steroids all worked great at making the symptoms go away. And the rash always came back. Also tried a collection of dermatologist prescribed benzoyl peroxide and salicylic acid typed products (increased itchiness). No effect on rash. This continued for close to 10 months! giving everything a good try. Cleaning bedding and surfaces and then my daughter began to develop the same rash in the same place around the nose! It was contagious. I was still hoping in was a hormone or some internal issue. After many failed attempts at seeking help through doctors and dermatologists I decided to take the nearly endless prescription to doxycycline that the dermatologist had given me. (I didn’t want to take it at first because I reasoned if this was a fungus then killing the bacteria would only encourage the fungus…) though the Dr. intended a one month course of 2bd 100mg I ended up with 180 100mg pills (?) I started the antibiotics around the same time I found some leftover veterinarian antiseptic prescribed to our demised lizard for a fungus he had: Nolvasan solution. The Vet diluted the Nolvasan, I think, 10 to 1.

    The cure: Doxycycline 2x 100mg the first day and then 1x 100mg for 30 days(or 10 more days than you see the rash) and a once a day swab with diluted Nolvasan solution (at night was good). I used a Q-tip to touch just the effected areas. Nolvasan is a pesticide and must be handled with care. Read the info. No eyes no mouth!! The itching stopped within a day and the healing was consistent and steady. Over the course of a month the rash effected area slowly grew clean as though the rash went deep and slowly lifted out as the infected skin renewed. With the extra doxy I was able to successfully treat my daughter as well. I treated her with 2x100mg the first day and continued 1x100mg for 15 days. What a trial, though. Don’t give up! Perioral Dermatitis does not itch nor does it have fluid filled pimples. So if you have an itch, make sure you make that clear to your doctor.

    • Thank you for sharing your story. I am so glad your rash cleared but I have a couple of things to say about your process. First, I would never use anything that is intended for use on animals on yourself. Animals metabolize chemicals differently and what may be safe on certain animals may not be safe for humans (and this is definitely the case in reverse). Secondly, perioral dermatitis rarely respond well to anything topical. Usually it is advised not to apply anything to it at all. It is likely the internal doxycycline alone that healed the rash as this is the common treatment among western dermatologists. This antibiotic would probably also have cleared a bacterial infection which may be what you had (I do not have enough info to say for certain what the diagnosis of your rash was). But internal Chinese herbs can work just as effectively for PD as doxycycline and without the negative effects on the immune system that oral antibiotics may cause. And keep in mind that perioral dermatitis CAN itch and it absolutely CAN have fluid-filled vesicles, that is part of its typical presentation. I hope your rash stays gone, but if it returns, be sure to get a clear diagnosis from your dermatologist before proceeding with self treatment.

  62. carina says:

    hi, i think i have this as litrally all the symptoms you have said are me!! i find that avacado helps initially but it wont go away completely around my mouth!! should i just hold back on the avacado too and not do anything?? the only problem is whenever i wash my face with warm water it does get really tight and i feel the need to mosturise should i just litrally leave it completely for a few days? thanks

    • LuAnne says:

      My POD was almost gone and then, stupidly, I went and had a facial. The next day, it was back again, not as bad as originally but back just the same. I’ve been using a yogurt mask once a day, swabbing with organic ACV twice a day and I’m using organic extra virgin coconut oil to moisturize my face now. The POD is slowly clearing up again. I had started just using the coconut oil on the POD area but now I use it all over my face and my skin is so soft. I think I’ll keep using the EVCO even after the POD is gone. I’m also using it as a body moisturizer.

    • It is best to leave the rash alone (i.e. do not put anything on it) but I hate that tight feeling – so uncomfortable. You could try applying a small amount of moisturizer to the healthy skin only or even better spritz your skin with some rosewater (avail at health food stores). I also find that applying a little apple cider vinegar (Zi Zai’s RosaceaHerbal facial toner) after I wash my face prevents that tight feeling, even if I don’t apply moisturizer.

  63. Mackenzie says:

    i can’t decide if i have PD or an allergic variety…i had it bad in high school & when i stopped using fluoride & only dove soap it completely cleared…i decided last summer to use fluoride for a few days b/c of tooth sensitivity…it fixed that problem but then my PD flared back up…i’ve not used fluoride on the whole for 13-14 yrs (i’m 30) but have on occasion or at the dentist & generally w/o a flare or if one came up, would go away w/in a wk of not using fluoride…this time it just stayed…i’ve also developed a sensitivity to gluten (last 3 yrs) w/ only intestinal symptoms but figured out after a few months that the PD was DEFINITELY made worse by eating gluten products…often w/in 30 min of eating something i would become itchy again (i have red skin w/ intermittent papules, cycles of drying/flaking skin at each side of my nose & along the lateral & inferior borders of my nasal passages, just at the exterior, can extend out to the nasolabial fold if i ignore symptoms) around my nose…i went to the derm back in aug & they gave me antibiotics & elidel cream…elidel def works, but as soon as it’s not bothering me anymore & i don’t put anything on it for 1-2 days it flares up again..i do work in a hospital & after reading this i’m reminded that my nose itches CONSTANTLY while i’m working w/ patients as i can’t really scratch my nose w/o 1st cleaning them so have to rub against my forearm…i have a coworker w/ another type of eczema who says certain hand sanitizers make her hands flare…she can only use the foaming kind or soap/water…i’m going to try just using soap/water to see if it helps…i currently only use dove or cerave to cleanse & cerave moisturizers am/pm after washing my face…the cerave is new but i started it after the rash had been going on a month..i could cut out the night moisturizer & soap & just rinse w/ warm water but my skin IS very dry naturally so i gotta put something on at least 1x a day…i do use an spf 15 but have for many many yrs as i’m very fair skinned & burn very easily..no foundation, just concealer & have been keeping it off the rash for the most part to avoid irritation…also, my 19 month old daughter started developing the same kind of rash tho to a lesser extent around the same time i did & it’s getting worse on her tho aquafor had helped it until recently (which makes me wonder if it’s simply a fungal infection but then wouldn’t the elidel not work on me?)..anyways, i’ll try to repost about my results w/ not using hand sanitizer but curious if you have any thoughts?

    • Tough for me to give input without having examined you and diagnosing you. I can say that PD is not very common in 19-month-olds, but it is possible. Sounds more like eczema to me, but again, I can’t diagnose without examining you. Have you considered seeing a TCM practitioner for herbs?

      • Mackenzie says:

        when i was a teen the derm i saw diagnosed it as a type of eczema, some particular name i long forgot related to fluoride & the soaps i was using…i feel like there must be some irritant in my environment that is causing it w/ me & my daughter, esp since she started having symptoms when mine flared up again last summer…i’ve been using soap only at work now for the last wk & i’m much less itchy at work than i had been though hard to say if it’s cleared up but still doesn’t explain my daughter, whose is much more severe than mine…i was thinking wet wipes maybe, as there’s alcohol in those too…regardless, i made an appt w/ another derm (we moved out of the area since the last time i went) for this & another issue i have…i would certainly consider natural medicine tho, i’ve seen it work better than traditional medicine for some things in the past…i live in philadelphia now…

      • Mackenzie says:

        another update – i did go to a derm here with my child & of course my symptoms had finally disappeared for a couple days but my daughter’s was still quite apparent…the derm said it looked like PD but didn’t give me anything to treat either of us….mine has of course popped back up but her’s has finally mostly cleared since i cut out gluten from her diet…i’ll be making an appt to see an alt medicine practitioner soon..

  64. Ann says:

    I noticed mine begin after I started using some new anti-aging makeup visible lift by loreaI I thought it might be the makeup or brushes. I work in a clinic once a month and the very next month I noticed my office mate and it looked like she had the rash around the nose also and she was scratching. I bought myself new makeup and brushes and began using acne face wash which I will now immediately quit using. My rash and bumps look exactly like the picture on here and I have a few in the laugh line . I had found that very odd that they were following the line. I am just very glad to know what it is and how to treat it. One thing though, I haven’t ever used steroid cream. Maybe this new makeup like the BB cream and anti -aging with pro retinal ayaluronic pro lastly plus titanium dioxide has been causing it. I used to have clear skin with never a problem until just recently. I’m 43 BTW. Anyway glad this info and pics were out here. Thanks

  65. Francisco says:

    Hi there, I am a 28 year old man. When I was in my 20`s I started to notice this red thing around my face, sometimes it was around my mouth, sometimes around my nose and then it suddenly dissapeared. After a couple of years, when I was 25, I moved to Germany and stayed there for almost three years. When I came back to my homecountry the red stuff appeared around my eyes, but this time it has not dissapeared, it is still there since almost one year ago. I use corticosteroids in order to keep it away, however when I do not use them, it it get worst. I have also noticed that when I have any kind of sexual activity it get more redish (I guess it is because my immune system get boosted, but I am not sure of course). Well, I hope you can give me some advice, thanks a lot in advance.

    Best regards.

    • Where do you live now? Perhaps we can find you a TCM practitioner nearby. I have colleagues all over the world. Any rash can get more red after sexual activity because of the associated flushing.

  66. Elena Ketslakh says:

    Hi! I’ve had PD for about eight months now. I have tried a lot of things my dermatologist recommended me but nothing seems to work. Could you please help find a TCM practitioner in Honolulu? Thank you!

    • These TCM practitioners graduated from the same grad school I did (The Oregon College of Oriental Medicine):
      Karen Tan, Wai Hoa Low, Cole Pacarro, and Leith Nippes. They are all in or near Honolulu, HI. I have not worked with them personally, but I know they got a good education. You can Google them or call their offices to see how experienced they are in treating skin conditions.

  67. Bridget Gough says:

    Hi I have what I think is PD I have a rash around my nose and also my eyes , a few years ago I had it around my nose only and thought it was related to a brass cleaner I was using . Now it started around my nose and eyes about 3 months ago it is very itchy , I have tryed cutting out sugar and wheat thinking it might be a food allergy , have gone back on the clean program a detox diet to see if that helps , a few months ago i went to a dermatlolgist and he told me it was stress ( I am in our house in peru at the moment we have been here for the last 4 months on holiday ) so didnt think it could be stress , he gave me this cream Advantan cream when i use it it clears up but when I stop using it it it flares up alot worse . Where we are in Peru is in the north it is very hot and we surf nearly every day so I am using sun screen everyday but we are here every year and this has never happened before .
    I was washing my face with honey but have run out and am now using clinque face bar , I use rose water for toner and jojaba oil with lavender for mosturiser . I have had acne problems in the past few years and since i cut out dairy and switched to use all natural products on my face it has cleared up .
    I have looked at photos of PD and it looks excatly like what i have .
    any thoughts on what i should do ???
    I have just stopped using the cream again now and its really flared up should i stop washing my face … and stop using the jojaba oil ?

    • Bridget Gough says:

      I just read above that PD dose not itch ? is this true and mine escpically around my nose is really itchy !!!

      • Perioral dermatitis CAN itch. But if itchiness is the main symptom for you, I might think about it being an allergic reaction rather than PD. Something to consider. Keep us posted.

    • Have you read all the comments readers shared on the following 2 posts?

      Am I Allergic to Beeswax?
      How I Healed the Rash Around My Mouth

      Though I cannot offer a diagnosis here, I’d like you to consider that you may be having a possible allergic reaction to the honey (contains propolis), or an ingredient in the sunscreen (the sunscreen chemicals themselves, fragrance or the preservative), or the jojoba oil(which is actually a wax that some people react to).

      • Bridget Gough says:

        The honey i was using in spn before we came to peru and had no reaction , now i am not using the honey and still have the rash so dont think it is that , it is very itchy so maybe it is an allergic reation to something how can i find out ? i was also using jojoba oil in spain and no reaction but i will stop using it , sunscreens are the same sunscreen i have been using for years .
        am going back to spain in a few weeks , shall i see a demotogist or shall i try and find a natural doctor ?

        • It is possible that you have developed an allergy to something you have been using for a long time – that is how Type IV Hypersensitivity responses develop (you have to be exposed over and over to a substance before your body starts to react negatively to it). But it may be something else. Best to get a clear diagnosis from a dermatologist. You can then choose natural treatment with a TCM practitioner or natural doctor (not sure what is available in Spain). Good luck!

  68. Jan says:

    What is the difference between this and seborihic dermatitis?

    • Bridget Gough says:

      I stopped using the jojaba oil and it is clearing up , it is still very itchy but seems to be slowly going away , I have also stopped eatting sugar and gluten for 2 weks so not sure which one is helping but it seems to be getting slowly better . will let you know if it clears up completly . my face looked like the photos for PD although it was very itchy all the time -

      • Severe itching makes me think your rash is more likely an allergic contact dermatitis or other allergic reaction, or possibly atopic dermatitis. While PD can be itchy, itching is not usually the main symptom. Keep us updated.

  69. Kylie says:

    I think I have this it looks a lot like it and like i thought of like something that could clean it so i thought of rubbing alcohol is that safe or no? Also i had a small amount of impetigo on my arm and i was wondering of you think if i would of wiped my mouth with that arm it could transfer on to my face if possible?

    • Yes, impetigo is highly contagious and can spread on your own body. Rubbing alcohol is “safe” but it is very drying and be an irritant and might aggravate it. If you truly have perioral dermatitis, mild soap/cleanser and water is best.

  70. Sharon says:

    My doc thinks mine stems from a vitamin B deficiency. She has me on a Vitamin B complex therapy and 100mg doxycycline 2x a day. I’ll let you know how it goes. Steroids and topical antibiotics made it worse.

    • Do you have cracks at the corners of your mouth (angular cheilitis)? This definitely can be caused by iron and Vit B esp. (Vit B2) deficiency. Learn more: http://www.dermnetnz.org/site-age-specific/angular-cheilitis.html

      • Sharon says:

        I don’t! My rash started on my left nostril and progressed to the other side and it now extends down my smile lines. It is red and has a lot of little white bumps, clustered (ugh). It is especially itchy right now but wasn’t as itchy initially. If this is an allergic reaction, I can’t imagine from what because haven’t introduced anything new to my routine. Very frustrating! I have been nursing for three years so the deficiency theory seems likely but only time will tell. Another weird symptom I had that surfaced a year ago was an orange tongue in the morning that would brush off. I feel like I’m falling apart! Haha

    • Sharon says:

      I’m happy to report that the vitamin b complex coupled with the doxycycline did the trick for me. I took 100 mg twice a day for ten days then 50 mg once a day until it cleared up. That took a few more weeks if that. It hasn’t returned and it has been almost two months. My doctor thinks it is in the same family as rosacea so it can recur. At least I know and have found a treatment that seems to work for me if I do have another outbreak. Thank you so much for this site because it helped me to identify an effective diagnosis and treatment! It almost helped me realize that steroids make this worse! Many, many thanks.

      • You are so very welcome! So glad you found something that works for you. Perhaps consider following up your antibiotic use with a month (or 3) of probiotics between meals to re-establish healthy gut flora – so vital to healthy skin.

  71. SJ says:

    I’m 20 years of age, and I randomly got this acne like rash on my face. I am almost 99% sure it is PD. I had no acne what so ever for the longest time. However, a lot from this article shocked me.

    -I did constantly use moisturizer to keep my face moisturized and I always wore moisturizer under my makeup. I do believe that moisturizer may be the main cause to this rash. I think moisturizer strips away or replaces natural oils (considering my face is naturally). My moisturizer was my sunscreen. I regret using this sunscreen, as Aveeno was always the best.

    Since I do attend university and have constant face to face interactions with different people, my foundation is mandatory to wear. But- my foundation is mineral foundation. I did start to apply toothpaste and did notice a difference. However it is still there, and worse of all, the places it got better has scarred up. Even worse than that is the constant burning and itching pain I have to go through. This is my 9th day, and there needs to be a cure for this, it’s started to become unbearable, I just want to scratch my chin/upper lip away!! Thanks for the article, I have been looking every where for this answer and will definitely introduce this article to my family physician since she believes it is hormonal acne, and I am 100% sure it is not. Thank you!

    • Gianna says:

      I have been struggling with PD for 2.5 months! It seemed to improve a little & then get worse again – but never completely went away.
      I couldn’t get in with the dermatologist as the waiting period was 9 weeks!!!!!
      Anyway I went to see my Dr. On Saturday 9th March 2013. I showed him photos and information that I had researched on. I just didn’t want to be prescribed any sort of cortisone! Anyway, he prescribed me Elidel Cream. For use on PD. Anyway, I have now been using it twice a day for 4 days and it has completely gone! I also got a script for metronidazole (as per my request) but I haven’t need to use it at all. So I have been able to get away with using NO antibiotics at all! I seriously was trying everything, including (doing nothing but use warm water to wash face). I am so thrilled and I highly recommend this cream. It cost me $35 for the tube! :) cheers :)

      • SJ says:

        Thank you Gianna! My PD seems like it is getting better but if it’s not better soon then I will definitely purchase the cream. Is it off the counter medicine or do I need a prescription to purchase it?

      • Gianna says:

        Yeah you do need a prescription for it unfortunately. But it is worth it. I really hope it works for you like it did for me! I was seriously stressing- doing everything that was suggested but nothing worked! Makes you feel so upset & self conscious. This skin disorder is just awful!!!!!

      • Bridget Gough says:

        is it a steriod cream ?

        • DermaG says:

          Definitely NOT!!! That was one thing I was very insistent on! I didn’t want to go back to that – As I think I caused the PD myself by using steroid creams…

          It is for the treatment of facial or eyelid atopic dermatitis in patients aged at least 3 months with 1 or more of the following contraindications to topical corticosteroids:
          1. Perioral Dermatitis
          2. Periorbital Dermatitis
          3. Rosacea
          4. Epidermal Atrophy
          5. Dermal Atrophy
          6. Allergy to topical corticosteroids.

          I have to say that is product is amazing. Very happy with it. I should put up some before and after photos (only 4 days apart).

      • Elidel (pimecrolimus) cream is typically prescribed when steroid creams do not work to reduce inflammation. This product should only be used short-term and only on the affected skin (not on healthy skin). This drug works by blocking the release of cytokines (important cells of the immune system that are partially responsible for the inflammatory process). While we want a reduction of inflammation in skin rashes, we do not want to suppress the immune response in healthy skin or in the body overall. This would have the possibility of increasing the risk of developing cancer or other diseases. In addition to short-term use only and applying only to the rash, anyone using Elidel should avoid or limit sun exposure as this drug makes the skin more photosensitive. Learn more here:
        http://www.dermnetnz.org/treatments/pimecrolimus.html

      • LuAnne says:

        DermaG: Did you stop using the Elidel when the rash cleared up? Just curious if it will come back if you stop. After reading your post, I got some Elidel samples from my dermatologist. I started using it on Friday night and it is much better already. Because of the side effects, I don’t want to continue to use it any longer than I need to, so I’m hoping I can stop as soon as the rash is gone. Oh, and if you go to their website, you can download an offer where you can get it for $0 copay.

  72. AngryFace! says:

    I was recently diagnosed with PD. My dermatologist prescribed Xolegel gel and Metrogel both seemed to make it worse. She also gave me samples of Locoid Lipocream and it seems to be working but now I am freaking out because everything online says I shouldnt use steroid creams for this condition! But it is the only thing that seems to help what should I do? Why would my dermatologist give me this if I shouldnt use it?

