What is Perioral Dermatitis?
Perioral dermatitis refers to a a common inflammatory skin rash around your child’s mouth. It can vary in cause, severity and the need for treatment but let me explain more.
Perioral Contact Dermatitis
The mildest form is a transient perioral contact dermatitis typically seen when infants start solids. You may see a bumpy flesh coloured or red rash around their mouth after eating that settles down a little while later. It doesn’t cause other problems and is not indicative of a significant food allergy. For a mild rash I’ll typically suggest just cleaning their face after eating as a first step or perhaps the use of an ointment during meal times (see below). However if the rash is severe, allergy testing and avoidance of the food may be required.
Perioral dermatits
For a more persistent rash it’s less likely to be a simple contact dermatitis and is often referred to as perioral dermatitis. This affects children of all ages and is also characterised by small red bumps and pimple-like eruptions around the mouth. These bumps may be accompanied by itching, burning, or dryness. In severe cases, the skin may become scaly and inflamed or even infected. In children, perioral dermatitis can be mistaken for acne or rosacea, so it's important to have a proper diagnosis made by a healthcare provider. The exact cause of this rash is not known, but it’s thought to be related to the use of topical steroids, inhaled steroids (asthma preventers), thick facial creams or a history of eczema. Yes, you read right, steroid use can cause this rash!
Diagnosis
Perioral dermatitis is usually diagnosed based on the appearance of the skin and a thorough history including what products you use on your child’s skin, any other conditions they may have or medications they may take. A skin biopsy is only very rarely required.
Treatment of Perioral Dermatitis
The most important aspect of treatment for perioral dermatitis is to avoid any irritants.
As I mentioned above, for the mild transient rash related to new foods, you can try wiping their face with a damp cotton face cloth after eating. If this doesn't help, you can apply a barrier ointment prior to eating that you then wipe off after eating. It’s important to wipe it off as keeping it on may make the rash worse.
For a more severe rash it’s important to see your healthcare provider who may suggest some of the following:
- Avoiding harsh skin care products
- Stopping all face creams (especially if any contain steroids)
- Topical antibiotic creams
- Topical immune modulating creams
- Sometimes oral antibiotics are required
Take Home Tip!
Perioral dermatitis is a common skin condition that affects children and can vary in severity. It usually doesn’t indicate any underlying disorder but specific treatment may be needed. If you suspect your child has perioral dermatitis, it's important to seek medical attention for proper diagnosis and treatment.
Medical references:
- American Academy of Dermatology. (2021). Perioral Dermatitis. https://www.aad.org/public/diseases/acne-and-rosacea/perioral-dermatitis
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2021). Perioral Dermatitis. https://www.niams.nih.gov/health-topics/perioral-dermatitis
- DermNet NZ. https://dermnetnz.org/topics/periorificial-dermatitis