Perioralni dermatitis

Perioral dermatitis

Redness is the main symptom of inflammation on the skin, which can have different underlying causes and requires a different approach to care, and often treatment. In addition, in addition to the redness itself, its localization, as well as some accompanying symptoms and sensations, can tell us a lot about the cause of the inflammation. In any case, it is very important to seek the help of a doctor for any long-term and acute redness, and through our series of articles we show you in detail certain dermatoses so that you can ask yourself the right questions and seek the help of a doctor if necessary. For this reason, today we are talking about perioral dermatitis.

What is perioral dermatitis and why does it occur?

Perioral dermatitis is a chronic inflammatory dermatosis of the facial skin. It occurs in the area around the mouth, and sometimes it spreads to the nose and eyes. Perioral dermatitis is recognizable by red bumps that look like pimples and usually appear on the nasolabial lines and cause burning, itching and tightening of the skin. Most of the patients are young and middle-aged women, but perioral dermatitis can also occur in children and men.

Perioral dermatitis

The etiopathogenesis of perioral dermatitis is unclear , with various potential endogenous and exogenous factors. A link between the local application of corticosteroids , in the treatment of seborrheic dermatitis, rosacea or acne, and the occurrence of perioral dermatitis was discovered in a large proportion of patients. Namely, people suffering from perioral dermatitis initially have a damaged epidermal skin barrier, and local corticosteroids lead to further deterioration. There is increased transepidermal water loss and slower recovery of the skin barrier. The amount of epidermal lipids, including ceramides, is reduced, and the same applies to collagen and elastin fibers. It is believed that the use of topical corticosteroids damages the wall of the hair follicle, which precedes the formation of edema in the follicle cells. 

The development of perioral dermatitis can also be preceded by the excessive use of moisturizing creams, especially those based on paraffin and vaseline, leading to occlusion and irritation of the follicles. As a result, the epidermal barrier becomes dysfunctional and there is edema of the stratum corneum and increased transepidermal water loss, which is manifested by a feeling of tightness and dryness of the skin. 

Perioral dermatitis can also manifest itself as a result of the use of decorative cosmetics, sun protection creams, fluoridated toothpastes, and even bacterial or fungal infections . Hormonal changes are also one of the possible causes due to worsening during the premenstrual period, pregnancy or the use of oral contraceptives. Symptoms often worsen after exposure to UV rays, heat or wind.

How to treat perioral dermatitis?

The treatment of perioral dermatitis requires an individual approach depending on the severity of the disease, and the most important thing is to identify and eliminate possible causes. Treatment usually begins with 'zero therapy' , which implies a complete cessation of the use of all topical medications and cosmetics, especially corticosteroids and cosmetics based on paraffin and petroleum jelly. "Zero therapy" may be sufficient in the treatment of mild forms of perioral dermatitis, but special attention should be paid to patients whose perioral dermatitis is caused by corticosteroids, because after stopping their use, the initial worsening of the disease occurs, known as the "rebound phenomenon". 

If no improvement occurs after a few weeks of 'zero therapy', local therapy is introduced. Many local preparations have proven to be successful in the treatment of perioral dermatitis, and the most commonly used are metronidazole, erythromycin, azelaic acid and adapalene. 

In more severe forms of the disease, when the desired effect is not achieved after several weeks of local therapy, systemic therapy is resorted to for a duration of 6 to 8 weeks, and in exceptional cases even longer. In the systemic treatment of perioral dermatitis, oral tetracyclines (minocycline or doxycycline) are most often used, except for children under 8 years of age, pregnant women and people sensitive to tetracyclines, when oral macrolides (erythromycin or less commonly clarithromycin) are used for systemic therapy. In rare cases when perioral dermatitis proves refractory to any other therapeutic option, isotretinoin is used. 

In the treatment of perioral dermatitis, the most important thing is to identify and remove possible causes, and with the appropriate form of therapy, in most cases, complete regression of symptoms is achieved. Therefore, it is of great importance  react in time and do not delay the visit to the dermatologist who will give you the correct diagnosis and prescribe adequate therapy. It is also very important to reduce the use of cosmetics to a minimum in order to prevent stronger skin inflammation.

What to use for daily care?

If your skin is prone to inflammation, it is recommended to use Skintegrine Spectra, which is a hypoallergenic emollient-type serum emulsion intended especially for the care of skin with a damaged hydrolipidic barrier and reduced function . Skin prone to dermatitis is a candidate for Spectra, which soothes and nourishes the skin with its potent anti-inflammatory ingredients, resulting in reduced skin sensitivity and inflammation. 


  1. Bukvic Mokos, Zrinka & Kummer, Ana & Mosler, Elvira & Ceovic, Romana & Basta-Juzbasic, Aleksandra. (2015). Perioral dermatitis: Still a therapeutic challenge. Acta clinica Croatica. 54. 179-85.
  2. Searle, Tamara & Ali, Faisal & Al-Niaimi, Firas. (2021). Perioral dermatitis: Diagnosis, proposed etiologies, and management. Journal of Cosmetic Dermatology. 20.
  3. Periša, D. & Brajac, Ines & Kastelan, Marija. (2012). Perioral dermatitis as a consequence of prolonged use of topical corticosteroids. Medicine Fluminensis. 48. 101-105.
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