    • She gave it to you because it does work to reduce redness and inflammation and because western medicine has little to offer for treatment of rashes beyond pharmaceuticals. That being said, now that you have started using it, do not stop suddenly. Titrate off it slowly (use less and less each day) to avoid a rebound flare up.

      • AngryFace! says:

        Thank u for the reply. It has been one day since I have used anything on my face including the Lipocream. Right now my skin so incredible dry I can’t image putting anything right especially the PD places. Yesterday I put a little vitamin E oil from the capsule on the surrounding areas (not the PD areas) just to get a little relief from the dry tightness. I have been drinking tons of water too. Usually I do not have dry skin issues I think it is from all the stuff I have been trying on my face lately. Any suggestions?

  73. Spencer says:

    I am a 24 year-old male and have been experiencing this dermatitis under and around my eyes for about five months now. I have been working in a hospital for 2 of those months, and in a computer lab associated with the hospital for over a year. I’ve battled with acne since I was a teen and over the past couple years, through self experimentation, noticed that it was directly associated with dairy and gluten. Those Western Dermatologist (and doctors) are usually are so ignorant about the effects of diet/lifestyle and immediately jump to a drug for the symptoms. (I digress).

    I stopped using Proactive 2 years ago and have since used coconut oil and a revised diet to avoid acne. With the flare up of dermatitis, I stopped using coconut oil and a natural moisturizer and have noticed that it does not flare up as much. For a while I wasn’t even washing it until I noticed that Dr. Bronner’s 18-1 soap actually does not disturb it too much. I am reluctant to put anything on or around it, but would like to use an SPF moisturizer to avoid possible skin issues in the future. Hope this is useful info.

  74. SJ says:

    Hey Spencer

    If you scroll up, you can see my post. My PD has not completely disappeared and it’s been two weeks now. I actually noticed that consumption of too much dairy does make it worse. I think dairy is one of the underlying factors as to why PD occurs, but at the same time I feel like SPF sunscreen (that I used as a moisturizer) made it way worse. I tested it out yesterday on my upper lip and what do you know… I broke out completely on my upper lip, believe it or not. I am going to try Aveeno moisturizer and see if that works out. I also heard that Dove soap is a miracle for any type of skin irritation. I will keep you posted :)

    • From a TCM perspective, dairy will usually aggravate this type of rash (most skin conditions, actually) because it is Damp in nature and Perioral Dermatitis has a component of Dampness (or Damp Heat) to it. Avoiding dairy, spicy/greasy foods, alcohol, and shellfish is recommended.

      • DermaG says:

        LuAnne: I have decreased the Elidel cream to once a day. So just weening my skin off it. I’ve only been using it since the 9th March which isn’t too long at all!!! So happy with results! I really hope it works just as well for you & everyone else! Also thanks for the tip about getting it for free :) it would be nice to keep some on hand but the tube needs to be thrown out after 12 weeks of opening. Perhaps I’ll get a spare and leave it unopened… Hoping to never have the need again! I really hate PD!!!

        • LuAnne says:

          Check with your doctor, too…they might have samples you can get. I got 2 sample tubes from my doc and, the way it looks, I’m not even going to finish one before it’s completely cleared up. It’s about 80% better than it was after only 3 days!

  75. liz says:

    is it okay to put vaseline on the area arount my lips and mouth?

  76. martin says:

    My wife has a similar rash could it be what I just read here ? How can I post a picture of it ?

      • AngryFace! says:

        Hey guys. Just wanted to up date everyone. My PD is almost completely gone. None of prescription meds worked for me. I used pure unrefined virgin coconut oil as a cleanser and moisturizer. I also use grapeseed extract oil sometimes for the same purpose. (Both organic). I also cut back on eating sugar. What helped with the pustules and rashy area was diluted orangic 100% tea tree oil. Small small portion of water with 3 or 4 drops of tea tree oil. Then i dipped a cotton ball in the mixture and then applied to rashy areas on face. This dried out the pustules and smoothed my skin. I also used diluted organic apple cider vinegar in the same way but not on the same days. Both these options can dry out your skin but the coconut oil and grapeseed oil extract helped with that. I am so happy my normal skin is back! I hope this helps someone else recover!

  77. LuAnne says:

    Elidel update: I used Elidel for 2 weeks. The improvement in the first few days was amazing. However, after about another week, it started getting worse again. I stopped after 2 weeks because (a) it was no longer helping and (b) I really don’t like the long list of potential side effects. The rash on my chin is still pretty much cleared up but its much worse around my nose. Not really too many bumps but very red and sore, like if you’d had a bad cold and your nose was raw from blowing it. So now I’m back with yogurt masks and acv. I also use organic extra virgin coconut oil to moisturize. Has anyone tried calendula cream? I’ve read that California Baby calendula cream has helped some people. I have some so I’ve applied it a couple of times but I don’t want to waste it if its not going to help. I keep buying different stuff to try and it’s getting expensive. Does anyone take oral supplements that have helped? I tried zinc for a while but I didn’t feel we’ll while taking it so I stopped. I really hope I don’t have to spend all summer like this. By the way, I’m 57. I thought PD was more a problem for younger women?

    • DermaG says:

      Oh LuAnne, I am sooooo terribly sorry that you haven’t achieved a satisfactory result with the Elidel cream. My PD has cleared up, sometimes a few little bumps come along when I use a different moisturiser. I will have to go back to using the organic coconut oil and Grapeseed oil. I have used the metronidizole topical gel (antibiotic gel) as well on some days. My Dr, told me to use nothing at all but the Elidel cream. No facewash soaps or any type of moisturiser. Just Elidel on its own. I really feel for you LuAnne, as I was desperate to have it cleared up and do think PD is typically found in younger women. I am 32!! Perhaps try the Metronidizole Gel. It may help you. Everyone is different and some things may work for you, but not for others. :(

      • LuAnne says:

        How long did you use the Elidel cream, DermaG? My doc prescribed Clindagel when I was first diagnosed. It was VERY expensive, even with insurance, but I got it anyway because I so wanted this stuff to go away. It didn’t work. It’s so frustrating! I’ve never had a problem with this before so I am really confused as to why it would get me at this stage of my life. I’ve never even had acne when I was a teenager. Zizaidermatology, is it unusual to get PD at my age?

        • I looked back at all your comments but I didn’t see your age anywhere. Perioral dermatitis is most common in adult women. I most commonly see women in their 20′s through 40′s in my clinic. It is not very common in children but it can occur at any age. Rare in men. Women who wear moisturizer and then apply foundation cosmetics have 13 times greater incidence of developing perioral dermatitis. This is suspected to be due to occlusion of the moisturizer against the skin.

          • LuAnne says:

            I’m 57. I’ve always used moisturizers but rarely foundation and almost never in the last few years. What are the treatments that are most effective for the women in your clinic?

  78. Alyssa Edwards says:

    I normally have clear skin, I will occasionally get a pimple or two about once a month. Recently I started noticing small red bumps around my mouth and on my chin and they will not go away! They are also itchy. I have had them for 2 weeks now. I use Clinique the 3 step skin care system I have forever. I have even stopped with the second step all I have been using is the mild bar soap and moisturizer. I dont know what too do! :(

    • Spruce says:

      It’s funny you should say thar as I too use Clinique 3 step and think that it might be the cause. I have stopped using it for a week and it has definitely calmed down but not yet gone. I have been using an anti- fungal cream also as this helped once before.

  79. Brittany says:

    Hi, I am 18 years old and I’m not positive I have this but a lot of the symptoms I believe I have. Around 2 months ago these bumps would appear on the corner of one of my eyes.. They were red and kind of itchy and sore.. I know better then not to scratch. I researched it right away and thought maybe it was eczema. I started putting petroleum jelly and aloe on it and it went away in a few days.. i didn’t think much of it because it wasn’t that noticable. I had a few outbreaks since then.. Usually around my eyes. But the last couple of days the skin around my nose has been dry and a new patch has appeared on my right eye. Monday I noticed more bumps on my left eye more under my eyebrow to e corner of my eye. I let it be not thinking much of it.. Then last night after exercising I took a shower and noticed how dry it was and noticed more bumps on each side of my chin. I put petroleum jelly on before bed but when I woke up my eye was swollen and the bumps got worse.. Same with the ones in my chin. I researched more today and started to think it was perioral dermatitis. I wash my face at night usually if my acres bad with a face wash, and I do wear foundation but I haven’t used any new products that I think could have caused this. I’m desperate for answers. My mom called the doctors and all they said to do was take Benadryl then see them if it didn’t help!

  80. J.R. says:

    Hello,
    I am a male, 33 and I was looking for information on how to tell herpes from pimples when I saw a mention of perioral dermatitis. I found this site by searching that term.
    I have been getting small red pimple like bumps on the outer edge of my lips for a number of years now. My friends would tease me about cold sores, but they have never presented with the symptoms of cold sores. With occasional exceptions of when I have tried to ‘pop’ them and just caused it to become worse as with actual pimples sometimes, they never look anything like the pictures I see of herpes.
    They often appear when I break out and often in winter after I would start putting on lip balm. Often they are accompanied by other “pimples” on my face. They are all red and tender and often develop several very tiny puss pockets that look just like two or three very small pimples. Looking closely at the skin these little pimples correspond to the number of micro pores along the ridge separating ‘lip skin’ from skin. A year or so ago I also started getting small irritations and pimple like blisters around the eyes. All of the various bumps fit in with the pictures I am seeing for perioral dermatitis. NOT floppy blisters, NOT filled with clear fluid, NO tingling before during or after.
    Dermatologist was never sure what I had because the by the time I would see them the areas were just red and obviously had been irritated but not identifiable. More then one agreed it did not look like herpes. They would say without seeing the ‘blisters’ they could not really determine. Very frustrating. These things often hurt, but can be drained like a pimple for faster healing, except the ones around the eyes, they just crust and generally act rash like.
    But reading through this page I feel this is a likely cause! I will present the concept to my derm next time I go in and I will change lip balms and moisturizers or stop them all together if I can.
    Glad to at least have a workable and likely looking idea now!
    -Tek

  81. ashley bowling says:

    sOk my is that i started off with cold sores so i bought abreava n started using the abreava i did not know your not suppose to rub it everywhere n i did now on my chin i have a really bad looking like chapped with bumps… it hurts really bad… even on my smile line…

  82. jane says:

    I had a rash both sides of my nose which fit in with your description of Perioral Dermatitis! I used steroids at first as I thought it might be eczema, but this only made it worse. I was also given roseacea cream by the doctor, which did not help. For months is stopped using any make up or moisturiser on the rash in my daily life, but it did not improve! On Saturday nights, I would cover it with ‘napoleon pro palette concealer and would always find the rash looked slightly better on Sunday morning. So I tried putting the concealer on the rash everyday for a month or so and the rash cleared up completely. I’m not sure if it was just that it protected the rash from the cold dry weather or if there is something in this particular brand of concealer that clears it up, but definitely worth a try if you are as frustrated as I was with the ugly rash! I still always have a breakout of a few bumps that moves around so I am going to still see a doctor and see if I can get rid of it completely!

    I would be interested to see if this concealer has the same effect for anyone else!
    http://napoleonperdis.com/aus/makeup/face/concealer/pro-palette-concealer.html

  83. Susan Bond says:

    I have had this in the past and it’s back. I only remember going to the dermatologist and finally getting some relief. I don’t remember what she called it… but I don’t think this was the name she gave it. Was it called something else about 10 years ago? Last time it was definitely around the bottom and bridge of my nose. This time I had a small flareup on my chin that went away by itself, but now have it in the same two places as before… on only the right side. You mentioned clean pillow cases. Since I sleep mostly on my right side… maybe that could be one way of preventing it again. I was hoping for something I could do without involving a physician.

    • SS says:

      APPLE CIDER VINEGAR CURED ME! (apply to cotton ball and apply 1-2x daily to affected area)

      • Livia says:

        Lately Witch Hazel has been helping and as I read from another comment, apple cider vinegar may help.

        • martinantonell@gmail.com says:

          I tried the fucidin ointment all over my face in d morning and apple cider vinegar before bed, the bumps and redness are reduced instantly and the rash dries within 2days, I only need to repeat this method once a week not to overdose d skin and to keep it from multiplying again until it goes away all together.. I hope d summer sun helps it dry too as I guess using sun block over d rash stimulates it as well (making d skin moist and d yeast flourishing in these conditions).
          Sent from my BlackBerry® smartphone from GO Mobile

          • Livia says:

            Ah fucidin, I will try it if it acts up again. The witch hazel continues to work for me. Slowly drying the rash, but not all together gone yet.

  84. Jocelyn says:

    My daughter was diagnosed with PD about a year ago. She has tried Clindamyacin and Cloderm. The rash seems to come and go. We are now completely off of the prescription creams and using a natural face wash and cream. It has seemed to get better after getting off of the creams but the redness has not. Do you have any suggestions for vitamins or natural topical creams. She is fifteen. We noticed this came about two months after she had her first period and wondered if hormones had something to do with it. She has very fair skin and is a red head. She is very self conscious about it and we want to help her. The dermatologist has said he could not anything else except recommended a plastic surgeon for some redness around the nose but she still gets the rash around the nose and across the upper lip.

    • Ah…hormones could be exacerbating the issue but redheads have a tendency for sensitive skin and/or red complexions. Do you live near any of the practitioners on my referral list? Take her to a TCM practitioner for a full consultation and some internal herbs. That would help the most. You may consider adding fish oil to her daily supplements to generally help reduce inflammation. There are other nutritional supplements that may also be quite helpful, but without examining the skin myself, I can’t make an accurate suggestion here.

  85. Jocelyn says:

    Would you stay off the Cloderm? It does help but I hate using drugs if we can fight it naturally.

  86. shawn says:

    I’ve been using docycline 100mg for a week now and my face has gotten worst. …not sure if it’s working or not. Everyone keeps saying it has to get worst before it gets better. …….I’m hopeful.

    • Bummer. However, I do not subscribe to the idea that PD needs to get worse before it gets better. I do suggest trying to be patient as the condition may go through some of its typical ups and downs even during appropriate treatment. One week is not long enough to determine if the treatment is what is causing exacerbation. Give it 2 to 3 weeks total and if it continues to worsen, go back to your dermatologist. Good luck.

  87. ChelseaB says:

    I started noticing my perioral dermatitis when I began dental hygiene school 2 years ago. I thought that it was from the masks that we wore but after being out of school for weeks I still have the rash in the place where a mask would be worn. Many of my classmates had similar rashes too, which we all said it was ance due to the unneccessary stress our teachers put us through lol. I live in Tennessee and it seem to get the worst in extreme weather. Either very hot or really cold and dry. I eat very healthy and use all organic body products. I will try to wash my face less and just use warm water. I’ve heard tea tree oil is good for rashes…would that be something to try?

    • What is this connection with health care workers and PD? I need to figure this out! Glad you shared your story.
      Tea tree oil can be applied directly to the skin (unlike most essential oils which need to be diluted). However, I caution you here because while some people report it has helped, others have reported that it made the skin even more irritated. If you decide to try it, use the smallest little dab possible (apply it to a Qtip/cotton swab then dab it on your skin).

    • AngryFace! says:

      Tea tree oil worked great for my PD, but it does need to be diluted with water as it can sting a bit. I recommend you google tea tree oil benefits for topical skin use. Very interesting facts!

  88. Kristin says:

    I think this is exactly what I have in small patches around my nose. The doctor prescribed a cream called Cloderm (clocortolone pivalate). It seems to be making it worse and I’ve been using it for 2 weeks. It’s itchy and irritating. I am also pregnant and the doctor said that could be a reason for the flare up because my immune system is low. I do remember getting it in the past but it cleared up after I went on Acutane. Since the Acutane, it’s flared up soon after I finished the 6 month program.

  89. Shlendie says:

    I am having a serious issue with figuring out what is the cause of my itching burning lips. A couple of months ago I started getting a red line surrounding my lip line, it burned and itched constantly. I am a big lip balm user especially in the dry winter and when this red line appeared I used all sorts of lip balms medicated and natural and petroleum jelly but nothing helped. I am a cosmetician and so I HAVE to wear cosmetics for work so being cosmetic free for less than 10hrs a day is not an option for me  I’ve never had any reactions to cosmetics before and since anything and everything made them burn, I could not link it to one particular thing. A while ago I stopped using regular toothpaste and mouthwash containing fluoride and alcohol because those defiantly burned my lips but very mildly. Then I found the product therabreath which did not burn but after reading your blog I realised it has Aloe Vera Leaf Oil in it.
    I started looking up online and a lot of sites recommended OTC cortisone cream which DID initially clear up the rash but as soon as I stopped using it, it came right back. The doctor has now given me a steroid cream as he said it was contact dermatitis and it has cleared up the rash but something keeps triggering it after a while. And waiting for an Allergist appointment takes too long. I have read your blog and am now going to go out and invest in some new products without certain ingredient, so fingers crossed!
    I have been wondering however if all this could be triggered by an excess presence of yeast in my body? My reasoning being (and I apologise if this might not make medical or any kind of sense!!) that for the longest while I could not think of why my lips were all of a sudden acting like this and then I realised that around the same time, my sinuses were getting very blocked. (My doctor diagnosed it as chronic sinusitis and again gave me antibiotics first then changed it to steroid nasal spray when the antibiotics did not work.) My independent research however, led me to a medical study stating that chronic sinusitis could actually be a fungal infection (Candida) rather than just a bacterial infection and the same rash around the lips was an indicator of a fungal presence (so in actual fact the steroids/antibiotics are not doing much at all). At the same time all this was happening, I was also having a reoccurring yeast infection! So the whole yeast problem seems to be also a reoccurring theme. Revising my eating habits I realise that my diet does infact consist of a LOT of yeast products and will am going to start cutting out yeast products and sugary foods and see if this helps at all.
    Do you think that there may be a connection to this in any way? A this point I have lost hope in going to the doctors for a solution, over the past few months nothing has helped and one doctor even told me that I was making all this up!! Even when my lips looked like I’d drawn clown makeup all over them. I did take some time off work in order to stay makeup free and see if it clear up, and it did for a bit then it came back. I also use to suffer from eczema when I was a child but I have not had it for about 15 years now and never around the lips.

    • Bummer. Sorry you are dealing with this. Just to be clear, anything I tell you is simply for your own educational purposes since I cannot diagnose you from here (I don’t have enough info to make a diagnosis anyway). But here is a possibility about your situation: my guess is that you developed a sensitivity to something in the lip balm or lipstick or other cosmetic used on or near your lips. Your past history of eczema indicates you have the potential to develop such allergic responses more easily than other people might. Antibiotics are so over-prescribed and I especially think they should never be prescribed for sinus infections (Chinese herbs are safer and more effective). Antibiotic use will kill off the necessary bacteria on your skin that keep the yeast under control. So I surmise that you developed an allergic reaction which caused the initial skin rash, then the imbalance of skin flora and pH of your skin has caused the skin to remain inflamed and sensitive. Topical cortico-steroids will reduce inflammation (swelling and redness) but they work by suppressing the body’s ability to respond to the things that triggered the inflammation in the first place. When you stop using the steroid cream, the body is then allowed to respond again (the trigger has not been eliminated, and now the body responds with greater inflammation than before), and the rash will flare worse than before the steroids were first applied. So if you are currently using steroid cream, do not stop cold-turkey. Instead, slowly titrate off of them (use less and less each day over the course of 2 weeks to wean off them). This will help reduce the risk of a rebound flare-up. I would simplify the number of cosmetics you apply to your face. I would avoid the use of anything containing beeswax (aka Cera Alba), this includes mascara and eyeliner and lip balm and lip stick and lip gloss. There are substitute products that do not contain beeswax available. If you like wearing a bit of color on your lips, try Zi Zai’s Tinted BeeswaxFree Lip Balm. Good luck and keep us posted.

