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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes. The rash is recognised by how it looks and where it sits, and a doctor can prescribe the creams and tablets that clear it.
- What it is: a common, inflamed rash of small red bumps around the mouth, and sometimes around the nose and eyes, also called periorificial dermatitis.
- Common trigger: steroid creams on the face, and sometimes steroid inhalers or nasal sprays, heavy face creams and cosmetics.
- Usual course: it can last months without treatment; with treatment it usually clears over 4 to 8 weeks, and antibiotic courses often run 2 to 3 months.
- Emergency: perioral dermatitis is not an emergency, but call 112 for swelling of the face, lips or tongue, or difficulty breathing.
Perioral dermatitis is not urgent. Swelling of the face, lips or tongue, or difficulty breathing after a new product or medicine needs 112. Painful blisters or punched-out sores spreading around the mouth or eyes, or a painful red eye, need prompt in-person care.
Can an online doctor treat perioral dermatitis?
Yes. Perioral dermatitis is diagnosed from how the rash looks and where it sits on the face, and tests are not usually needed, so it suits a video consultation. The doctor confirms the diagnosis, tells it apart from acne, rosacea and seborrhoeic dermatitis, helps you stop any steroid cream safely, and prescribes treatment when the rash needs more than stopping the trigger.
How an online consultation helps with perioral dermatitis
- A clear diagnosis: Perioral dermatitis, acne, rosacea or seborrhoeic dermatitis: the doctor tells them apart on camera.
- The trigger found: Steroid creams, inhalers, nasal sprays, cosmetics and heavy creams are reviewed one by one.
- Treatment that clears it: A prescription cream or a course of antibiotic tablets, chosen for how widespread the rash is.
- Getting through the flare: Why the rash often gets worse for a while after stopping a steroid cream, and why not to restart it.
What the doctor checks in an online consultation
The doctor asks about:
- Where it is: around the mouth, the sides of the nose, around the eyes, or elsewhere on the face.
- What it feels like: burning, tightness, itching or soreness.
- Steroids: creams or ointments used on the face, steroid inhalers, nasal sprays and tablets, past or present.
- Products: moisturisers, make-up, sunscreens, cleansers and toothpaste, and anything new.
- Hormones: the contraceptive pill, pregnancy, breastfeeding and changes with your cycle.
- What you have tried: creams, antibiotics and how long you used them.
Before the call, wash your face with water only, find good daylight, and have your face creams and medicines to hand.
Perioral dermatitis symptoms
Perioral dermatitis causes clusters of small red or skin-coloured bumps, sometimes with tiny pus spots, on a red, slightly scaly background. The skin around it often feels dry, tight and sore, and it may burn or itch. On darker skin the bumps can look skin-coloured rather than red. Typical features:
- bumps that often start in the folds beside the nose and spread around the mouth, and sometimes around the eyes
- a narrow band of clear skin right next to the lips
- a rash that keeps coming back or does not settle
- the cheeks and forehead usually stay clear
Despite its name, perioral dermatitis is not eczema, and it is not contagious: you cannot catch it or pass it on. It is diagnosed from how the skin looks, and a skin sample is rarely needed. Two clues separate it from its look-alikes: acne has blackheads and whiteheads, which perioral dermatitis does not, and rosacea does not usually cause spots around the mouth and eyes.
Perioral dermatitis or something else?
Swipe sideways to compare →
| Condition | What points to it |
|---|---|
| Perioral dermatitis | Small bumps around the mouth, nose or eyes, a clear band next to the lips, often after steroid creams |
| Acne | Blackheads and whiteheads, deeper spots and cysts, on the cheeks, forehead and jaw |
| Rosacea | Flushing and redness across the cheeks and nose, usually in older adults |
| Seborrhoeic dermatitis | Greasy, flaky patches on the eyebrows, sides of the nose and scalp |
| Contact dermatitis | An itchy rash where a product touched the skin |
What causes perioral dermatitis?
The exact cause is not known. It is most common in women aged about 20 to 45, and slightly more common on lighter skin. Fewer than 1 in 250 people are affected. Using steroids on the face is the most common trigger. Other triggers include:
- steroid creams or ointments on the face, even mild ones, especially when used for weeks
- steroid inhalers and nasal sprays, and steroid tablets
- steroid cream carried to the face on the hands after using it elsewhere on the body
- heavy face creams and moisturisers, make-up and some sunscreens
- toothpaste and dental products, in some people, including fluoride toothpaste
- ultraviolet light, wind and heat
- hormonal changes with the contraceptive pill, pregnancy or the menstrual cycle
Perioral dermatitis does not run in families.
