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Perioral Dermatitis

By

Jonette E. Keri

, MD, PhD, University of Miami, Miller School of Medicine

Last full review/revision Jul 2020| Content last modified Jul 2020
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A variety of causes of perioral dermatitis have been proposed, including exposure to topical corticosteroids and/or fluoride in water and toothpaste, but the etiology of perioral dermatitis is unknown. Despite its name, perioral dermatitis is not a true dermatitis. It primarily affects women of childbearing age and children. The eruption classically starts at the nasolabial folds and spreads periorally, sparing a zone around the vermilion border of the lips. But the eruption can also spread periorbitally and to the forehead.

Diagnosis of Perioral Dermatitis

Treatment of Perioral Dermatitis

  • Avoidance of fluorinated dental products and topical corticosteroids

  • Topical or sometimes oral antibiotics

Perioral dermatitis treatment is to stop fluorinated dental products and topical corticosteroids (if being used) and then use topical antibiotics (eg, erythromycin 2% or metronidazole 0.75% gel or cream 2 times a day). If there is no response, oral doxycycline or minocycline 50 to 100 mg 2 times a day or oral tetracycline 250 to 500 mg 2 times a day (between meals) may be given for 4 weeks and then tapered to the lowest effective dose.

In contrast to acne, antibiotics can usually be stopped. Topical pimecrolimus (for people > age 2 years) also reduces disease severity. Isotretinoin has been successfully used to treat granulomatous perioral dermatitis.

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