  90. Olivit_nha says:

    My daughter suddenly develop this problem and we have taken her to the kaiser yes they did say that it is infact dermatitis from what they gave us for med it did not work. I really want it to be cure !

  91. Jane says:

    does toothpaste help rashes?

    • Do you mean applying toothpaste as a topical treatment on a rash? Hmmm….maybe someone else can chime in here. I have never found toothpaste to be helpful for anything but making your mouth taste better and for spackling holes in the wall in a pinch.

  92. LuAnne says:

    Actually, in the case of PD, toothpaste with fluoride is identified as one of the culprits that can cause the rash in the first place. I don’t know if it’s been scientifically proven but I know I switched to non-fluoride toothpaste when I had it and I just stuck with that even after the rash went away. I’m pretty sure it wasn’t a cause of my PD because I switched toothpastes long before the rash started to go away.

  93. Katharina says:

    I have experienced tiny bumps around my nose since few months. Eventually it spread around my mouth and chin and I wasn’t sure what it was till I read your blog. I try to eat well and use only organic products on my face but still dealing with it though. I found that fresh basil and mint leaves with a pinch of turmeric ,mix together in a blender and apply as a facemask on the affected areas heals acne and any other inflammation on your skin. I am on my second day and my skin feels fresh and clean and the tiny bums are despairing. Basil has antibacterial compounds that makes it as a good cleanser,and detoxifys your skin. Mint prevents from dryness and cleans up pores and turmeric helps you defeat the signs of aging plus takes care of scares and inflammation.

  94. Terry says:

    I think I might have this one minute there was nothing thee then a little rash started and withinh about 2 hours patches around my mouth chin and nose

  95. tina bivins says:

    Work in healthcare…im wondering if it has something to do with the wearing of a mask. We breathe our own hot breathe onto our faces all day.

    • Hmm…interesting point. But I don’t wear a mask and neither do most of the nurses I treat. So there must be something else contributing. Do any of your coworkers also have perioral dermatitis?

  96. Lynn MacDonald says:

    I am soooooooo sick of dealing with this rash around my mouth. It keeps me home because it is so dry and flakey…red and sore…tight….itchy at times….urghhhhhhhhh : (((((

    • EL says:

      You really should go to a physician and have them write you a prescrip for Nystatin cream – you can get one with steroid or without. You have a yeast infection of the skin. Nystatin is extremely effective – mine cleared up in less than a week. I had tried more conservative measures such as Nizorel, Selsun Blue (salicycic acid), coal tar shampoo, Clotrimazole cream, probiotics, tea tree oil, Vit E oil, zinc soap and cream. I also stopped all moisturizers and creams but NOTHING worked for my stubborn yeast infection except for Nystatin/Triamcinolone cream. In less than 5 days, I had no more scaly, dry, cracked bleeding skin under my nose and upper lip!! FYI perioral dermatitis is a descriptive term which basically means skin irritation in and around the mouth – it can include any number of skin conditions but based on your description if sounds as if you have seborrhagic dermatitis which is caused by Candida yeast (it sounds gross, but this is also what causes vaginal yeast infections). If you have a history of eczema and or dandruff, this is the likely culprit. For whatever reason, your body’s immune system has been unable to keep the normal yeast flora on your skin under control. Normally most people’s immune system can keep the normal bacteria and flora in check but sickness, fatigue, allergies, hormone changes, etc can weaken your immune system thus allowing the yeast to get out of control and lead to infections. Be sure to continue the Nystatin according to your doctor (usually two weeks) even if your skin clears up or the yeast will come back. (BTW, I’m a PA by profession and have done a lot of research into this condition.)

      • E says:

        As far as i have found, research has not shown yeast to be the sole cause of perioral dermatitis. Do you have reference to the research you speak of that shows this? I would be interested in looking at the study. Thanks!

  97. Lynn MacDonald says:

    I use natural toothpaste…..no difference….. It started six weeks ago……at corners of mouth (red) and around the edge of uppper lips…..now has spread to right upper eye lid….and first under my left eye and now underf my right eye (just two small lines of it). There is also a little patch next to my mouth on the right side. It causes me to stay home often….I have meetings to go to and just want to hide…..avoid talking to people as much as possible….sure that people are staring at my freakish face…..like i have this contagious mess all over me……… I put a little tiny bit of vitimin E from a capsule on it tonight…just to give some moisture……..i read this wasn’t good to do above (i used the vit E before reading).
    When I went to the doctors she thought it was herpes…a cold sore…… I tried to tell the doctor it wasn’t……I’ve had a cold sore before…i know the difference…. I am not a pill taker…but I am at the point where I think I might need to go get a prescription just to get it under control…… It’s taking over my life……it might seem stupid but is……… : ( any ideas???? Thank you..

  98. La says:

    I definitely have it.
    Have not been using steroid creams nor taking any medicine. Have clear skin generally though skin that gets dry (have had gutate psoriasis for a few month period before).

    Wear alot of moisturiser for this reason and living in cold conditions. Also probably use too much foundation. maybe my makeup remover or the face mask I used created the over dryness and caused the outbreak.
    Very frustrating as its getting worse and all I want to do when I go out is use thick foundation to cover it.

  99. This is a great post! It’s exactly what I have and it has appeared twice – triggered by pregnancy. I however do not use commercial moisturizers – I follow an non-toxic routine of the oil cleansing method. But I was using steroid creams to keep it under control, and stopped a few days ago. I’ve been using diluted apple cider vinegar and essential oils like tea tre oil and rosemary, which I’ve read are very effective. Do you think I should discontinue those treatments as well?

    • I hope you weened yourself off the steroid cream (not just stopped it cold-turkey). Rosemary essential oil should be diluted with jojoba oil (or another carrier oil) before you use it topically on the skin. Tea tree oil can be used on the skin without diluting it. If they are not irritating your skin, I see no harm in trying them to see if they are effective for you. You may want to change up your oil-cleansing ritual. PD often gets worse with too much oil applied to the skin (but not always, so see how your skin responds). Keep us updated!

      • Thanks for your help! I do dilute the oils in almond oil. I didn’t wean myself off the cream – I thought I was supposed to go cold turkey? I also got an Omega 7 supplement from an herbalist. I’ll cut back on the oil cleansing method and just try water, then. I also went gluten-free a few months ago and it really helped the eczema on my hands, but hasn’t helped my face. The herbalist suggest I go dairy-free to see if it helps, too. What do you think? Mine seems to be triggered by pregnancy, then made worse by steroid creams.

  100. Isabel says:

    HI,
    I’v had perioral dermatitis for about 5 months now. It started off very small and then spread to all of my chin, under my nose and in between my eyebrows. I am on a gluten free diet and cut out sugar (except in fruits) that seemed to help but it never goes away fully. i don’t use any cosmetic products either. I recently got a blood test and figured out I was very low in iron. Could that be the problem? I use a natural zinc chamomile cream on my face which also seems to help a bit. Also I now take a multi vitamin and iron supplements. If it is because of my iron deficiency how long would it take to see an improvement if im taking 100 mg of elemental iron? Thanks!!

    • It is possible that iron and zinc deficiency are part of your underlying imbalances. There is a nutritional supplement that would be great for you, but it is only available through licensed healthcare providers. It is a mineral supplement called Chezyn made by Standard Process. You want to be cautious when taking mineral supplements because you do not want any one mineral to be out of balance with the other minerals in your body. Plus, many of the over the counter supplements are very challenging for your body to absorb. See if there is a nutritionist, acupuncturist or naturopath (or even your dermatologist!) who can order Standard Process products for you. Most of the time I see improvement in skin conditions within 2 to 3 weeks of starting supplementation (if the supplement is the right one and if the body can absorb it properly).

  101. Livia says:

    I have developed what I believe is perioral dermatitis. Mainly concentrated at the corners of my mouth, but has shown up just under my nostril openings and a couple of tiny spots on the outer edges of my lower eye lids. I am in my mid fifties and have had gorgeous skin since my mid twenties. Other than menopause which went smoothly, the only changes I have experienced are: hypothyroid, unexpectedly, for which I now take 15 mg of desiccated porcine thyroid in an acidophilus filler, a thyroid support supplement called Thyroid PX, and being more and more health conscious I am all but gluten and dairy fee. My thirty year old daughter experiences this similar rash, but for her she claims it is caused by a gluten intolerance. Can an intolerance all of a sudden attack me like this? I have never had any allergies all my life. My rash is never itchy, more like prickly and sore if I touch it. I tried out a cortisone cream with no improvement. Now I am using Natural Skin Healing Ointment by Thera Wise, which an ND gave me. It seems to relieve the dryness and perhaps the soreness but I cannot say it is reducing the rash. The minute blister-like formations seem to need to dry up on their own. The other day the rash seemed to be improving and then the next morning a new group right under my nostrils appeared! It is very puzzling. I no longer use it, but for a couple of years I was using Ombra Melkfett on my lips every night to relieve dryness. Based on some of what you write in the Aug 22 2012 article I wonder if I have cause this to happen. I have been considering to see a TCM Dr. for my thyroid issue, maybe this would be another reason to explore a TCM avenue.

  102. Lisly says:

    I have been suffering from a very bad rash around my mouth every summer for 3 years in a row. I live in New Mexico and often travel to California to see my parents in the summer. I first started to get cracked lips when I started wearing braces and thought that this might just be dryness. To start with, I have always been dermatologically challenged. But as the years go by, my skin problems around the mouth got worse. I was blaming it for the dryness in the air and the heat so I stayed home most of the time which made me sad since I always love the beach in California. I even watched my diet and made sure I stay away from crabs and shrimps (which i dearly love!) I just get really anxious when summer comes and dread the dryness, pain, itch and the flakyness which last the entire summer long. Just a few weeks when spring came, my friends and I went to Albuquerque to have lunch. It was not that hot but when i got in the car, I felt the heat just consume my face. That night, the itch hit me and I was in hell for the next week. I decided to see my dermatologist and he himself could not figure what it really was. He decided to work on my acne first which started flaring up too just when the weather starts to warm up.
    Since I read about your blog, it gave me an idea of what other things I might be allergic. I should look at my toothpaste. I use Vanicream a very lite moisturizer and Blue Lizard as sunscreen while I have prescription Differin, Finacea and an oral antibiotics. I see some impovements for my acne around my forehead but not around my mouth and chin. I would like to take matters with my own hands and be more patient, take more healthy and natural path. This is the very reason why I started to do some research over the internet. This has been very frustrating for me but your blog gave me hope.

    God Bless You.

  103. Sandra says:

    I think that I may have this. I have itchy, red bumps around the bottom of my nose, under my lip on my chin, and some on my lower eye lid and eye brow – with some dry scaly parts, lots of itchiness, and sometimes burning -also some bumps are filled with the clear fluid like mentioned in the article. When I first went to the doctor he thought I had contact dermatitis allergic reaction and prescribed antibiotic for one week. It cleared up as I took the medicine, however directly after stopping the rash occurred now worse than before. I went to the doctor again and he told me there was nothing more he could do and made me an appointment with an allergist – I never thought I had allergies though and after reading this my doubts are becoming stronger. I was wondering if maybe my doctor had not considered this option? Should I see him again and suggest that this is the reason for my rash? I have been suffering from it off and on for months now. I am trying every suggestion listed in your article to help me but the rash is so progressed I feel like I need more medical help.

  104. Aniko says:

    I am on OR nurse and have developed a rash such as you described. It gets better on my days off and reappears with with vengeance when i return to work. I have tried everything topical i can think of and it is just getting worse. Right at this moment it is particularly painful.

  105. Terri says:

    I have been treated for all those things you listed and everything I have been given by the doctor has made it worse and burned my face and made it severely itchy. I’m bright red around my mouth and nose. I have been tested for sti’s and had blood work done and I’m healthy. I’ve tried everything seen the doctor 8 times in the last going on 7 months. I’m tired of my face looking like this its embarrassing. I found that some of the treatments I have been given started to make my lips and mouth numb. Even antibiotic creams and salves do not work. I’ve seen a dermatologist and other family doctors hoping someone would have an answer. I’ve had red dots around my nose as a teen but never this bad. I look burnt. Please help!

    • Livia says:

      I have recently been using Witch Hazel which seems to be drying and clearing up my similar sounding rash. Have you explored sensitivity testing not with an allergist but with an ND, a licensed registered Naturopathic Doctor. Good luck.

  106. antonella martin says:

    hi all, i have had this since last april, begining of may.. at first i tot it was an std or something as it was the time i went out with this one guy, just him! at the same time i started the pill, done my nails with gels at this really dodgy salon which didnt even dust regularly :S you ll be glad to know it was only a one time.. but as mentioned here, i did notice everytime i do someting to my nails it comes bek with a vengance :S i touch my face a lot and do scratch my nostril area, so tonite im trying an antibiotic ointment and see how it goes, tomorrow i will use apple cider vinegar in case it is a yeast infection.. a couple of years ago my skin became sensitive and i would have outbreaks of urticaria, so i tot this was similar, but the anti histamine cream didint help :( i also had the keratine done in december 2012 (a couple of months before the outbreak) at the same salon and had some urticaria outbreaks around my ears but they subsided.. but kept using the shampoos post treatment for another couple of months in 2013.. also in april i visited a friend in hosptial twice.. i did try not to touch anything (as i am a bit ocd on contamination lol) and i also had to work in our laboratory at work from april till june ( I work in a waste management facility and we do accept pharmaceutical waste) i used to work in a pharmaceutical company 3yrs ago in the laboratory so it is possible I acquired some sort of allergy to a particular product.. anyway i trid to list anything it might have possibly triggered this in the hopes it helps someone else.. my best guess is it could be something or several things that happened coincedently at during the same period and the combination of certain catalysts is different from one individual to another.. ohh and yes i might be a little emotionally stressed as I work full time, study part time and broke up last year from an 8yr relationship and came back home with my parents.. but on the whole am more healthy and serene.. also last year i changed my diet, had to avoid items such as veal, beef, dairy products, spices, oranges, lemons, mandarins, bananas, beans, chili.. due to food intolerance, so i might have a vitamin or mineral deficiency or something :/ your comments and opinions would be immensey appreciated! thanks and goodluck xxx

  107. amie says:

    I used some nair facial hair remover (the strips that warm) at the corners of my mouth two years ago. At first it was like my skin was blistered. Then it peeled and stayed an awful red color for a while. I tried ice and not wearing make up. It didn’t help. I went to my regular doctor, who prescribed an anti fungal cream and a steroid cortisone cream. He bepueved it was bacterial. This made it somewhat better but it kept returning. I visited two dermatologists. One told me I had contact dermatitis and wamted me to continue use of the cortisone. This didn’t help either. It’s gotten to the point that if I use make up or soaps of any kind (even cerave that the dermatologist recommended) my skin becomes agitated around both corners of my mouth. It’s also started up around the corners of my nose and the dip in my chin. It’s embarrasing but I’m out of money for pointless meds and unhelpful doctors.

    • Jess says:

      Try braggs apple cider vinegar I have heard it works wonders for people who have skin problems especially POD. It’s all organic and it helps the burning feeling stop for a bit!

  108. Berry says:

    I’ve had a little bit of redness around my nose and mouth, but I just sort of put up with it. A few days ago, my face literally just exploded in red. The area around my nose, mouth, and chin is red, scaly, and a little bumpy. I’ve never seen it like this before. It seems like I probably have PD, based on the descriptions, and I’ve been taking Docycline for 2 days but what you said about Rosacea stood out:
    Rosacea can also affect the forehead and nose (unlike perioral dermatitis)
    I do have have some redness across my nose, and a little on my forehead. I do have pretty long bangs, so perhaps that’s a factor.

    I really don’t know how to go without moisturizers. My skin feels so dry!

    Any ideas would be helpful!

  109. Jess says:

    I was recently diagnosed with perioral dermatitis and given a topical antibiotic lotion. This did not work so I tried taking an oral antibiotic while also putting on apple cider vinegar to the affected areas. It has been two days now and I am hoping I Will see a change. Any advice?

  110. Stephanie says:

    I was just diagnosed with PD after having this rash for 8 MONTHS! I should have just gone back to the dermatologist sooner. My general practitioner gave me a steriod cream thinking it was eczema, and that cream does calm it down and dry it up, but never clears it. So now the dermatologist gave me clindamycin gel to apply twice a day and also gave me 40mg of Oracea (doxycycline) to take for a month, once a day. I started trying the gel on my face twice a day and it has gotten worse. Maybe this is because I have stopped the use of the steriod cream all together. It is so painful and just burns all the time. I started the Oracea today. Does anyone know how long it will take for the antibiotics to clear this up? I am really hoping soon. The summer heat and sunshine have made this so much worse! The rash has also gone inside of one of my nostrils and I can’t put anything on it. It hurts very badly. Does anyone have an idea of how to soothe that without applying a cream or ointment? In reading this blog I saw that you should not apply moisturizers, so I typically would put aquaphor on there to protect it and that stops the burning a bit. I’m hoping I see a turn around soon.

    • It is possible that stopping the steroid cream caused the rash to flare up. Topical antibiotics will not help it if that is the case. Also, topical antibiotics (Clindamycin gel) typically do not do much at all to help perioral dermatitis. Oral antibiotics (the Doxycycline) are the usual drug of choice that western dermatologists employ for PD but the time it takes to clear it up varies from patient to patient. Sometimes it can take 2 months, sometimes treatment does not work at all. In my clinic, I treat skin conditions naturally – i.e., using acupuncture, herbs, nutritional supplements and natural topical products that I manufacture myself (Zi Zai Dermatology’s products). I avoid the use of pharmaceutical antibiotics whenever possible (basically I do not recommend the use of oral antibiotics unless there is a serious infection that my herbs cannot treat effectively). That being said, I know many patients with perioral dermatitis that responded very well to conventional western treatment of oral Doxycycline after 1 or 2 months. I have many more patients whose PD did NOT resolve with antibiotic use but it did clear up when they switched all their daily skin care products to Zi Zai Dermatology products. I have other PD patients who responded well to internal herbal medicine, and other stubborn cases where nothing has worked yet (antibiotics, herbs, topicals – nothing helped for very long). How long will your case take to treat? I cannot say. But you have a few options available to you: you can just stay the course and finish the antibiotics and see how well your skin clears up. If it does not clear up, you can do a second round of the antibiotics. Or you can choose natural treatment. You also have the temporary option of going back on the steroid cream to calm the current pain and burning and then WEAN down off it slowly (instead of suddenly stopping it which can cause it to flare up worse). Or you can ride out this painful moment and simply wash it once daily with lukewarm water and a mild cleanser until it calms down on its own (or with the help of the internal antibiotics). Good luck and keep us posted!