How to treat perioral dermatitis at home
The first step, for everyone, is to stop putting products on the affected skin. This is sometimes called zero therapy:
- Stop all face creams, make-up and cosmetics on the rash, unless a doctor has advised otherwise.
- Wash your face with water only until the rash clears.
- Stop using steroid creams on your face. If you have used a strong one for a long time, ask a doctor how to stop.
- Wash your hands after using a steroid cream anywhere else on your body, so none reaches your face.
- Avoid picking or squeezing the spots, and avoid soap and foaming face washes.
- If you need sunscreen, use a light liquid or gel one, and wash it off when you come in from the sun.
- Once it has cleared, use a soap substitute, and an unperfumed moisturiser if your skin is dry or sensitive. Keep the routine simple, and introduce new products one at a time.
Mild perioral dermatitis can clear with these steps alone. If it has not improved after a few weeks, or it is widespread or sore, a doctor can prescribe treatment.
Which perioral dermatitis treatment might the doctor recommend?
Treatment depends on how widespread the rash is and what triggered it. This is the framework the doctors use, in line with dermatology guidance.
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| A few bumps, no steroid use | Stop face products, water-only washing | Yes | Not usually needed |
| Mild rash that has not cleared | A prescription cream, such as metronidazole or erythromycin | Yes | Not usually needed |
| Widespread or sore rash | A course of antibiotic tablets for several weeks | Yes | Not usually needed |
| Rash after a steroid cream | Stop the steroid, with a plan for the flare that may follow | Yes | If a strong steroid was used for a long time |
| Keeps coming back despite treatment | A review of triggers and a longer course | Yes | Referral to a dermatologist may be needed |
Rash around your mouth not settling? A doctor can find the trigger and plan treatment in one consultation.
See available times →Treatment options for perioral dermatitis
What you can do yourself
- Stop all creams, cosmetics and steroid products on the rash, and wash with water only.
- Expect the rash to look worse for a while after stopping a steroid cream; do not restart it.
- Be patient: perioral dermatitis clears slowly, over weeks rather than days.
- For a mild rash, ask a pharmacist about azelaic acid gel or a sulfur-based product.
Prescription treatment
A prescription is never issued without a consultation. For a mild rash, the doctor may prescribe a cream such as metronidazole, erythromycin or pimecrolimus, usually for up to 4 weeks. For a more widespread rash, a course of antibiotic tablets from the tetracycline group, such as doxycycline, lymecycline or minocycline, is taken for several weeks, often 6 weeks to 3 months, to calm the inflammation; the response is usually quick. Stopping too early is a common reason it comes back, but unlike in acne, the tablets can usually be stopped once it has cleared. In pregnancy, a different antibiotic such as erythromycin is used. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Steroid creams on the face are the most common trigger, and using them keeps the rash going. Rich, heavy moisturisers and make-up can keep it going too.
How long does perioral dermatitis last?
Without treatment, perioral dermatitis can come and go for months or even years. With treatment, most people recover well: it usually clears over several weeks.
After a steroid cream is stopped, the rash often flares for a while before it improves. This is expected, and restarting the steroid only starts the cycle again. Once it has cleared, it usually stays clear as long as steroid creams are kept off the face, though it can come back.
Special situations
Pregnancy and breastfeeding
Hormonal changes can trigger it, and some antibiotics are not used in pregnancy, so tell the doctor if you are pregnant, trying to conceive or breastfeeding.
Around the eyes
When the rash is around the eyes it is sometimes called periocular dermatitis, and it is treated the same way. A painful red eye or blurred vision needs prompt in-person care.
Steroid inhalers and nasal sprays
These can trigger perioral dermatitis when the medicine reaches the skin. Do not stop a steroid inhaler or nasal spray you need; the doctor can advise how to keep it off the skin.
Long-term use of a strong steroid cream
Stopping a strong steroid cream suddenly after long use can cause a severe flare, so the doctor may switch you to a weaker cream or a non-steroid cream first.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When perioral dermatitis is treated online, and when you need in-person care
Treated online: perioral dermatitis around the mouth, nose or eyes, finding and stopping triggers, coming off steroid creams, prescription creams and antibiotic courses, and reviews when it comes back.
In-person care: a rash that does not respond to repeated treatment, an uncertain diagnosis that needs a dermatologist, and eye symptoms such as pain or blurred vision.
