What Is Perioral Dermatitis and How Do You Get Rid of It?
Perioral dermatitis can look a lot like acne—but treating it like a breakout can make things worse. Here’s what may be triggering it and what to do instead.
What Is Perioral Dermatitis and How Do You Get Rid of It?
If you have ever had a cluster of tiny bumps around your mouth that looks suspiciously like acne but refuses to respond to anything you normally use for breakouts, there is a good chance you may be dealing with perioral dermatitis (or POD for short) .
And this one is particularly frustrating because most people accidentally make it worse before they realize what it is.
It looks like acne, so you reach for your acids, retinoid, benzoyl peroxide, or spot treatments. Then the area gets even more red and irritated, so maybe you add a little hydrocortisone to calm it down.
Unfortunately, perioral dermatitis usually wants the exact opposite.
So let’s talk about what it actually is, why it happens, and what you should — and definitely should not — do about it.
What Is Perioral Dermatitis?
Perioral dermatitis is an inflammatory rash that most commonly develops around the mouth, but it can also show up around the nose and eyes. It usually looks like clusters of tiny red or skin-colored bumps and may come with dryness, flaking, burning, stinging, or redness.
The reason it gets confused with acne so often is pretty obvious: it can look almost exactly like a breakout. But unlike acne, these bumps are not primarily caused by clogged pores, which is why your normal acne routine may do absolutely nothing for them.
Or worse, make them angrier.
What Causes It?
Sometimes we can pinpoint the trigger. Sometimes, annoyingly, we can’t. But there are a few common culprits:
Topical, inhaled, or nasal steroids.
Steroid creams, including hydrocortisone, are one of the most well-known triggers. They may temporarily calm the rash, only for it to come back with a vengeance when you stop using them. And it is not just creams — steroid asthma inhalers and nasal sprays can also contribute, especially around the mouth and nose.
Toothpaste or teeth-whitening products.
Certain ingredients in toothpaste, whitening treatments, or other dental products can irritate the skin around the mouth and trigger or worsen a flare.
Too many actives.
Retinoids, exfoliating acids, scrubs, benzoyl peroxide, and other strong ingredients can be the tipping point, especially if the skin is already irritated.
A compromised skin barrier.
Anything that dries out or irritates your skin can make it more vulnerable — travel, cold weather, wind, or over-cleansing. Once the barrier is compromised, outside irritants have a much easier time triggering inflammation.
A new product touching your face.
Sometimes the trigger is not skincare at all. New hair products, fragranced laundry detergent, or fabric softener on your pillowcase can all irritate the skin enough to trigger a flare.
What Should You Do?
If you think you’re dealing with perioral dermatitis, my first piece of advice is usually the least exciting one: back off. This is not the time to throw every active in your bathroom at it.
Pause your actives. Put exfoliating acids, retinoids, scrubs, and spot treatments on hold.
Cleanse gently. Stick with lukewarm water and a mild cleanser — no scrubbing.
Keep moisturizer simple. Use a lightweight, gentle moisturizer rather than layering on heavy creams and oils.
Skip the hydrocortisone. It can temporarily improve the rash but ultimately make perioral dermatitis much worse.
Also take a look at anything that regularly touches the area around your mouth — toothpaste, lip products, heavy creams, makeup — and consider whether something new may have lined up with when the rash started.
And unfortunately, patience is part of the treatment. Perioral dermatitis can take several weeks, and sometimes longer, to completely clear.
When Should You See a Provider?
Mild cases can often improve just from removing the trigger and simplifying your routine. But perioral dermatitis can also be stubborn, and some cases need prescription treatment.
If you have simplified your routine and the rash is not improving, keeps coming back, is spreading, or you are not sure whether you are actually dealing with perioral dermatitis, get it checked.
Acne, rosacea, contact dermatitis, and perioral dermatitis can look surprisingly similar, and the treatment is not the same. Getting the diagnosis right can save you months of throwing the wrong products at it.
The Bottom Line
Perioral dermatitis is one of those annoying skin conditions that makes you want to try everything in your bathroom… and usually, that’s the last thing it needs. Simplify your routine, look for possible triggers, and give the skin a chance to calm down. And if it is not improving, let a provider take a look instead of continuing to guess.
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