    • a martin says:

      i was using antibiotic ointment and apple cider vinegar alternatingly for 2 weeks and was improving a lot. then i stayed in the summer sun without sunblock, burnt my face, the skin peeled off (but not from everywhere) and it kind of eresicated the problem. this was last week, since i had to reintroduce after sun and moisturisers i do have slight eruptions here and there probably where the skin was not damaged a lot and didnt peel lol so ill be bek to the ointment for now, will keep u posted and goodluck xxx

  111. Amber says:

    I am going to the Dr because I do believe I have this and I am a nurse as well. Same symptoms mild burning the bumps are around my laugh lines and in to my nose it has now spread down to my mouth. I have never had acne nor any problems with breakouts before!

  112. Michele Pollock says:

    This perfextly describes the condition that I am currently encountering. I see my dermatologist on Thursday and the appointment can’t happen soon enough! It isn’t bad enough that the rash is ugly, but the burning sensation is the icing on the cake. I have suffered with this for over 10 years (now 46) and, although I don’t remember the name that my called it, the treatment had been (excuse my spelling) Doxicycline and Finescia. The symptoms come back routinely until it flares badly enough for me to go back to the dermatologist. Your information helped me immensely. It helps to put a name to the enemy and to know that I am not the only one in this war. Thanks.

    • a martin says:

      the itching is terrible.. i started to suffer from urticaria on my twenties but this is different. what i read and noticed is d yeast is kept in check in our bodies by eating foods such as yoghurt and oranges. i had to eliminate these from my diet and with the onset of summer and sweAt this condition came out. i will be introducing a little yoghurt or try it directly on my face as im scared d vinegar will dry my skin and increase vitamin c intake. ive been using moisturisers and sunblocks to my forehead for wrinkles and wherever i use some sort of moisturisi g product d condition erupts again like crazy obviously increasing near d mouth area.. so increasing d yeast hypothesis. hope this info helps some of you xxx i hate d itching!!!! aaaa!!!! :D

  113. Christine says:

    I’m also a nurse who has PD. I was diagnosed by a dermatologist and given a script for an abx cream which was pretty effective. I used it off and on whenever I had a flare. I seemed to have gone a year or so without a very bad outbreak (lasting longer than a week or burning pain) but the other day (while working in the hospital) I felt like I had acid spilled down both sides of my mouth. I was eating at the time and figured it was related to the food. Now I’ve read that not only topical steroids but also inhaled steroids can cause flares. I work on a respiratory floor and common timing for scheduled nebulizer treatments are right before I go to lunch. And as others are commenting, my skin starts to feel better on off day. I always thought this was because I had more me time for better face washing, etc but now I’m questioning if it’s because I’m not exposed to these chemicals. I’d been taking care of someone with an acute exacerbation of a chronic respiratory illness so you can imagine the nebulized medicines I’d have been exposed to.

    • Very interesting! I am going to look through my patient charts (or inquire with my PD patients who are nurses) to see which department they work in. I myself am not exposed to nebulizers or inhalers, nor are all of my PD patients, but it would be interesting to look at what percentage of PD patients are. Thank you for sharing.

  114. DoughnutGirl says:

    Thank you for this site. I finally feel like I am not alone. I moved to Seattle 5 years ago and developed PD, it eventually went away after about a month (I always have little red bumps around my nostrils but it’s hardly noticeable). I moved to NYC, then back to Seattle 3 years later, and Lucky Me, PD has found me again. Strangest thing, I am a teacher and on the first day of school it developed again. Reading all these posts from Nurses makes me think it is something environmental in the school or in the hospital. For me, when it is flaking, which it seemed was part of the healing process, it looked like I had stuffed my face with a powder sugar doughnut that wouldn’t go away. Terrible. (Luckily I teach Kindergarten so I fit right in)

    I’m going to try the Apple Cider Vinegar tomorrow and I’ll let you know what works. I am against using antibiotics and steroids unless it’s life threatening. Right now, it seems like the only thing being threatened is my pride. But still, this is no fun. I’m trying to eat healthy to see if that helps but I’d much rather be eating powder sugar doughnuts.

  115. Rhonda says:

    I am also a nurse and have this! I have worked in the operating room for the last 10 years. I am not on any steroids, but do take an inhaler for my asthma. I am really interested in why this happens so frequently in healthcare professionals.

  116. Penny Thompson says:

    Are you a doctor? My 25 yr old daughter is freaking out because she always gets these unheard of rare conditions. She has exactly what you and the picture describe but she is a severe skin picker with severe anxieties and she has been using cortizone on her face every night for many years. She is also depressed. Now she doesn’t know what to do because she can’t use the cortizone and she can’t stop picking. We have tried many treatments for that and if course her depression and anxiety are worse. Of course the doctors around here have no idea what this is!!!! At first we thought it was from her boyfriend because he doesn’t get a close shave and it had a muzzle or beard pattern to it. I feel so bad for her. She has been through so much I couldn’t begin to tell. I hope the doctor gives her doxycycline and it clears up. She also just started using clindamycin a few weeks ago for minor acne and we thought that might have caused it. If you have any helpful advice it would be greatly appreciated.

    • I am not a physician, I am a practitioner of Traditional Chinese Medicine and I specialize in treating skin ailments with acupuncture, Chinese herbal medicine and nutritional support. I have not examined your daughter so I cannot diagnose her. However, you say she used a topical steroid on her face every night for years. Although she probably used one of the weaker OTC creams, it is possible that the long-term use of the steroid caused some of the problems she is currently suffering from. Learn more here: http://www.dermnetnz.org/treatments/topical-steroids.html. I would recommend seeking natural healthcare for her to address the skin conditions, as well as the anxiety and depression. Try one of the practitioners on my referral list, or contact me directly for a recommendation near you.

  117. Natasha Rathor says:

    I used to have completely clear skin and complexion until June this year. I went went Morocco with my partner and i don’t know what has happened to my skin since I have come back. A cream I was using for months before going on holiday started to react very badly with my skin.
    After stopping use of the cream I came out with a really bad flare up around my mouth over my upper lip and chin. The skin was raised and swollen and completely inflamed. I took anti-histamines and after 2 days of burning and being inflamed the redness went down to leave patches of wrinkly tight dry patches. They cleared up but just left marks over my face and since that time my skin was ok.
    This time round is 10 times worse. I was seeing a beautician for facials to get rid of the marks left and she gave me a cream I was using which was fine. I went to her on Sunday for my regular facial and she decided to change the cream. I know a lot of other people who use this same cream including my mum and they’ve been fine with this cream. I layered it on my face on sunday night just as i was advised and woke up on Monday morning looking like a burnt tomato!
    My whole skin was red and inflamed and swollen. I’ve been used ice packs on it, aloe vera jelly to cool it and rregularly washing it with cold water. 2 days later i have the same problem, tight dry wrinklly patches all around my mouth on my chin and upper lip, around my rose and under my eyes and on my temples this time too. Please can you recommend something or give me something to clear this up in the next 2 days please as I have a very close family wedding to go to this weekend and am not going if my face is still like this.

  118. Hollie C. says:

    I have had a rash around my mouth and eyes and nose, on both arms, my right breast, between my thighs and on my left butt cheek. I have had this for 2 years and I am so sick of it. I have been given a cream and an ointment and steroids. Nothing works. It itches, burns and just over all annoying as hell. Not sure anything will help at this point.

  119. Kym says:

    I am experiencing this rash for the first time at age 37. I have done nothing different in my skin care routine, but have had a terrible time with allergies the past month and have had to use an albuterol inhaler much more than usual. (on average I may use it 1-2 times every few months but for the past few weeks i have had to use it almost once a night as i wake up wheezing) I really think my rash is PD and that it was triggered by the steroid in the inhaler.

    • That is possible if the substance in the inhaler at all contacted your skin. Have you considered seeing a TCM practitioner to treat the allergies so you don’t need to rely on the inhaler so much? TCM can be very affective for seasonal allergies.

  120. Stacey says:

    I have this for the first time. I had been looking for a natural plant based lip plumper and found some lip plumper masks that you leave on for 30 minutes. For the past 2 nights I have worn these overnight. The morning after I noticed some irritating bumps on the sides of my mouth just above the jaw line. These are not very noticeable but by feel I know they are there. I applied some lavender oil to help this has many healing properties. Needless to say I will be returning the rest of the product.

  121. Livia says:

    As follow-up to my comments June 25, July 16 & 18. My basic symptoms were: 1. eczema like dryness flakey skin directly below my nose never itchy but almost sore like a needle prick to the touch 2. a small patch of dry skin near the inside of the bridge of my nose towards my upper eye lid, and 3. POD closer to my upper and outer corners of my mouth and a tiny bit under my eye lashes towards the outer lower part of my eyes, these were mildly itchy at times. They only changes in my life about two months prior to the appearance of the rash was going gluten and dairy free, which I still am, closing in on five months. (FYI I feel great and have lost 7 lbs.)
    My natural attempts were giving relief but were not ridding the rash. I have since broken down and have given a prescription cream a try which HAS WORKED!!! It is called: ELIDEL – (pimercromilus cream 1%)
    Results: 1. eczema/dry patches disappeared with in a few days and 2. the POD is all but gone, the tiny raised irregular spots took about a month to dissipate, some sort of fell off, the others have just gotten smaller and smaller. The ones below my eyes are still there but getting smaller. Once it is all gone, I will stop using the cream and see if any of it comes back. Will post again at that time.

  122. Heather says:

    Hi, my rash around my mouth is not as red as the photos here, and there are some bumps, but mostly dry flaky itchy skin& redness around. Also, some itchiness and bomps over my eyelid. It only began to flare like this a few weeks ago, went away after a few pills of benadryl, and now has returned, again when I was at work. I had side of the mouth cracks for almost a year and a little spot under my lower lip that was itchy and flaky and never would quite go away, for almost a year, which I finally tried a steroid cream on, and clearly that caused this reaction to grow around my mouth.
    Now, I following all the directions you listed, except have not yet tried antibiotics. I work with herbs and ayurvedic practices, so I wonder what herbs you would recommend I take to heal this. I wonder with the side cracks if it is a candida or imbalanced acidity in my body at large, or perhaps a small fungal infection in the small itchy eczema-looking patch below my lip.
    I can heal this on a systemic level and I want to now! Thank you!

    • Livia says:

      There was a Canadian product that I have used for years but is no longer available, called Korner’s Cold Sore Remedy. If you work with herbs etc, you may be able to make some of your own. The main ingredient is Geranium maculatum. It is amazing for any type of cold sore, herpes blister type or cracks in the corner of the mouth type. This product dries and heals them very quickly while keeping them moist at the same time.

  123. Kristina Donnellan says:

    I cut out all products with sodium laurel sulfate (SLS) as this is believed to be one of the causes of perioral dermatitis. Only use natural products on my face and sls-free toothpaste. It seems to have helped, together with metronidazole treatment.

  124. Julie Hollenbeck says:

    My son gets red rashy bumps on one side of his mouth starting in mid-august and it usually clears by November. It’s happened every year for the past 4 years. He wears no creams on his face and we don’t use fluoride toothpaste. We have tried every topical naturopathic type cream. He takes chinese herbs to clear heat. But so far nothing really clears it up. It’s obviously worse after he eats. He’s 6 years old so it’s difficult to keep his face spotless and greaseless. We are very confused by the seasonality of this breakout. Any advice would be great!

  125. Crystal C. says:

    I am a 28 yo registered nurse, I have this exact rash on the corners of my mouth, nose, and eyes for the past 10 months. I have tried everything over the counter I could get my hands on. I tried oral fluconazole, and numerous topicals. The only thing that somewhat kept it at bay was a topical steroid ointment, but now it doesn’t even seem to be working. I’ve tried diet changes, organic facial products, ect. I may not be accurate, but it’s possible it started around the same time I started nasal corticosteroid allergy sprays. I tried stopping it for a week and didn’t see much of an improvement. I work almost every day so I can really comment on whether it gets better ony off days. I wear mineral make up n cleanse/moisturizer my face I’m AM an before bed. I have a vacation coming up so I’m thinking I will try your recommendations.

    • I have heard of several anecdotal reports of perioral dermatitis being triggered by the use of inhaled steroids for asthma and allergies. My recommendation is seeking TCM treatment for the allergies so you don’t need to use the inhaler as often (or at all). TCM treats allergies and asthma very well. FYI, never stop the use of rescue inhalers without consulting with your healthcare practitioner.

  126. mary says:

    Hi.
    I have an awkward one. The area around my mouth is very dry and i experience very severe redness around my mouth when i eat any kinds of food. It will appear to affect the immediate skin around my mouth while i am eating and because of this i cannot eat in public anymore. I have dropped down to a size 6 because i am always working therefore wont eat. My dermatologist says she cannot test my skin as there is no direct concerns with food high in acidity etc. My mouth tirns red after eating any foods and its so humiliating. There is no burning or soreness just redness and i will wake up sometimes to find red itchy bumps around my mouth area. What could this be? I have been prescribed protopic ointment by my dermatologist but this has only aggrivated the redness and sort of flared up my skin around my mouth.

    • Livia says:

      Just from my own experience and talking to various naturopathic doctors, which I am not, I would strongly recommend you going on a totally gluten-free diet for two to three months. Gluten is in a lot of the general population’s foods these days and is a major culprit for many skin problems. It may sound difficult at first, but really it is not. Then after the three months you’ll see if there is any improvement or hopefully your skin irritation will disappear. No cheating. One intake of glutens can stay in your system for up to two weeks, so it is important to be diligent. Be patient. Slowly re introduce wheat and glutens and see what happens. Secondary would be a dairy free diet. But only do one at a time.

    • I do not understand why your dermatologist cannot test for allergies. Allergy testing seems to be the most important factor in reducing your risk of future reactions, so if you were my patient, I would certainly have you tested. It certainly sounds like an allergy to me, but as usual, I cannot diagnose anything via this forum. Perhaps this article about allergic contact chelitis will provide more info for you: http://www.dermnetnz.org/site-age-specific/allergic-contact-cheilitis.html

  127. Olivia says:

    I have had this rash recur several times since I was 19 years old. It was originally diagnosed as rosacea and my dermatologist created some cream that I used for a couple of months then one day the rash was gone. I don’t think the clear up had anything to do with the cream she gave me. The rash returned about 5 years later. A new dermatologist diagnosed it as peri-oral dermatitis. Gave me a round of Doxycycline and the rash was gone again. about 3 years later it returned, same treatment and same result. The rash returned again last year and we did the same treatment and the rash once again disappeared. a little over a year later and the rash is back. I’m waiting to pick up my prescription of Doxycycline again. This time I noticed the rash starting to appear right after starting to use Listerine again. Haven’t used it since last year when I switched to a whitening mouth wash. I think the Listerine may be what triggered this flare-up.

    • Interesting. Let us know if the rash disappears when you discontinue use of Listerine. Listerine contains sodium benzoate which can cause allergic contact dermatitis or urticaria (hives) but I have not suspected it to be the cause of perioral dermatitis. Readers, do any others of you think Listerine or similar product triggered your P.D.?

  128. uniquelyq says:

    I think I have this. I have a red spot around my right nostril and six small bumps on the left smile line. I don’t use steroids because I react badly to them. I don’t wear make up everyday but when I do, it isn’t much-bb cream, a little mineral powder, concealer. And mascara. (an addiction of mine) I am going to the doctor tomorrow for another issue and I am planning to ask her about it. I am allergic to the antibiotics that are suggested. I have really dry skin so going with out moisturizer is not really an option. Is there something else you would suggest so my skin wouldn’t feel so tight?

    • Couple of suggestions: make sure you wash all your makeup off every night, do not wash your face more than twice per day (once in morning, once before bed), and try applying apple cider vinegar on clean dry skin after you wash. If the climate you live in is not excessively dry, the ACV might be enough to reduce dry tight flaky skin. A bb cream should be all the moisturizer you need if your skin is supple enough. If your skin is that dry, I suggest seeing a TCM practitioner for herbs to help address the underlying Dryness that seems to be preventing your skin from healing fully. Keep us updated.

  129. Alina Arencibia says:

    Hi there, I had an outbreak of PD in my 20s. That cleared up after they tried steroid cream which made it 1000x worse when stopped and then a round of oral antibiotics. I was diagnosed with Rosacea in my 30s. Since then another derm. told me I don’t have Rosacea (6 mos. to a year ago – diagnosed with eczema on my hand at that time) and another derm. told me yesterday that I don’t have R. but I do, just not the traditional kind? Anyway, the reason I was at a derm. yesterday was because I had a horrible outbreak of PD. I am 44 today – my skin has been reddish and irritated for about a month or so including some swollen areas I thought were hives. I thought this was due to loading up with sunscreen in these particularly hot past months (which always irritates my skin and eyes as I sweat a ton, live in Fl. and walk my dog and son everyday). Within a few hours, I went from irritated to a horrible red bumpy mess, slight itching and pimple looking bumps with white ick in them! This was really pronounced at the chin and out, around the mouth, traveled up to the eyes, on the forehead (less noticeable), the neck (fewer but they are definitely there), and the chest. I was prescribed 4 things. One of them was a better eczema cream for my hand as the stuff someone else gave me she said was not good/strong enough. These 4 prescriptions came to over $700 at the pharmacy! I popped all the pimples, washed with a clean, damp, cool washcloth and applied my normal Eucerin. I woke up this a.m. to better but not gone. I called the Dr. to see if there was another oral antibiotic in the bunch that I could that wouldn’t cost $200+ for the 60 day supply and to verify that Perioral Dermatitis can spread to the neck and chest. I can’t find anyone that has had this on chest and neck online at all. The Derm. assistant insisted that it can spread to neck and chest and that the most important of the scripts was indeed the oral antibiotic. I am not sure if I should go ahead and get the antibiotic or not. Wanted to note that I stopped all supplements (multi vitamin, flax oil, calcium, Flexcin.) I started the Flexcin recently (maybe a week or so ago) for my joints. It is made with shellfish but I have never had an issue with shellfish before. Have you ever heard of of PD spreading to chest and neck? She did notice around the eyes and said it had gone ocular. Thank you very much for any info you can provide!

  130. mane says:

    My rash and pimples started after I used depilatory wax ( Nair) and now I cannot get rid of them. I am applying Benadryl and it surely relieves the itch… But does not go away as yet.
    Mane

  131. Kelly says:

    I have had redness and scaling, worst case weeping/bleeding on my nose, around my mouth and on my lips for months. I went to the dermatologist(s) and they thought it was contact dermatitis. I was first prescribed a topical steroid but it didn’t help. I changed my toothpaste, face cleanser, face lotion, laundry detergent, hand soap, and dish soap to dermatologist recommended/ natural/ fragrance free. I only use vaseline on my lips. All my patch test results were negative. The redness and scaling had gone away for ~2 weeks and today I notice redness again. I am clueless on what I have and I’m hesitant going back to the dermatologist because I feel like I have wasted so much time and money and got no answer. I have already spent close to $400 on the appointments and patch test. Help! :(

    • It is impossible for me to diagnose you without an actual examination and health history. It could still be allergic contact dermatitis – if you have not determined the allergen, the rash will return if you are still coming into contact with that substance. Did your derm test the exudate for bacteria to rule out impetigo? (Most dermatologists can easily diagnose this upon visual inspection but sometimes a swab is necessary). Have you read my post on Beeswax Allergy and How I Healed the Rash Around My Mouth? I suggest reading them and be sure to read the comments below each post – readers have shared so much helpful information and their stories may help you figure out the trigger if your rash is indeed of allergic origin.

