Perioral dermatitis

Antonio La Paralela
septiembre 22, 2020
Tiempo de lectura: 4 minutos

Perioral Dermatitis

I often hear that I’m lucky to have amazing skin, free of scars, spots, pimples or large pores.

I always say that the lucky part is in my genes; my mother and grandmother have great skin, too. The rest has nothing to do with luck or glamour. Many people think that a good dermatologist and expensive creams solve everything.


No one believes me when I tell them that I have very sensitive skin, and sometimes my skin breaks out to the point of looking like an ogre. ?‍♀️

Let's get to the point: perioral dermatitis, which affects mostly women between the ages of 20 and 35, often diagnosed as 'adult female acne' or rosacea. In fact, the treatment is practically the same. This dermatitis usually appears overnight: you go to bed like a princess, and wake up like a monster!

It doesn't always look like acne, because the pustules don't necessarily have pus. They are usually red and inflamed, and there are many of them, which makes it seem like they are pimples. But whatever you do, don’t squeeze the bumps, go straight to a dermatologist if you think you might have perioral dermatitis. Just looking at your skin, you’d swear they are pimples. But if you could see them under a microscope, you’d be able to tell that they are micro-lesions on your skin.


How do you know if you have this type of dermatitis?

  • Pustules appear and spread rapidly;
  • They appear in great concentration around the mouth, and sometimes reach the area around the nose, hence the name “perioral”;
  • They usually appear in people with atopic skin and respiratory problems: asthma, rhinitis (me!), etc.;
  • Pustules often hurt like an internal pimple, except they are already outside the skin;
  • Itching is (very) often a symptom;
  • The skin is usually dry in the affected area and your skin feels uncomfortably tight.

If you have seen the images and have many of these symptoms, consult a dermatologist, as there are dozens of treatments: from topical or oral antifungals and antibiotics, to low doses of retinoids.

Not all skin reacts the same way to each treatment.

What works for one person’s skin does not work for another.

The bad news here is that treatment can take very long, up to 6 months or longer to fully get rid of the problem and there’s no guaranteeing that the problem won’t return in a couple of years. If you have ever had this condition, it is quite likely that it will reappear.


 What causes perioral dermatitis?

One cause is abusing corticosteroids, both topical and oral. When we use this type of medication, the immune system is "depressed" to reduce inflammation. In this state of "waiting", your body’s defenses are lowered and less able to protect itself against other microorganisms such as fungi and bacteria that already exist on the skin.

This gives the chance for microorganisms to multiply, but while using corticosteroids, you don't notice it. When treatment with this type of drug finally ends, as if by magic, perioral dermatitis appears. I could almost call it "my friend" because I had it 4 times in 10 years.


Last time, my perioral dermatitis occurred after using a cortisone nasal spray for a prolonged period (for rhinitis). It was recommended by an ENT doctor who obviously had no idea about my problem. And I would never think that this medication could cause dermatitis. But it did.

As this wasn’t my first rodeo, I called my dermatologist right away and he prescribed a treatment, but he warned me that it may take some time to notice an improvement.

Stress aggravates this condition, so you might want to stay away from the mirror for a couple weeks. During all these "dermo-dramatic" years of my life, I read a lot of nonsense related to the condition in Dr. Google. Some websites say that cosmetics cause perioral dermatitis because your skin becomes dependent on the product, others say that you should stop moisturizing your skin during treatment.

Your skin must be moisturized!

First, to reduce discomfort and second, because moisturized skin is much healthier and more resistant.

I uploaded pictures of myself to offer som

e proof that I did in fact have this issue, and that I speak from experience and with knowledge. Many people have the same problem and are unaware of what it actually is, and as a result spend years suffering from it. We are here to help you!



My skin got much worse in the days following these photos, but I didn't think about taking pictures because I never thought I would post about this. I almost cried from despair and discomfort, but "time heals all (your skin’s) wounds." I added some pictures of other people I found on the Internet, but my skin stayed the same. The lack of moisture makes your skin dry (as you can see in the second photo), which makes the problem more visible.



I won't give you any advice about medication, because as I said before, treatment can have several lines of attack. The first time I had it, I tried 8 different types of treatments. It’s best for the dermatologist to evaluate you and treat you correctly.

My most recent bout of dermatitis was resolved using antifungal facial cleanser, combined with a topical and oral antibiotic.

Some useful tips for dealing with dermatitis:

  • Avoid touching the affected area so that it does not become more inflamed
  • Keep the area hydrated as per your skin’s needs
  • Use sunscreen!
  • Replace toner with thermal water after cleaning your skin     
  • Stop using foundation for a while

I hope you find this advice helpful because, as I said at the beginning, many people suffer from this type of dermatitis without understanding what it is and really struggle to find a treatment that works for them.


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