When to get in-person care
Call 112 or go to an emergency department now for:
- swelling of the face, lips or tongue, or difficulty breathing or swallowing after a new product or medicine
Get medical advice the same day for:
- painful blisters or punched-out sores spreading around the mouth or eyes, especially if you feel unwell
- a painful red eye, or blurred vision
- a rash spreading quickly with a fever
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about perioral dermatitis: show the rash on camera in good light, and list every cream, inhaler and nasal spray you use.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s perioral dermatitis? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Rosacea can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about perioral dermatitis
What is perioral dermatitis?
Perioral dermatitis is a common inflamed rash of small red bumps around the mouth, and sometimes around the nose and eyes. It often burns or feels tight, and it usually leaves a clear band of skin next to the lips.
Is perioral dermatitis contagious?
No. Perioral dermatitis is not an infection, so you cannot catch it or pass it on, even though antibiotics help it. The antibiotics are used to calm the inflammation.
What causes perioral dermatitis?
The exact cause of perioral dermatitis is not known, but steroid creams on the face are the most common trigger. Steroid inhalers and nasal sprays, heavy face creams, cosmetics and hormonal changes can also play a part.
Is it perioral dermatitis or something else?
Perioral dermatitis is clusters of small red bumps and scaling around the mouth that leave a clear rim next to the lips and often extend to the nose folds and eyelids. Acne has blackheads and larger spots across the face; rosacea flushes and brings visible vessels on the cheeks and nose, mostly after 30; contact dermatitis from lip balm or toothpaste is itchy and spreads onto the lips; and seborrhoeic dermatitis is greasy, yellowish scale in the nose folds.
Can you get rid of perioral dermatitis overnight?
No. Perioral dermatitis clears over several weeks, not overnight. Stopping steroid creams and face products and washing with water only start the process, and a prescription cream or antibiotic tablets help when it is not settling. Expect a flare at first if you stop a steroid cream.
How long does perioral dermatitis last?
Without treatment perioral dermatitis can last months or years. With treatment it usually clears over several weeks, and courses of antibiotic tablets often last 2 to 3 months.
Why did my rash get worse after I stopped my steroid cream?
A flare of perioral dermatitis after stopping a steroid cream is common and expected. Restarting the steroid makes it look better briefly but keeps the rash going, so a doctor can help you through the flare with other treatment.
What is zero therapy for perioral dermatitis?
Zero therapy for perioral dermatitis means stopping all face creams, make-up and other products on the rash, and washing with water only until it clears. It is the first step for everyone and is enough for some mild cases.
Which antibiotics treat perioral dermatitis?
Creams such as metronidazole or erythromycin are used for mild perioral dermatitis. Tablets from the tetracycline group, such as doxycycline, lymecycline or minocycline, are used for more widespread rashes, and erythromycin is used in pregnancy.
Does fluoride toothpaste cause perioral dermatitis?
It may in some people. Fluoride in toothpaste is one of the suggested triggers of perioral dermatitis, along with steroid creams, heavy face creams and cosmetics. Ask the doctor or your dentist before changing toothpaste for long.
Can perioral dermatitis come back?
Perioral dermatitis usually stays clear once treated, as long as steroid creams are kept off the face, but it can come back, especially if treatment is stopped too early.
How can I prevent perioral dermatitis coming back?
Keep steroid creams off the face unless a doctor prescribes them for a set time, rinse the skin around the mouth after using a steroid inhaler or nasal spray, use a light, fragrance-free moisturiser rather than heavy creams or ointments, keep make-up minimal and oil-free, choose a gentle cleanser or water only, use a plain sunscreen, and finish the full course of treatment rather than stopping at the first improvement. Perioral dermatitis rarely returns when the trigger stays away.
Is perioral dermatitis the same as rosacea?
No. Rosacea causes flushing and redness across the cheeks and nose, usually in older adults. Perioral dermatitis clusters around the mouth, nose and eyes, but some treatments overlap.
Can an online doctor treat perioral dermatitis?
Yes. Perioral dermatitis is diagnosed from how the rash looks, so a doctor can assess it on camera, identify the trigger and prescribe creams or antibiotic tablets when they are needed.
- Periorificial dermatitis, DermNet, New Zealand, 2022.
- Peri-oral dermatitis, British Association of Dermatologists patient information leaflet, updated February 2023.
- What is perioral (or periocular) dermatitis?, Primary Care Dermatology Society patient leaflet, December 2023.
- Perioral dermatitis, MSD Manual Professional Edition, reviewed September 2026.
- Perioral dermatitis: symptoms, treatment and prevention, Harvard Health Publishing, Harvard Medical School, 31 January 2024.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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