    • Stacey says:

      I had a similar issue and after trial, error and research I finally got some virgin coconut oil and applied this about 2+ times per day and in about a week my skin was back to normal. Make sure to apply this to your face when it is damp and not dry this way it helps to keep moisture inside. It really does wonders.

      • kelly says:

        Just wondering if you’ve had any luck finding out what may be the trigger for healthcare workes? Im a nurse and get this rash often, doxycycline is what usually clears it up. Its uncomfortable and a very unpleasent place to have a rash, any advice as to what could help stop it from reoccuring??

        Thank you!

        • Livia says:

          Someone told me it is simply the constant exposure to such a variety of germs and viruses etc. in the medical professions. But that does not explain why the rest of, not in the medical profession, get it?

  132. lucy says:

    I am a health care worker (dental nurse) and have had this for 4 months. it is really getting me down as its so ugly I am getting embarrassed talking to people. creams make it worse, so now since Friday I have been taking flucloxacillin. no change yet but will see :(

    • lucy says:

      Update: the antibiotics didn’t work.
      I have now been given some metronidazole gel to use for a month.
      Been using for a week but no change :(

      • LC says:

        I don’t know how long you used the antibiotics for but it took several weeks, maybe even a month, for them to work on my rash. I used Doxycycline.

  133. mmusic85 says:

    I have had that rash on the corner of my eye for 7 months. It started as a small spot and grew quickly after. I was told its a fungal infection but no creams or antibiotics have helped its now on my left eye too. Sometimes it’s a tiny dot other times it is like the picture you posted. I very stupidly took the morning after pill twice this year and I am wondering if that is what has caused this rash? I have never had the morning after pill before and do not plan on taking it again.

  134. Diane says:

    Thank you for this open forum to learn. I have had this for about a week .. bumps around the mouth, mostly now on chin .. and it hurts & has a reddish/brownish tone. I ate some habernera hot sauce last weekend, and a couple of days later the skin issue developed. But I also starting eating spinach again .. which is high in histimine. I’m trusting it is a reaction to something .. but what? Been wearing a red lipgloss I got at health food store that is supposed to be natural. I’ve been slathering skin w/coconut oil among other things, but will stop upon recommendation & just let it be & see what happens.

  135. StickyMacD says:

    I have not seen a doctor yet but I have been trying hard to figure out what is causing a very similar rash with me. I have had quite a lot of changes to my skin care and I am going to stop everything. The products I use are all SLS and Paraben free, 100% pure organic aromatherapy based. The base is a palm kernel oil – been using it for 3yrs with no problem. Recently started their anti aging range with Myrrh oil and Frankincense, Blue Orchid, and Argan Oil, Ginko Biloba and Lavender. I did have some success in clearing it up with a lanolin based balm that contains Manuka, Borage, Sage and Rosemary. However it is not as successful now and I am wondering if that’s due to me over moisturising now that i have read this – I recently started a daily skin care routine having never bothered with one before. I use a mineral powder based make up for skin conditions and it BURNS, itches and makes it much worse.
    I have had a flare up before and an anti fungal cleared it, steroids defo made it worse. I have put Tea Tree on it today to see if it will help.
    The sad thing is that all these products I have been using have made the rest of my skin look and feel so fab, reduced lines and fixed other dryness problems I have had. I’m going to go and see my doctor for some help today. Thanks so much for blogging this.

  136. Dr said I had rosacea and eczema, took antiobiotics, used pres. cream, helped very little. I have sores, bumps all over my body. Even on back. legs ankles arms, and inside my nose and have had it ? around vagina area, also. This has been on going on for 8 months now. I’m at my wits end. The occular caused me to lose eyebrows and eyelashes. I itch and will hardly go anywhere. Been to several Dermatologists and my Doctor and no one knows about this. I even had them on the bottom of my feet. Where can I get help? I just turned 69, am female and not well. I struggle with this everyday. Whatever it is, it’s even leaving markings on my hands now. Could someone help me?? I’m Delores Devine–e-mail is devinedelores@yahoo.com Thank you

    • I have emailed you to find out where you live so I can refer you to a TCM practitioner. Widespread rashes like you describe need to be evaluated in person by a trained professional before any treatment can be suggested. Glad you contacted me – check your email.

  137. Julie says:

    I have this rash around my mouth as well. It is starting on my chin and goes up under my nose. But I have also noticed it on the bridge of my nose now. As well as a little bit on my cheeks.
    What is weird is that a rash started on my chest the day before the mouth rash showed up. Weird right?
    The only things that I’ve done differently in the couple days is have a cider (alcohol) and eat a mango.
    Any insight?

  138. Michelle says:

    Thank you so much for this! I was able to figure out that it was my laundry detergent (Used to wash my pillow case) causing it! Commercial detergents are so full of chemicals! I just recently moved back to MA and have been using my parents house to do laundry, had this rash since….after bringing my own detergent it cleared right up. Method and the honest company (o/l only) make great chem. free ones

    perhaps this is the common link between your healthcare professionals – if they have their work scrubs washed in the workplace (I know a nurse who’s job offers that)

  139. Samantha says:

    I am very happy to have found your blog. I have been suffering from perioral dermatitis for almost three years and I’m starting to fear that it will never go away. It doesn’t really come and go. It is always here. It started as two little patches but was soon taking over my whole face. The dermatologist could not help me and I’ve only been able to get it partially under control. I do not use any products containing sulfates, fluoride, or really anything else. The only things I put on my face are shea butter and coconut oil. I do not even use chapstick or wear makeup. I take supplements for suggested deficiencies, I’ve gone gluten free and dairy free… But it never stays away for long. It has been around my eyes, cheeks, mouth, on my neck and has most recently started showing up on my collarbones. Not only is it awful to look at, but it burns, itches, and sometimes I cannot even put water on it. I’ve done everything I can and I really don’t know what else to do… I’m mostly just tired of the pain, as my ego has already been beat down to where I don’t care how it looks. Please help… What can I do?

    • Lisa says:

      Samantha, all I can tell you is that when I gave up peanut products and tree nuts i became dermatitis free. I probably ate peanut butter, and loved walnuts, every day of my life from childhood, and perhaps that led to the sensitivity. When I have flare ups I wash the affected area with anti-bacterial soap, which is very drying, until it subsides and then I am very careful to avoid nut products. I also have tonsil problems that are aggravated by nuts. Good luck. I am 55 years old, have suffered from perioral dermatitis since the age of 25, but have been problem free (unless I accidently eat nuts) for 5 years. I hope this information may benefit you. Lisa

    • Samantha says:

      Hi everyone. I posted earlier this month and was struggling really badly with perioral dermatitis. I got really sick and developed this rash all over my neck, shoulders, and chest. It was itchy, red, and painful. Someone reccommended African Black Soap by Nubian Heritage. I went to my local help food store and it cleared the rash up rather quickly and so out of curiosity I started using it on my POD and IT FINALLY CALMED DOWN! Mind you I have been trying things for years to no avail. If it starts to get red I wash with the soap and it clears up within hours. It’s magical. After I use it I put on a little Shea butter with coconut oil cause the soap can be drying. I hope this info can help someone who is struggling, cause I know how frustrated I was. Good luck!!!!

      • ella says:

        with d inser of winter and hence humidity in Malta and less sun exposure mine seems to have returned but i noticed it came back especially after i did a collagen facial :S im not sure what else d ingriendients wer as the beauty therapist made d mixture but will see if it retreats with tanning salon use. its eeally itchy and im scared it leaves scarring :(

  140. Livia says:

    Hello Zi Zai,

    Has there been any study on this condition indicating that may be a form (perhaps a new form) of shingles. I heard of someone with this and after years of searching a medical practitioner suggested this and the anti shingle’s medications worked to rid it.
    My rash has spread onto my left check and has lasted there about two months, but it differs from the rash on my mouth, and from the rash under my nose. Rash on cheeks is slowly clearing with a rosacea cream but I am not confident that it will entirely go away. Mouth rash staying constant nothing new but not going. Most of under nose rash went with Elidele cream, so the dry sore flakiness is gone but the odd red spot appears..

  141. LC says:

    Elidel worked to quickly clear up my rash several months ago but, after stopping the Elidel, the rash came back. After reading the possible side effects for Elidel, I decided not to try it again. I’ve had the rash twice more since that episode. It hasn’t been as bad as the first time but I’ll get a rash on my chin and then I also get a few bumps right below my eyes that come and go. I’m in my 50s and I’ve always had clear skin until this mess started earlier this year. I’ve tried all of the home remedies I’ve read about…ACV, yogurt masks, violet extract, etc. and nothing helped. The only thing that seems to help mine is antibiotics (specifically, Doxycycline) but it takes several weeks for it to clear up even with the antibiotics. Then, as I said, it seems to always come back. I’ve begun using only extra virgin coconut oil for my facial moisturizer so maybe that’s why it’s not coming back as severe as when I initially got it but I don’t know that for a fact.

  142. Lillie says:

    I have had this rash around my chin for months and cannot figure out what is causing it. I have tried everything from tazorac, Topicort, hydrocortisone cream, Benadryl, sunburn gel, to aloe vera and nothing has worked. I’m a nurse and where no makeup. It itches and burns sometimes. It’s embarrassing because I’m always being asked what is wrong with my chin and I do not know. Have set up an appt with a dermatologist in 2 weeks, so I hope I can get some relief and figure it out. Help!!

  143. Diane says:

    NURSES: from what I’ve seen, it could be those latex gloves you use! but obviously I’m no expert. I did start leaving my outbreak alone as ZiZai suggested, & it went away. But it did come back in a few weeks, not as vengeful as before. After reading about walnuts/peanuts, I’m fearful I may have to try giving them up. I do eat gluten free. I wonder about the beeswax in my lip moisturizer, or the lip gloss .. I am afraid to use them very much. I’ve been having different kind of skin issues for a few years now. Waiting upon blood & stool tests .. it’s got to be a gut issue coming out in my skin.

    • christine says:

      We have latex free gloves. For me I think it has to do w the respiratory medications or possibly the hospital handsoap. I ate gluten free for almost three weeks for other reasons but it had no effect on this or my dermatographia. Good luck to you.

      • Latex allergy is a very different reaction than perioral dermatitis. In perioral dermatitis there is no allergic immune response and the rash appears very differently than we see in allergic contact dermatitis. I agree that PD is possibly a reaction to chemicals or meds that healthcare providers come into contact with; subtle but frequent contact or airborne particles.

    • Lisa says:

      Diane, I hope your experiment giving up nuts is as successful as mine has been. My 28 year old daughter is also experiencing the dermatitis and is going nut free so I can report back on whether she also found an improvement. I also read a fascinating and disturbing article in Elle about the emerging problem some people are discovering from eating products including genetically modified corn, which is very hard to avoid now. This is the link: http://www.elle.com/search/?q=genetically+modified+corn+

    • Diane says:

      Update: Mine is a result of digestive issues & streptacoccus in my gut .. all a result of the wicked evil root canal the dentist performed on me. Thank God blood & stool tests show what is going on w/me.

  144. BETTY JOHNSTON says:

    I AM BETTY AND I THINK I HAVE PD I HAVE THE RASH ROUND MY NOSE AND INSIDE MY NOSE ALSO SPREADING OVER TOP LIP I RECEIVED 1 WEEK OF ANTIBIOTICS AND NASEPTIN IT STARTED TO IMPROVE THEN JUST CAME BACK AS IT HAS DONE OVER THE LAST 10 WEEKS I WAS ALSO GIVEN FUCIDIN H WHEN FIRST LOT DID NOT WORK SAME RESULT FADED THEN CAME BACK NOW I HAVE BEEN PUT ON NYSTAFORM AND HAVE SEEN NO IMPROVEMENT MY SKIN GETS TIGHT AND FLAKEY AND SO DRY I HAVE USED VASELINE TO TRY AND KEEP IT MOIST IF YOU CAN BE OF ANY HELP IT WOULD BE GRATELY APPRECIATED THANK YOU

    • The tight, flaky and dry is typical once the rash starts to heal. Did your dermatologist diagnose this as perioral dermatitis? I am not certain I have ever seen a case where the pd spread internally to the nose. I will have to research this. It certainly does not affect the lips themselves. So if by “over top lip” you mean superior to the lip, then that seems typical, but if you mean actually on the surface of the lip, you may want to go back to your dermatologist to rule out other issues.

  145. Margaret Sanchez says:

    I am 53 year old women. 7 weeks or so ago I got a rash on my face on my chin and smile line area. Additionally there is tightness and redness. After 2-3 weeks it was mostly gone. Then this morning I awoke to the exact rash but more intense. I feel this is somehow related to stress as both times this was the common denominator. Just a thought

    • I would be more apt to suspect a contact dermatitis (probably allergic reaction to something you put on your skin). Now remember, I CANNOT DIAGNOSE ANYONE via this forum, but I mention this stuff so you each can do more detective work. That being said, do a thorough review of all the products that you put on your lips and face. It may just be perioral dermatitis, but if it is an allergic reaction, the solution is much simpler: remove the offending substance.

  146. Cheryl Nehr says:

    In recent weeks I have a slight red rash around my smile lines and a little on the chin. After reading, I think it may be perioral dermatitis. It seems to come one day and lessen and then return. I have used tretenoin for years, but wondered if it was starting to dry me out too much and leading me to possibly over moisturize. Thus, I started using a sulfa wash and Ziana which is less potent than the tretenoin and treats the bacteria on the skin. I am seeing improvement, but it is not completely gone. It seems to look the worse in the evening after washing my face especially if I use an over the counter face bar soap versus the sulfa wash. I am not sure if there is more I should do. I will call my dermatologist if it does not resolve itself soon. Do you think I am doing the right things?

  147. Jessie says:

    Hello. I have Perioral Dermatitis. I am 27. I have had flare up’s in the past and have been given steriod creams.. they are a “no no”. I have found this out the hard way. The flare up started on October 29th 2013. I really didn’t want to go and get my prescription from the doctor due to the fact that it was very expensive and I have read blogs in the past stating that what I have been prescribed (Metronidazole gel) could make my PD worse. Since the 29th I have tired all of the organic ways of trying to heal my PD and nothing has really worked. I did read on using Mederma gel and this seemed to make it worse? Wondering what your professional opition is when it comes to using a Rx. I take a probiotic, I use a natural free from everything facial cleanser, tea tree oil, no lotions, no sun..(I live in MN).. my face hurts from the burning, redness flaking and zit like pimples! Thank you for your time and professional opition!

    • Samantha says:

      I’m not a professional but I wanted to share with you what worked for me. For three years I tried everything. Antibiotics, all the natural things suggested. The rash never went away for more than a day. When I gave up fluoride and sulfates it improved but did not go away. A few weeks ago I tried african black soap and it finally happened-my skin is clear. I just use that and Shea butter. Just wanted to offer it as a suggestion since it really helped me. Good luck!

  148. Sara says:

    Hi! I read your comment below about your rash originally starting with an allergic reaction to beeswax . I have experienced a rash near my lips, and it seems to come back every year about this time (autumn). After I read your comment about beeswax I thought of the bee balm chapstick I use (and probably use mainly in the autumn when the air is dry). I wonder if it’s thus that’s causing my rash!

  149. Shaun Recco (male) says:

    I believe I have this condition. The affected area is around my left eye and it moves. Once the little red bumps dry over, they flake off and new ones appear. My bottom eye lid was affected and currently the outside corner of my eye is re affected which is where this started almost a month ago.

    • BETTY JOHNSTON says:

      I HAD PD AROUND MY NOSE AND SPREADING ROUND MY FACE FOR 3 MONTHS AFTER 2 CREAMS AND AN ANTIBIOTIC DR GAVE ME NYSTAFORM CREAM WHICH I AM GLAD TO SAY AFTER A COUPLE OF WEEKS DRYING AND FLAKING SKIN IT HAS FINALLY GONE I JUST KEEP APPLYING A LITTLE IN THE HOPE IT DOES NOT RETURN BETTY

  150. marivel manaoat says:

    can i use petroleum jelly to make it subside. my case is not severe so its just around my mouth on lip line area only. actually its stinging or mild burning sensation felt around my lip line.

  151. Annetta says:

    I am pregnant and noticed this line that is red in my smile area and a few bumps under my nose. They look like pimples and a rash. If it is what you have called it perioral dermatitis, how do i treat it being pregnant? I have tried acne creams, and other ways to dry it out, but nothing works. It is worse with moisturizer so I am going to take that out. What would you recommend? Thanks

    • You want to avoid using acne products containing salicylic acid during pregnancy. High doses taken orally have been shown to cause birth defects and pregnancy complications. A small amount used topically is generally considered safe, but if it is not necessary, then avoid it during pregnancy. Beta Hydroxy acid (BHA) is a form of salicylic acid and should also be avoided during pregnancy.

    • Kristin says:

      Hi Annetta
      I too had PD my entire pregnancy. It was terrible! I tried everything for basically 8 monthes to get rid of it and nothing worked. I tried to stay away from a prescription but after experimenting with all the natural remedies (grapeseed oil, black clay soap, coconut oil, etc) the doctor gave me Finacea. I used it my last month of pregnancy and it definitely helped the redness and irratation. Good thing is, when I gave birth, my daughter came out with absolutely perfect skin and my pd went away! I’m convinced my suffering gave her a great completion! I absolutely feel your pain with having a terrible rash in your face when you feel
      like you should be glowing but it will hopefully go away like mine did. Good luck and congratulations!

  152. Grace says:

    I started using an organic all plant based moisturizer ang developed this at the corner of my mouth and eye in the same side. Can’t get it to go away even after discontinuing use.

  153. Jillian says:

    Hi. many thanks for you ‘valued’ information. A few years ago I was under a massive amount of stress, I started out with acrid tears which caused eczema around my eyes, I was given eye drops. The eczema got worse and spread, I was given cortisone cream, It them became infected and wept heavily, so I was given antibiotics, then bingo, I now had full blown body dermatitis and was not able to go out as I became extremely sun sensitive! Now my eczema on my face became open sores! they wanted to put me on steroids, but I decided to take the Acupuncture/Chinese medicine route! something fantastic happened within six weeks (two visits per week) it completely vanished! I can never be more thankful to Chinese medicine, it gave me my life back…………

  154. karen says:

    i think i have this ive always on and off since my early 20s had bad skin recently (about 3 months) ago after i finially got on top of my bad skin i started with a small patch of dry red slightly flaky skin either side of my nose which i though was eczema and used my hydrocortisone cream on this didnt work and its only got worse and over the last 3 months it has spread round either side of my mouth and my chin at first i thought it was a bad flare up but the spots have no heads in them the skin is very dry and flaking all over when i dont cover it up with make up all my face is so red it could make me cry, ive beeing using cetrabean none stop for the last 3 months and had no improvement ive been to the doctors who has told me to leave the rash and seemed very disintrested :( much to my dismay. i feel so low and down i dont want to go out as my face is so red and very sore think im going to print this and take it back with me

    thank you

    • Find a doctor who cares more. And generally speaking, GPs (general practitioners/family docs) are usually quite weak in the dermatology department. (No offense meant to those who actually are experienced in dermatology).

  155. Ashley says:

    Wondering if any of you use Clorox wipes? My daughter who is 3 1/2 has this by her eye. It’s been there for 4 days. Two things happened this week that I’m wondering about. She helped me clean with Clorox wipes and the other she was carrying around a dove travel soap bottle. I took it from her when I seen she had it but didn’t wash her hands. Its just lil bumps slightly red on the outer corner of her eye. She says it’s not itchy but in the morning says her eye is leaking a little. As of now using aquafor it this doesn’t help I am going to start cleaning with deluted vinager. My sweet baby. Also might add she has KP on her arms

    • I actually broke out in a systemic rash when I came into contact with Envirocide (a potent antibacterial cleanser I use on instruments in my clinic). There is nothing on the cleanser’s label or in any written info about the substance that says it causes skin reactions. But I know for a fact that is what caused the rash. In many cases, allergic contact dermatitis can show up around the eye, even if the skin around the eye does not come into contact with the allergy-causing substance. If this is what is going on with your daughter, it should resolve on its own now that you are helping her avoid the cleanser. Benadryl helps, but I cannot advice you to give that to your daughter as I cannot dispense medical advice, only information to help you figure things out on your own. Good luck.

  156. Jodi says:

    Hi I first had what I guess was this as a teenager…it was pretty bad:( around my eyelids and my nose burning itchy snd red.I went to doctors who prescribed steroid creams etc which just made it worse.In desperation my parents took me to a naturopath..I took dr schuessler cell salts and just applied aloe Vera and have managed to keep it at bay like this. It seems to me to come on when I am stressed. I don’t wear any foundation usually but do always wear mascara…Interestingly a doc prescribed me the antibiotic mino tabs once and that definitely helped…I am quite stressed at the moment and it has reappeared..Thankyou for your page I am going to stop the advantage cream I have been applying and will head to doctor to get antibiotucs

  157. Tanvir says:

    I’ve just read the article and I would like to give thanks to the author. Often I go through almost similar problem on my face but I am not sure about its identity. The symptoms start with runny nose, cough, often headache and after some days something like reddish un-itchy rash starts to appear between the nose and upper lip. Its painful if the rash is being touched. After some days runny nose turns into discharge of thicker mucus, rash turns white on nostrils. Normally it goes away after some days. Currently I am suffering this and it is winter here.

    • Hmmm…I cannot diagnose this from description alone (And truthfully, I cannot diagnose anything via this educational forum – sorry!). I advise seeing a dermatologist while the rash is visible to get a clear diagnosis. It is possible that it is a herpes infection (or possibly impetigo). Such rashes are caused by the herpes virus that lies dormant in the nerves. If a common cold diverts your immune system, the herpes virus can take advantage of this and flare up with a rash. Check with your dermatologist – it is worth getting a better understanding of exactly what you are dealing with.

  158. Stacy Carter says:

    I am frustrated also. My rash started while I was working a contract singing job in Japan around June of last year and will not go away. It wasn’t until recently that it really started getting worse. It is in my smile lines on both sides and a small patch under my mouth on the right side above my chin. I am so upset because it is not possible for me not to wear make up with my job. I am back in Japan where now the weather is very dry so not using moisturizer is most definitely a problem. I live in hotels and don’t know if maybe it has to do with what the bedding is washed in (bleach) and such. I have had eczema growing up but it hasn’t been for a long time and I am now 53. I have also used propolis candy and honey for my voice, but have stopped since reading about this condition. I wash my face frequently because I wear foundation when I perform, but now I only perform on the weekends and don’t wear make up during the week, but it will not get any better. My skin used to be very clear. What can I do?

  159. Meg says:

    Hey guys i know how your all feeling its horrible. Basically 2 years mine started after my doctor prescribed with me a cortizone cream to use on the skin around my mouth because it was very dry, red and he thought it was eczema however, after using the cortizone for one week i saw an improvement therefore I stopped using it as they were only a few dark marks around my mouth which i thought was when my skin had been damaged. 2 days later I started to notice these spots coming around my mouth and so i applied the cortizone cream this made it worse so I went back to the doctor and he gave me a higher dose of cortizone which at the time i didn’t know it would make it a whole lot worse. The spots seemed to calm down but then they returned worse therefore I kept re-applying the cortizone little did I know this was making it worse so for months every time i saw these spots coming I would put the corizone on. Then one day my mum suggested I go to my local Chinese doctors and she explained to me what was happening. She told me to use this cream which says B6 on it in a white tube and after applying the cream I noticed the spots going straight away! I was very happy. I continued to use the cream for a week and my mouth was completely clear! However a week later they returned so I carried on using the cream again and now i start to notice I can not leave the cream off for any longer than 3 days else the spots come back. My question is, is my skin used to this cream? Is this cream okay to use on a daily basis? I usually wash my face then apply the cream around my mouth and in the morning my skin will be fine. Also I have noticed on just one of the outer corners of my eye I have got a few red bumps, could this be PD? And although I did not use the cortizone by my eyes could it have spread from my mouth to by my eyes? I don’t have any by my nose though. I do get nummular eczema or its also known as discoid eczema so could it be to do with my eczema? Oh and by the way I am only 17 years old and this started when I was 14 nearly 15 after applying cortizone.

    • Thank you for sharing your case. Without examining you, I cannot say for certain what is going on but PD can most certainly show up along the lower lateral (outside) region of the eye. It typically appears as tiny little bumps or a dry red patch. Allergic contact dermatitis can also appear this way. It could also be your eczema. (Now that’s not very helpful of me, is it?) I wonder if the original redness around your mouth (for which the doctor initially prescribed the cortisone cream) was either your eczema or allergic contact dermatitis (be sure to read our recent blog post about such possible rashes here). When you stopped using the cortisone cream, your immune system, which had been suppressed by the cream, was finally able to do its job and it overdid it, causing a worse reaction. This is typical and the way to avoid this rebound effect is to wean off the cortisone – never stop it cold turkey. I do not know what is in the B6 cream (besides Vit B6?), but I would advise the same protocol: wean off it slowly. If you are currently applying it twice per day, only apply it once per day for the next week or two. Then only apply it once every other day for another week. Then only apply it a couple the next week. Then you can stop it and see what happens. Try to avoid applying anything near the eye – that spot will typically resolve on its own when the area around your mouth resolves. Please write back again to update us. Good luck.

  160. Kim says:

    WOW! Just spent the last hr reading all of the comments & replies. I am fairly sure I have PD, as I have everything that describes it perfectly! Back in the fall I found your blog via a fellow blogger & from reading all the info I discovered I too was allergic to beeswax! Changed all my lip & anything with beeswax in it & much to my surprise it all cleared up. Now this all over my face! I have used steroid creams on & off for years as I have very sensitive skin, being a redhead, that kinda goes along with me. Haven’t used creams in the past month and is that why this is appearing now? My face fills like it has been burned! I noticed in one of your replays above you told someone to not use to much oil as it can make things worse, how so? I also use oil cleanse when I have to wear makeup, would it be better to not? I also have been using either jojoba oil or coconut or almond oil afterward because as I said my skin feels burned! I know you can only recommend as you can not see me, but please any recommendations you have & can give will be greatly appreciated.
    Thank you for your time

  161. Jocelyn says:

    I have small bumps around my lip. There red and filled with a white liquid,they sometimes ich. I get them once a while around the yr. Help?

    • Not enough information. Could be herpes (cold sores), contact dermatitis, perioral dermatitis, or something else. See a dermatologist next time it happens so you can find out what exactly you are dealing with. Then you can find the healthiest way to address it.

  162. Juliette says:

    I’ve been picking at my skin and using Clindamycin gel to prevent infection for a really long time and I think I finally became allergic to it and it doesn’t work anymore. The redness, bumps, itchiness started around the nose and then spread to the chin, around the eyes, and glabella. I don’t know if it’s a bacterial or fungal infection, but I’ve tried this natural salve made with goldenseal and myrrh (which have anti-bacterial and anti-fungal properties) and it has definitely helped with the itchiness and the scaliness I had around the nose, but the skin is still a little red and bumpy. My skin is so sensitive that even eating and moving my face makes it more red. I’ve stopped using makeup and only wash my face with clay. I also made a natural mask made with antimicrobial ingredients that help with my acne and skin irritation: manuka honey, apple cider vinegar, bentonite clay, aloe vera, cinnamon, turmeric, and nutmeg. I’ve learned such a huge lesson, don’t touch your face! I’ve heard that popping a pimple in the “danger triangle of the face” area can lead to brain infections and even death!

    • I had never heard of anything called the “danger triangle of the face” before, but it looks like such an idea exists. Thanks for mentioning it! Here is some info: http://www.doctoroz.com/videos/facing-triangle-death. It is definitely good advice to not pick, pop or otherwise open up zits or imperfections of skin on your face, but don’t lose sleep over this danger triangle of the face. For your case, I like some of the ingredients you listed as currently using, but I recommend staying away from cinnamon and nutmeg on the delicate skin of the face – these substances contain oils and acids that can be quite irritating to the delicate skin of the face.

  163. Gloria Rooney says:

    I think I might have perioral dermatitis under my eye. I am female and work in a hospital. I rarely wear foundation and never wear eye makeup. I have recently been applying a steroid cream to a rash my son has so may have touched my eyes. Gloria,

  164. Chrissy says:

    I’m 53 with rosacea. I developed PD for the first time 2 months ago and after 2 dermatologists, 2 different treatments that gave me minimal relief I decided to try my own treatment. Before bed I washed my face with African Black Soap, then in the morning I cleaned my face with a mixture of Braggs apple cider vinegar & distilled water 50/50. My face was completed cleared up including the redness in 3 days!! It’s even helped my rosacea. The African soap makes my skin feel a little tight but by morning it’s fine. My skin feels smooth and soft and clearer than it’s been in years. My maintenance now is African soap cleansing every 2 days, braggs acv every morning. Noxema cleanser or Ponds cleanser on days I don’t use African soap. I hope this helps.

  165. Adam says:

    Hey everyone, another guy here. :)

    I’m 31 and I’ve had issues with skin for a while – since high school. Mainly, I believe to have dyshidrotic eczema – which is a condition where small, clear, insanely itchy bumps appear. I normally get them on my knuckles and fingers (who the hell knows why). I’ve also had them around my elbows as well. Anywho, I have this crap eczema condition going on as we speak. But surprise surprise, I wake up one morning to see some small red bumps on the corner of my left eye. It’s a lil itchy and red too. Awesome. Of course, what I think, is that this eczema has spread. It kind of looks the same, but it’s nowhere near as itchy. It’s a very minor case in that it’s probably only about a dozen or so small lil bumps. Yet, it’s there, and has been there for well over a month now. Possibly two. I don’t know what to do. And that just rhymed. :)

    The eczema issue normally says hello around the winter time, when everything dries out, but seems to get worse when, and this sounds weird, when I’m stressed out.

    Any advice would be fantastic. Good luck to everyone as well. It’s all just a bullshit inconvenience. :/

    • Skin afflictions most certainly are inconvenient! Sorry for your eczema. Dyshidrotic eczema (also called pompholyx) follows a typical cycle of blistering then peeling and drying and then it teases you by going away for a while only to return. While it may take a while to treat, it does respond to internal herbal treatment. Find a good TCM practitioner here. Can’t find someone nearby on that list? Tell me what city you live in and I shall ask my colleagues if they can recommend someone near you. Also, our EczeHerbal ointments can be quite helpful (although they will not “cure” the disease). Use our EczeHerbal 1 ointment during the phase of little bumps, and then apply the EczeHerbal 2 ointment when it goes into the peeling phase. Good luck and update us if you try internal Chinese herbs for this.

  166. Heidi says:

    Hi. I am female and just turned 40 last year. You have described what I have exactly. It started for me about 3 months ago. First around both nostrils evenly. They would dry up and then I would have very dry flaky skin. It cycles like this. Then it spread to my nasolabial area, both sides. Now I have these tiny bumps under one eye – about 4 in a perfect semi-circle that follow the crease under my eye. I have never had acne. I never wear foundation and I wear minimal makeup, if at all.

    I saw a dermatologist in early Nov last year and he prescribed clindamycin phosphate lotion 1%. He said to use it 2x daily for 2 weeks and it should clear up. Well it did nothing (at first) so I stopped using it. But the rash is strange. It comes and goes. In my case, I was diagnosed in April last year as hypothyroid and started taking levothyroxin. I have wondered if my rash cropped up as a result of my thyroid imbalance. Or is it hormonal? I just don’t know. In any case, I stopped using the CPL and set about to mix up my cleansing routine to see if it was product-related. For example, I always cleanse once daily with a gentle scrub like Neutrogena Deep Clean (have for years with no problems). Then I use a light moisturizer (Clinique Dramatically Different Moisturizing Gel). I have been using that on my face ever since I discovered that using traditional moisturizers was causing milia spots on my eyelids. They went away when I started using the Clinique. I think the other moisturizers were too strong. So I tried switching up first the cleanser, then the moisturizer.

    I have had marginal success sticking with the gentle scrub and only using the Clinique on my eyes, and a generic moisturizer on my face. The rash seemed to clear a little. Then earlier this month the rash exploded worse than ever. The only other thing I can think of is illness in my household. My son was sick from Jan 2 – 17 and in the end it was strep which he passed to me. My rash has since cleared up but is it because I was on amoxicillin for 10 days? Did it flare up because of strep? In the past week I have tried adding the CPL back in my routine. I cleanse, then dab the CPL on either side of nostril and nasolabial, then apply regular moisturizer over it. THEN I’ve started adding a dab of neosporin + pain relief around my nose because it was getting so dry, chapped, and painful, splitting at the creases. Long story short, the rash seems under control around my nose and mouth except for these 4 new bumps under my eye.

    I am going to see a different derm next month. I will print out this article and show it to her along with some pictures I took when the rash erupted earlier this month. I would really like to know why, after 40 years, I now have this. It’s very frustrating.

    • Yes, dermatological issues can be exceedingly frustrating. No one has a clear understanding of why perioral dermatitis develops, so don’t hold this against your new dermatologist. It is possible the oral antibiotics cleared up the p.d. for you recently. Topical antibiotics (such as Neosporin) have not been shown to be very effective in most cases. For the flaky/tight phase where the skin can feel very irritated around the nose, my patients apply a thin layer of out Little Red Rash Ointment. It doesn’t clear up the p.d. for most patients (internal Chinese herbs are prescribed for that), but it certainly helps with the cracking and flaking. Write in again if you find something that works for you.

  167. Tracey says:

    Hi, I have just realised the connection between the rash and my job. I am a receptionist at a medical centre, and about a month after I started the rash occurred around both nostrils and has not cleared since, although it does ease over the weekend. I have always worn a small amount of foundation over my moisturiser, and never had acne as a youn girl. I’m wondering if it could be the pink hand wash that most medical practices tend to use.
    Thanks

    • We know that perioral dermatitis is not an allergic (immune) response, so the question is: what is it about the hand wash (or any other chemical we suspect is connected to this) that causes the skin to respond in this manner? I appreciate your contribution to this discussion and I hope we figure out the exact causation. Wouldn’t that be awesome if our shared knowledge solved this problem for the human world?

  168. Julia Hamilton says:

    I have had this condition for about 4 months now and have finally had it diagnosed by a dermatologist. I have it all around my mouth, nose and eyes and it is so sore and itchy it is driving me crazy!! I have used nothing on my face now for 3 weeks and have been taking antibiotics for 3 weeks but up to now I have had no improvement whatsoever. I am feeling very low and just don’t want to be seen by anyone! I am a 53 year old female and have never had anything like it in my life. I just wish it would clear up, it is so painful and depressing, I just want to scratch my face off!

    • I know how you feel I had it for about 5 months myself had antibiotics and creams no good then the doctor gave me Clotrimazole cream and this helped clear it up I have been clear since Christmas good luck betty

      • Julia Hamilton says:

        Thank you Elizabeth, I was given that cream and all it did was peeled off all the time, I will try it again though if it worked for you.

    • LuAnne says:

      The first time I had it, it lasted for months too. After nothing else helped, someone on here said they used Elidel and it worked for them. I got some samples from my dermatologist and it was like a miracle. It was gone in no time. I’ve had it a few times since then but it hasn’t been as severe and it hasn’t lasted as long but I usually start taking antibiotics within a week or two of the symptoms starting and I only have to take them for 2 weeks. I really recommend you try the Elidel, though. When I had it so bad that I didn’t want to be seen in public, it helped a lot. It does have a long list of side effects though so I would only use the smallest amount you can get away with.

  169. Julia Hamilton says:

    Thank you for that, I am on my way to the chemist now to see if I can buy it over the counter, I’ll keep you posted.

    • LC says:

      You can’t…Elidel is a prescription and it’s pretty expensive. If you’ve been seeing a dermatologist, you may want to ask if they have some samples. That’s what I did and I only had to use a small amount from the sample tube before it was cleared up.

      • Julia Hamilton says:

        Hi LC
        I am in Spain and you can buy a whole load of things here that are prescription only in most countries. I managed to get some – as you said VERY COSTLY €40!! but I tried it last night and it was very very sore and inflammed, but I am going to persevere with it and I’ll let you know how I get on. Thanks v much – Julia

  170. Diane says:

    Does anyone know what the Internal Chinese Herbs are that are good for this. I was doing real well until this weekend & it flared up again. Am suspect of some things .. slathering coconut oil on that area, or eating gluten, overeating, so stil mysterious.

    • When we prescribe internal herbal medicine in TCM, we formulate according to how things present in the individual. So, there is not really one set of herbs or one herbal recipe for the treatment of perioral dermatitis. There are certain herbs that we tend to use in most formulas for perioral dermatitis, but these herbs alone will not cure the condition. To get a prescription for yourself, seek the care of a licensed professional:
      http://www.zizaidermatology.com/blog/find-tcm-specialist/

  171. Cristin says:

    I am 41 years old and have never had any issues with the skin on my face. Not even when I was a teenager. Then about a month ago I started noticing little bumps around my lower nose and lower cheeks and it eventually turned into what appears to be severely dry skin. It has spread to most of my lower face and chin, though there seems to be a bit of a barrier around my mouth. I asked my doctor about it and she suggested it is just dry skin due to the season. She gave me some Dove facial soap and moisturizer meant for sensative skin, but that only burned. I took to the internet in hopes of finding and answer and the symptoms here seem to align. There are 2 changes that could have induced this. 1) we got a puppy and I’ve never owned a dog before and 2) I started using Colgate toothpaste instead of Tom’s of Maine. I’m going to follow the suggestions here to stop point moisturizers on my face, wash with only water AND I’m going to switch back to Tom’s of Maine toothpaste. I will let you know how it goes.

  172. Julia hamilton says:

    Thanks to LC I have tried elidel cream that she suggested which was ver expensive but along with the antibiotics the dermatologist gave me I pleased to say that my PD is finally clearing up hurrah!

  173. Jodi says:

    Hi went to the doctor finally after stopping all the nasty steroid creams (which did seem to help briefly but then only made it worse) and was prescribed mino tabs a low dose antibiotic as the doc said perioral dermatitis is a mild skin infection…I have been taking these for 15 days now along with putting aloe vera on the red bumpy patches and using thin Lizzy concealer cream which covers it really well and moisturizes it and after about a week of the antibiotics it has really started to clear up:) I can now go out and off to work without putting any concealer on and it has completely stopped burning flaking and itching!!!
    I really believe stress and potentially eatIng too mUch sugar are my triggers for this..the concealer allowed me to still go to work and out in public. Without this it looked so terrible.wearing the concealer made me feel better therefore reduced the stress..In my case it did not irritate the condition as it was not an allergy..hope this is helpful :)

  174. dj says:

    Dear Zi Zai –
    I am pretty certain I have perioral dermatitis but I am not certain what has caused it. A dermatologist that I saw once for skin irritations and acne on my chin presecribed a variety of topical treatments, one of which was Cloderm. Upon researching further, it looks like Cloderm (clocortolone pivalate) can cause as a side effect, perioral dermatitis. And, as I read on your blog steriods in general tend to cause PD. I am 41 and have had relatively good skin up until the last bunch of years (having three children, increased amounts of stress and significantly reduced hours of sleep due to stress). But, now I am suffering from what seems like PD (around the sides of my mouth and chin) coupled with the occassionally acne breakout also in and around my mouth and chin with random ‘dry’ patches around the side of my nose or on my forehead (but small above my brow. I am looking for a regimem to follow for facial cleansing. I am vigilent about cleansing my face at night — typically with Jason Pure Natural Super C Cleanser. Over the past two months I have stopped using any type of moisturizers and started to use avocado oil or Coconut Oil as a moisturizer. Is this the right skincare regimen given the changes I am experiencing? I assume stopping the use of Cloderm is wise. Thank-you for any advice you can lend. Confused and frustrated. -DJ

    • Hi. First off, no one really knows what causes PD and it often is mistakenly diagnosed as acne in many cases. Coconut oil or avocado oil should be fine, so long as you don’t apply more than twice per day. I have not found one perfect skin care regimen for PD but many of patients have gotten good results using the following:
      HerbFlower Cleansing Powder (any of the varieties) – as daily cleanser
      AcneHerbal Facial Toner – apply after cleansing and patting skin dry
      AcneHerbal Facial Serum – to gently moisturize without clogging pores (and the herbs help address acne-like blemishes)

  175. Di Marshall says:

    Hello, I also suffer from PD. I am 54, so I thought I should have escaped this skin issue. I am also in the health care field . My PD seems to improve when I am off work. Therefore I must be allergic to work. LOL!!

    Thank you for this very useful information. I have been trying to improve my PD condition naturally. I first tried coconut oil topically. It made my skin feel better, but didn’t really improve it. I then started using grape seed oil. Again, this made my face feel better by reducing the burning and dryness, but did nothing to improve my PD. Next was Aloe Vera. That seemed to make my face feel more dry. Stopped the Aloe after two days.

    I stopped using any kind of makeup, lashes, ect several months ago. I also just use my facial cleanser, but quit all of my other facial regimes. I use a medi spa line called Clarity Rx.

    About five days ago, after it went to bed. I was having a hard time falling asleep due to the burning and dryness on my face. I remembered I had some Mary Kay Extra Emollient Night Cream in my night stand. I put that on the inflamed areas. I have a bad patch that was the worse below the corner of my mouth. Also, around my nose , in between my eyebrows and my eyes. ( eye lids, under my eyes and some pimple like sores in the corner of my eyes. I also had a few pimple like sores on my lids as well). The next morning. My skin had improved by about 30%. How can this be? Everything I had read instructed that I not use anything on my face. Especially a petroleum based product. I’m not sure what’s in that “pink” Mary Kay stuff, but it is greasy in my opinion.

    Five days later, and my face is at about 90% improved. I noticed after a 10 hour work day, my face was “pink” in the PD areas but not as bad. Most of the pimples are gone, but a couple still remain. I really don’t know where to go from here. I know I shouldn’t use the Mary Kay for my PD, but I do like that my face feels and looks better.

    I just wanted to share my story and get your thoughts.

    Thank you
    Di

    • Julia Hamilton says:

      At 53 I too thought I had escaped skin problems like this, but after consulting with a dermatologist who gave me antibiotics and using Elidel cream which was on prescription and cost €40 a tube, (and which was suggested to me by another sufferer) I am completely free of this awful dermititis!! It took a good few weeks, but I am pleased to say I now longer have it – hurrah!!

  176. jen says:

    Hi – Thank-you for your response. I have used a topical Erythromycin to slow down the PD which seems to have helped but it is hard to tell. I’d rather not be relying on an antibiotic but I want to try and eradicate the PD and then adopt a better long term skin care regiment. Do you have an opinion regarding the use of a tea tree oil skin ointment (specifically, Desert Essence) or the use of tea tree oil in general to help treat PD? I will check out your skin care suggestions above. -dj

    • Julia Hamilton says:

      As I have said to other suffers, I tried antibiotics and Elidel cream which was suggested to me by another sufferer, and although the cream is expensive €40 and only available on prescription (unless you live in Spain like I do!) it has cleared up my PD and I have completely clear skin again. It took a few weeks, but well worth it.

  177. Kristina says:

    I am a 38 year old health care worker. I am a speech therapist in a long term acute care setting. The only correlation I could see between therapy & nursing is the alcohol based hand sanitizer we all use or the latex free gloves. I have had this rash before around my eyes. Seems to break out when I use a moisturizer my skin doesn’t like. About 2 years ago I started getting small white bumps on my chin, sides of my face and forehead. I started applying my son’s Elidel to those affected areas and they would temporarily clear up. About 3 or 4 months ago my rash moved to the “smile creases” and on pasts of my chin. Red, bumpy, sometimes itchy and burning as you described. I just saw my PC NP and she prescribed an oral antibiotic. It’s been 4 days and j have to notice as difference. Today actually seemed to be over of the worst days. I do apply a light moisturizer for sensitive skin under the BB cream I use. I will stop doing this post your advice.

  178. Kelly says:

    I’m a dental hygienist. I have been getting red patches/bumps/fluid like spots around my mouth and where my glasses rest on the bridge of my nose, for about 6 months. Tried a lot of stuff but nothing helps. I’m the same as many of the other health care professionals in that it gets better over the weekends and has completely gone away when I am on vacation. I am now going to try different masks. I was thinking it could be the aluminum strip in the nose of the mask, but I am having a hard time finding masks without it. But the red pimply looking rash around my mouth also shows up the first day back at work. I’m on the no lotion or anything on my face mode now. I am 57 years old and I am not loving it. I went to a dermatologist and he said to use metro gel. it didn’t help. he also thought it could be contact dermatitis from my glasses and to try a piece of mole skin on the pads. I haven’t done that yet, but the spots aren’t just there either. I just wonder why after 12 years has this started. Something with my old age maybe. i was also looking at getting different eye glass pads for my loupes. next option is to get some hypo allergenic masks, and rip out the metal nose piece if i have to.

  179. Juliette says:

    I wanted to follow up on my POD and let everyone know what has helped. I still think clindamycin topical gel triggered it, more specifically the harsh ingredients such as propylene glycol it contains. Also I’m allergic to benzoyl peroxide and never in a million years would think that something like organic cotton balls would give me a rash, but they’re bleached with hydrogen peroxide, so that might be a suspect as well. I decided to take oral antibiotics, doxycycline, a couple of weeks ago and they have helped tremendously, the redness is almost gone! This is the only thing that I’ve read has helped others quickly, so I recommend going to a dermatologist or your PCP to get a prescription. Topically I decided not to put anything on my face considering that practically everything that you can get over the counter or with prescription has nasty ingredients (glycols, parabens, SLS…). I only wash my face with clay, that’s it only 1 ingredient! You can use any kind, kaolin, moroccan red, bentonite…it’s so simple just take a tiny bit and mix with water, and voila you have a cleanser. I highly suggest to put products on your face that have minimal ingredients that you can actually pronounce and that are certified organic. Try to minimize putting anything on your face until the rash clears up. Obviously toothpaste and shampoo are a necessity. I recommend Uncle Harry’s tooth powder, it contains very minimal ingredients and is non irritating. As far as shampoo, it was very difficult to find an organic shampoo, they don’t exist until I found Nourish body wash, it says it’s body wash, but it works just like shampoo/conditioner in 1 and it is as pure as you can get.

  180. Juliette says:

    Well, actually that shampoo is not as pure as you can get, raw eggs would be! Before there were shampoos, there were raw eggs, 1 ingredient!

  181. I had perioral dermatitis for more than 3 months, I was so frustrated with it that I began going into a depression and losing my job. That sounds a little extreme but at the time I was single and I guess you could say somewhat hoping to find a husband. I could not date, because my face looked like an unexplained out of control bumpy bright red rash. I would pray everynight that I would wake up and it would be gone! I searched hopelessly for a cure, trying many different steroid creams that the doctor had given me for and started just trying whatever I could find. I seriously tried everything from Valtrex to yeast infection cream to mayonaise! I seriously would have put dog poop on it if I thought it would help. I finally came across a picture of a woman with the exact same looking rash, that was the first time I had heard of the name. It said the treatment was to do 10days of antibiotics and that’s it!! Also, that the steroid cream only made it worse! I had been using the steroid cream for many months now to simply control the redness some that I was developing stretch marks around my mouth. After I stopped the steroid cream, the rash got 10x worse I was tempted to use it again, the article said it would get worse before it got better. My skin had been so used to having the cream that it went in some what of a withdrawal. I hung in there and after about 5 days of no steroid cream and continuing to take the antibiotics while also applying antibiotic ointment it was disappearing!! Finally, I felt hopeful and within 10 days the rash was gone!! Now, after 5 years there are still minimal scars from the steroid cream they look somewhat like stretch marks around my mouth. But I am glad I was able to find a cure before I continued to abuse the skin any more than I already had. There is hope!

  182. Karen says:

    I have suffered with Perioral Dermatitis since I was a teenager, although it was not diagnosed correctly until a several years ago, I am now 46. The rash would typically begin with one red raised bump in the fold between my nose and lip. It has the appearance of a pimple but I know immediately that it is not as it feels entirely different; it almost fees sore like a rug burn, for lack of a better description. For years I would treat it by keeping the area clean and using whatever cream I could find in the medicine cabinet. It always seemed to be lingering beneath the skin just waiting for an outbreak, A few years ago, I began using cortisone cream on it and it appeared to be working. This was the worst thing I ever used. Soon after, the rash began to spread (until then I could confine it to the one are) down to the chin. If I attempted to stop the cortisone, it got worse. I had seen a dermatologist prior to this who had prescribed doxycycline which cleared it up but it returned within several months of discontinuing. I did a little of my own research, discovered that the dose prescribed was lower than what was recommended which would explain the limited effectiveness, I gathered my research and history and found a fabulous dermatologist who listened to all of my information and prescribed the recommended dosage of antibiotic.The key here is that I found a “specialist” who was listening to me and not making a diagnosis with one glance! So , after completing the prescription I was free of this rash for the longest period of my life, nearly 4 years! I did not realize how tormented I was with this until I was free of it! Unfortunately, 3 days ago I began feeling that little pimple in the philtrum (groove between nose and mouth). I am so disappointed that it seems to be returning! I do wear liquid foundation daily, I work out daily (sweat aggravates this) and I work in the healthcare field (this is not something I can link to the problem, but who knows?). I am trying to get a handle on it without antibiotics but it may be my only option. Vanity causes me to continue using the foundation whenever I leave the house and as much as I know it is part cause for the problem, I can not resist applying. For the record, the first dermatologist put me on a topical medication (don’t remember what it was) and it was very irritating as most creams seem to be.. Hope this info helps someone!

  183. Wendy says:

    I am now convinced that this is what I have. I am a lawyer so doubt there is much of a link with occupation for me except for stress (I do notice it seems worse when I am more stressed). I had a derm appointment today but had to cancel due to being stuck in court. Of course I am frustrated because I was hoping to have an answer/treatment. I had an early emergency spay (hysterectomy) a few years ago and since that time my skin has been odd to say the least. I have acne and dry skin and all sorts of combinations that don’t go well together. I first started with the bumps after I’d been sick for about 4 weeks from mid December through mid January. Admittedly, there were times I didn’t wash my face because I felt awful and honestly the rash seemed to be better the less I did to my face. I tried some steroid cream I had for some other weird flaky stuff I had on my chin and it seemed to work well…. Initially. Then the rash reappeared and was a little more obstinant to my parade of creams but it went away. Now it’s back and shows no signs of retreat. Since I missed my appointment today I decided to surf and came across your page and now I’m certain that what I have is PD (not trying to diagnose myself, but wondering why my efforts aren’t working). I didn’t read through all the replies here but wondering if PD goes along with various immunodeficiencies or over active immune systems. I’ve had some other issues (intestinal) that are happening around the same time as the PD. I tend to have “flare ups” of it all at he same time (not trying to over share, just curious).

    I’m going to try your advice and I will post back. Thanks for your awesome wealth of knowledge!

    • Diane W says:

      Wendy, 1st I have concluded after several trips to a Derm Dr that all she ever does is give me some type of prescription cream. I wanted to find the ROOT cause. So I don’t know that you will learn as much as you do on this site quite honestly (just my 2 cents that’s all). But ..

      re your last comment: PD going along with various immunodeficiencies systems — I believe it does!!! (again only my 2 cents) After having a root canal, my health went down & come to find out thru blood/stool tests I have a heavy growth of a bad bacteria in my gut, so my immune system is very compromised as well, which goes hand in hand w/ root canals. I recently went to a biological dentist who removed the root canal + 4 crowns because underneath were mercury fillings & mercury. That was the 1st step. Now to rid my body of this bacteria, & get my system back in shape. And THEN I’m hoping for good skin.

      • Imbalances of gut flora most definitely can be reflected in the health of the skin. Not only are those bacterial colonies necessary for our overall immune health, the endothelial lining of the digestive tract is very similar to our skin and our skin on the outside often mimics what is going on on the inside. And any deficiency or over-activity of the immune system can contribute to skin maladies. However, just because a person has a skin imbalance, this does not necessarily imply that they also have an immunodeficiency or an autoimmune disease. In many cases, a full health history should be considered when a new chronic skin condition develops to be certain that no other underlying health issue is also present.

  184. Fi says:

    Thanks so much for your helpful website. I’ve got what looks like & what the dr believes is Periocal Dermatitis. It came up as 1 bump at the edge of one eye 5 months ago & they steadily multiplied and i now have about 12 all underneathe and some come up on the top eye lid. ive been using Aloe vera from the plant on it twice a day for 3 weeks & taking probiotics & zinc but the bumps keep coming. Is periocal dermatits treated with the same things as perioral dermatitis? Also is it normal to only have it under one eye? Your help would be so greatly appreciated! Thank you

  185. Kelly Flores says:

    I have always had very sensative skin. I have never really worn anything more than cover up in the way of makeup except on a rare special occasion. All I have really washed with was water, and occasionally used Neutrogena sensitive skin cleanser and astringent on days when I really sweat. I have been blessed with fairly clear skin and een complexion all my life.

    In January I turned 42, and a couple months ago I started feeling a tight swollen feeling all around my nostrils and sides of my nose. Using my normal stuff with salycilic acid in it I was hoping to avoid acne, but I broke out anyway. The skin became very red and bumpy all around my nose. I was not using makeup, I am unemployed and looking for work for 22 months now. The last month it has seemed to spread like wild fire. It is now around my nostrils un der my nose, down around both sides of my mouth and chin, and at the corners of both eyes and creeping underneath them. I can barely touch my face to wash it with plain water, or on good days I try Oil of Olay sensative skin wet and wipes. I am ashamed to be seen in public, and this is the most important time of the year for a teacher looking for a job.

    I have no insurance due to not being able to afford it. I paid a $75 office visit to a clinic last week because my face littlerally is dry and scaly, and if I accidentally scratch a bump it seeps and bleeds like crazy. The nurse practitioner who saw me never came closer than 6 feet away. She said it looks like Eczema and prescribed a scalp oil steroid to apply at night. The prescription is $197 for 4 ounces! I can’ t afford that. My sister, an RN gave me a little of the same stuff that was prescribed and I have been using it nightly. My face is even worse now. The underlying discomfort has eased but my face is dry and feels like it is going to split. There are a lot more itchy bumps too. My sister says they told her she has “Delicate European Skin” we were born in England and have Mum’s sensative skin. She said that oil clears her skin up within 3 days and it happens to her every spring and fall when the humidity changes in the air. I have used this well over a week now and it is not clearing up.

    I am wondering if I need to call that clinic and ask them if it can be PD or if they will call in an oral antibiotic to see if it clears up. My hair has also gotten brittle and sheds worse than normal. I have spent over an hour reading all the comments and suggestions here and am rather confused as what to do.

  186. Brandy says:

    I found this page beyond helpful (but also panic-inducing as I see “months” and “antibiotics”) however before I could get to a Doc I had already picked up and taken my prescription Valtrex (for herpes but also takes for cold sores, which I have). The symptoms immediately made me believe I had a newly evolved form of my herpes simplex one. I had never felt anything like it except- cold sore. I also popped a 1,000mg lysine while I waited for my presc. to be ready. As I always do when I feel the itch. Since it was clearly coming in as a rash, I pulled out my rarely used “Lysine +” ointment, active ingredient: zinc oxide and applied like moisturizer. It calmed it immediately. However for the next day it stayed steady, and I still had to wear make up for work. I know this came on via stress as I was moving, was 3weeks into a new job, and my relationship was STRUGGLING. I used zero new products, same ones for a year or two now. And they’re even Origins! I am now looking at a almost clear face after only two days of this accidental method. I know it was PD. I matched every photo. But I believe zinc and lysine saved me. Of course I’m continuing my method, because who knows, but it’s dramaticlly better. Also, I have been on NuvaRing for four months now, so I wouldn’t omit a hormone issue. PLUS I took accutane 7 years ago, developing a heat/sun intolerance 5 yrs ago. Sorry for the novel, just wanted to share!

    • Glad you found something safe (the lysine and zinc) that worked for you. And I am glad you found our blog helpful. But I caution you and all readers not to rely on photos for self-diagnosis of skin ailments. It is sometimes unbelievable how similar unrelated skin conditions can appear, or how differently the same disease can manifest from one individual to another. Thank you so much for sharing and I hope your skin continues to stay clear.

  187. Jenny says:

    Thank You! I think I can now get this under control. I was wondering though what herbs can be used? I am planting my first organic garden and thought maybey I could plant some.

  188. Andrea says:

    Is there any treatment recommendation for children? My son got his 4-year immunizations last week and nada localized reaction. We were told to treat with hydrocortisone. And this weekend he developed the rash around his mouth, nose and cheeks. Is there anything we can give him OTC?

  189. Sheree says:

    This is what worked for me. Please try this stop applying steroid creams. Stop using floride toothpaste stop eating cinnamon. I am using Toms floride free tooth paste. I get it from the health food store. I also apply DERMAE ITCH RELIEF LOTION it has ‘tea ‘tree, ‘vitamin E and Chamomile in it. This i also found at the healthfood store. After I put the DERMAE on I apply a thin layer of BALMEX diaper rash cream it has zinc in it. This i found at target. After doing this for one to two weeks I found that my rash had lessened and started to disapear. It’s been 5 years now for me that I have no longer suffered with the rash. Once in a while i start to feel the slight burning on my face and at that time I imeadiatly apply the Dermae cream. I no longer use the Balmex because the Dermae keeps it at bay. Occationaly I now have cinnamon or floride and notice the burning sensation on the face. I hope this works for others out there. I know what a burden this was for me and I had to share.

    • Thanks for sharing but I have to strongly CAUTION AGAINST ANYONE SUDDENLY STOPPING THE USE OF TOPICAL STEROID CREAMS if you have been using them for more than a couple of days. You can develop a strong rebound reaction where the rash gets worse than ever. Titrate down – slowly reduce your use over time. Then you should be able to safely stop it. How long it takes to titrate down off the drug depends on how long you have been using it.

  190. Andy says:

    I am a 27 year old physical therapist having trouble with my skin,around my mouth and right eye. 3 years ago my doctor told me the face rash was an allergic reaction to shellfish (got an allergy test for shellfish- negative) took predinsone and it cleared up in a week or 2. One month ago the symptoms came up again (redness around my mouth and around my R eye- itching, burning, dryness)My doc said it looked like a contact dermatitis- took benadryl and it resolved in a week. Exactly one month later it is happening in the exact same area again… So annoying! I currently have hydrocortosine cream…am taking Benadryl… and have a referral to a dermatologist…

    • It could be allergic contact dermatitis – the skin around the mouth and the eyes is very sensitive so you actually can get a reaction in those areas even if the allergen did not directly contact that skin. Glad you are going to a dermatologist to get it figured out. With skin stuff it is always best to know what exactly is going on. You can choose more natural treatments (rather than cortisone cream) but it is best to get a diagnosis so treatment will be as effective as possible. Good luck!

  191. tammy says:

    I am also a nurse that developed this in Feb. I declined getting the flu vaccine, so we had to wear surgical masks. I wondered if some chemical in the masks sparked it? Does anyone know if they are chemically treated? Or the fact that while I was talking the air in the mask and on my face was often moist(yes, I dislike the word, too:)). This is also the same time I came off a loonnggg run of antibiotics, 7 months. I keep thinking it could be fungal.

    The hand soap that we use has a main ingredient of triclosan, which is used as a pesticide. So, that’s wonderful we get to put that on our skin numerous times a day.

    I wonder if we are developing allergies to nitrile gloves now? I keep a box of nitrile gloves at home to wear when I cut peppers/onions/garlic and also when I clean. Looking online, it looks like some people are sensitive to these gloves.

    I would love to find the correlation with this rash and health care workers!

    What keeps it at bay for me is Manuka Honey masks in the am and before bed. Zinc pills(take on full stomach) and also I used diaper rash cream that has 12%zinc on my chin and leave it on overnight.

  192. Jessica says:

    I had a rash that broke out around this same high stress period last year. I’m finishing my master’s degree and this is exam/deadlines period. However last year it seemed to be more like contact dermatitis on a limited area on my right cheek. This time it started about 3-4 weeks ago as what looked like a breakout as a reaction to the sample kit I ordered from Paula’s Choice (Skin balancing kit). I think the combination of products with 2% salicylic acid and retinol really must have irritated my skin. I have combination skin (oily t-zone, rest is normal with dry patches in the winter). I noticed that this breakout area was really dehydrated and my T-zone was getting so oily. No matter how much moisturizer I used, it remained flaky until I applied hyaluronic acid. The oil balance has since balanced out more.

    These breakouts became several whiteheads and have disappeared. However, now I’m left with this rash that seems to look like PD. I have not gotten to see a dermatoglogist yet (because where I live, it takes an appointment and waiting period of 3 months before I get to see one) and honestly, I’m not too keen on taking an anti-biotic for so long and prefer a natural solution.

    Yogurt masks and especially a mask of honey with some tumeric have helped to calm it down. It feels slightly itchy when I wash my face. It was calming down and appeared to be subsiding right up until last night. Now it’s more irritated again and I can only think that the oatmeal mask with yogurt I tried using yesterday had irritated it. My mom thinks it’s not PD despite my rash having a similar pattern and thinks I’ve just aggravated my skin too much.

    What I intend to do is:
    - continue the honey and tumeric mask (sometimes I open a capsule of probiotics and mix in).
    - I wash with an SLS free soap and spray la roche posay’s serozinc after. La roche posay’s cicaplast baume B5 helps with moisture and some soothing. But it’s not miracle cream in getting it to disappear.
    - Increase my probiotic intake for a while
    - try a paleo diet as I’ve understood that PD could be an overgrowth of candida?

    I desperate to find a solution to handling this for fear of it returning in the future. I still have another stressful year to face before I’m home-free. Perhaps a cream with zinc might be a good investment.

  193. amanda says:

    I am 27 and have never had an issue with my skin and one day woke up with a rash to the right of my chin it was very red and flackey … I told myself I was probably about to start my period and didn’t think much about it well after 2 months went by and it got worse (on my whole chine under nose and beside nose) I started to get very frustrated…. I don’t use and special cleansers I honestly use cover girl foundation from the dollar store because that’s how non sensitive my skin…. I work with a racialist and she started giving me things I could try because again it just looks like dry skin… I’ve used st ives cleaners …. I’ve tried great moisturizers… I tried coconut oil…. And now the past few days have been trying aloe from an aloe plant. It always seems like its starts to go away then BAM its back… Well it just dawned on me that I’ve been taking a pill called slim trim u (an all natural bee pollen weight loss pill) I’ve taken it for awhile but was thinking maybe I’ve taken it too long and maybe its making me produce too much estrogen and my body can’t keep up???????? Or it causes dry mouth horribly could that be a cause?????? I stopped taking the pill today to see if it starts to get better…. Any thoughts….. I’m so sick of looking at this horrible rash and I feel like when I’m talking to someone that’s all they see.

  194. Tami says:

    Having always had very clear skin, this whole facial rash thing has been pretty disturbing. Fortunately (at least so far) it has not reached the extent of some of the reports I have read on here & I’m trying to keep it from spreading further. I too believe I have perioral dermatitis. I am also a health care worker, although I no longer work in direct patient care & therefore am not exposed to some of the chemicals as frequently as others are. However, I do not fit the age range that is usually affected by this condition & that had me a little confused. I am 55 years old & have been post menopausal for the last 4 yours. Then I read on & found out the condition can be brought on by chronic topical steroid use even if the steroid is not being applied directly on the effected area. Well, let me tell you! This fits me to a T! You see, about 8-10 years ago I developed granuloma anullare (GA). The only treatment for the circular lesions which look alarmingly like ring worm is yep you guessed it! Steroids! I have had multiple injections over the years to remove particularly stubborn lesions that did not respond to the topical steroid cream. This condition is set off by stress. I changed positions last year & went from a clinical position to a research position. Quite a change & learning curve for me! I noticed a huge increase in my GA and have been relying very heavily on my clobetasol cream. In fact more so then ever before in the history of my GA. As I have settled into my new position, my stress level has decreased somewhat & the GA isn’t being quite as bothersome as it had been before. I’m pretty caught up with my lesions right now so I recently quit using my steroid cream. Now comes the PD part. Just the past few weeks I have noticed the same type of lesion everyone else is describing. At first I am thinking dry skin, then I’m thinking poison ivy, from there I moved on to a Herpes outbreak (of which I have never had in my life!) I moisturized, exfoliated & cleansed the area like crazy! Then I got the wild idea to try topical steroids. I didn’t want to use my clobetasol because I knew that was pretty strong & thought it wouldn’t be a good idea to put it on my face. So I got some over the counter cortisone. Success!!!!Or so I thought. Stopped the cream, it came back. I thought maybe I didn’t use it long enough, so I tried it again. Same thing. Okay, that’s not working so I started looking to the internet for some answers. I don’t really have anything definitive to report just yet, but I’m trying. I looked at my skin product labels and have stopped all product with SLS in it. I have also stopped the use of fluoride. So far I am treating it with topical tea tree oil. It’s too soon to say if anything has helped yet. From what I am seeing, I’m not putting too much hope in the tea tree oil. It seems it is met with varied success for this condition. But I do prefer a more natural method of dealing with things like this so I thought I would give it a try. I am considering a paleo diet as well. I am part way there anyway with some changes I have recently made to my diet so that may be the way to go next for me at least.
    First GA, now this! Both difficult to treat. Why are skin issues so darned hard to figure out? You wouldn’t think it would be that difficult!

  195. Krissy says:

    Hi there,

    I’ve had a rash under the right side of my nose for 4months now. It’s really itchy & sometimes has white bumps with fluid (like small blisters) that turn into a red patch & eventually flake. I’ve been tested for a bacteria/staph infection & I don’t have that, though I’ve been using Bactroban for 7 days & it hasn’t really changed. I tried metrogel but it caused the blisters to spread. Since getting the rash. I’m just washing my face with Himalayan salt & using coconut oil (but I don’t put coconut oil on the affected area) which hasn’t made it any worse or better. I’ve changed my toothpaste to fluoride free & am taking sink tablets but it hasn’t really changed. My doc gave me antibiotics (6 weeks) for perioral but I’m reluctant to use it in case I don’t have it & it causes it, does it sound to you like I have it? It hasn’t spread anywhere else but it’s driving me crazy & it keeps getting better & then a lot worse. I don’t wear any makeup apart from mascara & eyeshadow. I haven’t used any cortisone creams at all. Thanks for your help

  196. Amy says:

    My husband and I both were diagnosed with this around the same time. Started around my husband’s eyes. I got it a couple weeks later. Now it’s spreading across my face while his is mostly still around his eyes. Convinced it must be bacterial and contagious to some extent. My daughter started having eczema the same time. Anyone have suggestions? I can’t do antibiotics because I’m breastfeeding. Have done all the natural remedies and nothing has worked.

  197. Sarah Nelson says:

    I was first diagnosed with eczema at the age of 18, a year ago last February/March by my family doctor who didn’t seem to give my diagnosis much thought. It originally showed up like typical eczema, dry, red, flaky skin on one side of my mouth and leading to my nose. I had just returned from a 3 month trip to Ghana and had actually contracted ringworm while I was there. That was cleared up, and I was told that there was no connection between the two. Initially moisturizer (Okay Complete All Day moisturizer, SPF 15 oil free) worked to keep the flakiness and pain down, but was not a cure by any means. It was then that I sought treatment and was told that I had eczema. I was prescribed what I am now told was a very hard steroid cream that should not be used on the face whatsoever, as it causes severe bleaching of the skin and many other symptoms. I no longer have the cream so unfortunately I am without that information, but I used it for several months with varying results. Shortly after starting to use said steroid cream my “eczema” went away, but a rash of tiny, red, blister like spots appeared on my face and continue to appear to this day. They ooze clear fluids when popped or if a major flare occurs and I use my new steroid cream. In December I was given a “natural aloe cream” which I threw out promptly after realizing that when applied it caused a full facial flare. At this point my ” one side of the mouth eczema” had turned into a both sides of the mouth, nose and around the eye rash that sounds exactly like what you are describing. Before using the aloe treatment that one time I had never had a flare anywhere other than my eyes, nose or mouth, and to this day have not had another. In December, upon finding out my face had, basically, exploded, I went to the hospital to see another doctor. I was met by a doctor I had never met, and was slightly more interested in my “eczema” than my family doctor. He was astonished that I had been prescribed such a strong steroid for my face and instead gave me Elocom Cream 0.1% (Mometasone Furoate 0.1%) and told me to use it for two weeks twice daily, and after that to use a plain Glaxal Base that he also prescribed me. I took my prescription to my pharmacist who promptly told me that if I ran out of the Elocom Cream to come back for a renewal. He didn’t seem to believe that two weeks was enough. The Elocom Cream finally reduced the flare and after only a few days there was almost no trace of it ever having happened. To this day, I still use my Glaxal Base cream, twice daily, and only use the ElocOm Cream when there is a stronger flare. I still haven’t used all of the Elocom Cream prescribed to me, as I use it sparingly. It also seems to make the fare ups worse before they get better, and it works incredibly fast but it is not a cure.

    I have since cut dairy almost completely out of my diet, I live off Almond milk and dairy free yoghurt and have found stress to be another trigger. Less stress and lack of dairy have seemed to improve my skin, as dairy is apparently also an acne trigger. Some days I am almost completely rash free, and others I am not. I do wear make up most days, as I am 20 and that’s not uncommon, and the only face wash I use is Olay 2-in-1 daily facial cloths, which now that I read the back sound like a nightmare for my skin. I follow up with Bioré Blemish Fighting Astringent, my usual Glaxal Base cream, and 10-15 minutes later apply either my Olay oil free moisturizer or Bio-Oil. After that comes the make up, usually only used to hide the rash itself. I have not worn make up for three weeks straight, but have used the Glaxal Base and Elocom Cream when needed, and still the rash persists. I do not believe that this is eczema, as every account of eczema seems to follow the itchy, flaky, painfully rule and I have none of those. My rash isn’t particularly painful to touch, only to look at. Also, what I now consider a “flare” is usually more than a quarter shaped rash of more than a dozen bumps. I often only get seven or eight red bumps at a time, and on the odd ocassion, one or two in a different location (other than my eyes).

    There is almost always a slight rash on the right side of my mouth, where the initial rash appeared, and the rash around my eyes, which only showed up in September, is extremely treatable.

    As a young adult, the last thing I want is a rash to exist so soon after I grew out of my acne and I am desperate for a more productive treatment, if not an outright cure. Any opinions or recommendations are greatly welcomed. Thank you so much for your time!

  198. Helen says:

    Hello. I am 28 and am having an ‘episode’ of what I think is this condition at the moment. It started before Christmas last year and looked as if I had a cold and had been blowing my nose alot (very red around my nose)and has spread to the area below my mouth. Luckily it is no where near as bad as some of the pictures I have seen. I went to the pharmacy and they suggested trying E45 cream which didn’t seem to help at all. It looks worse straight after a shower etc. I will try using only the bare minimum on my face and see how that works out.
    Good luck to everyone else.
    Oh, and I do work in a health care type enviroment but not in a hospital/GP practice.

  199. Lori says:

    So I have been living with this rash for 7 months! It’s awful! I don’t think it’s stress related because I had already been through an extremely stressful time in my life 4 -10 months earlier. I had a triplet pregnancy, was in the hospital 3 months, lost one of my babies then moved across country when my twins were 3 months old. The rash started after everything had settled down. I think it started from over use of glycolic acids I was using for acne. Started around my mouth, which I thought was a cold sore. Progressed up to my nasal folds and mouth folds. Thought it was an allergic reaction so I used hydrocortisone. It somewhat went away but when I stopped using the cortisone it exploded and moved up around my eyes as well. I stopped wearing makeup at this point because it looked awful! I tried nystatin, which I already had and got no results. Finally called and made an appt with the dermatologist but it will still be another month before they can see me. The rash was spreading more around eyes so I went to urgent care and had two NP’s tell me that it is rosacea and prescribed Metro gel. I really didn’t think it was rosacea but used the metro gel anyway. I have been using it for three weeks and it only makes it worse. It burns and turns my face red. So I stopped using everything, did a ton of research. This is what I have been doing for only 3 days and the PD is drying up!! Took away all products that contain SLS…..hair products, toothpaste, face cream/washes etc. Wash my face with a very small amount of dr Bronners baby mild soap, spray face with a homemade sea salt water mixture (leave on for 30 min, rinse), apply organic natural aloe gel. I also did a organic yogurt mask.
    After night one the next morning areas around my nose were pink, the next day they started drying. Today they are itchy but still drying. I’m still seeing my dermatologist next week but I hope this regimen continues to work!!!

    • Discontinuing cortisone creams can often lead to a severe flare-up of symptoms, so I am not surprised by this in your case. Glad you are finding improvement now though.

      Also, very sorry for your loss.

  200. Lochlain says:

    I am a 23 y.o male that works in the cosmetic industry. I’ve suffered from PD for almost a year now. I am currently taking Doxycycline and am into my second week with not change as of yet. I live on a strict diet and have so for the past few years due to food intolerances. I do not consume any gluten, grains, lactose, fruit, refined/natural sugars, alcohol or caffeine. Despite my food intolerances, I’m still not sure whether this is linked to my PD. I never wanted to resort to antibiotics, however I saw it as a last resort after having tried every organic and natural topical remedy mentioned above. I will reluctantly continue to take my three month course of antibiotics however if my PD does not disappear I may look into Accuraine. My dermatologist and doctor have both mentioned this as an option. Would happily continue on the natural route, however I now need a ‘quick fix’ or cover-up so to speak, as this is beginning to effect my career given my particular industry. Does anyone have any experience with Acutaibe treating or worstening PD? Thanks.

  201. Lynne says:

    I think I might have this problem but how do I know for sure, even the Dermatologist I saw the past week was not sure?
    It started last November (9 months ago) at the right side of my mouth. I thought it might have been impetigo. No antibiotic cream helped so I tried a cortisone cream and it made a huge improvement but did not get rid of it completely. Infact when I stopped using ithe cream it came back. Visited my own GP twice and two different creams tried. Neither one worked and so I continued with the cortisone cream. GP sent me to Dermatologist and am following instructions to the latter but the rash is looking extremely angry and is spreading. Every day I am seeing new areas of eruption, I now have it below my nose, across the top of my lip , on my chin and this morning I find it on the edge of my nostril.
    Even tho I note that ‘flare ups’ occur is this spreading extreme or typical?
    I am over 60, have never had anything like this but have used Cortisone cream on my feet .
    Can I expect this to start improving soon?
    By the way for other health issues I have been on a ‘ Natural path’ for healing for approx 15 months.

  202. mary ray says:

    I had been getting this problem for 2 years now.but I usually get it with a uti or yeast infection… Itchy vaginia and an us…. Or burning pee.. But the stages.. Day one is my right lip in the corner would get big… Then it tingles. Day 2 its super red and itchy.. Mt nose will itch.. Then eventually by day 5 its red and pussed.. But Dry.. Leaves a mark that goes away by say 12.. I tried abrevua, creams, impetago, yeast, but I get it every month… Like Gish stop already… My top two teeth are rotten.. I’m overvweight too.. Could thus be it

    • Because I have never seen you in person, Mary, and have not examined you, I certainly cannot confirm any sort of diagnosis for you. But you may want to research herpes simplex (HSV I or HSV II) as this sounds more like what may going on here.

  203. Cynthia says:

    After researching this and looking at my 2 year old I am certain this is what she has!

    Hers can be flared all day, clear during nap, then flare later in the day. Is that a possibility of this as well?

  204. Susan says:

    You mentioned early in the post that a number of women worked in healthcare. I think I know what triggered my flare up–something common to all and I’d be curious to confirm–a cleanser called Hibiclens. Since I started using it, my face erupted. Upon stopping, it’s been slowly clearing. If I use, I can see the reaction a day later.

  205. Shane says:

    I’m a 24 year old male and I also work in healthcare as an RN. Roughly a month ago I developed the irritation on my chin and around my nostrils, almost as if I had a mask on. I’ve had one doctor suspect contact dermatitis and prescribe steroids which were of no help. The next Dr claimed it must be seborrheic dermatitis and also prescribed steroid despite me telling him it doesn’t work. I’ve avoided the cream and seen gradual improvement. I plan suggesting antbx at an upcoming visit with another Dr. Thanks for the article!

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