Perioral dermatitis is an inflammatory facial rash that usually appears around the mouth. It can also affect the skin around the nose or eyes, when it may be called periorificial dermatitis. It is not contagious and is often mistaken for acne, eczema or rosacea.
What it looks and feels like
The rash usually consists of clusters of small bumps on dry, flaky or irritated skin. Bumps may look red on lighter skin and skin-colored, brown, gray or purple on darker skin. Some contain a small amount of fluid or pus.
The skin may burn, sting, itch or feel tight. A narrow area immediately next to the border of the lips is often unaffected. Blackheads and deeper acne nodules are not typical.
Possible triggers
The exact cause is not fully understood. Corticosteroid creams used on the face are a common trigger, and the rash may initially improve with the steroid before returning or worsening. Steroid nasal sprays and inhalers may sometimes contribute when medication repeatedly contacts facial skin.
Heavy cosmetics, rich moisturizers, sunscreen, skin irritation and hormonal changes may also play a part. Not every person has an identifiable trigger.
Diagnosis
A clinician usually diagnoses perioral dermatitis by examining the skin and reviewing products and medications. Tests are not often required, but a swab, skin scraping, patch test or biopsy may be considered when another condition is possible.
See our Skin Health section for information about other common rashes and skin conditions.
Skin care
Use a simple routine. Stop unnecessary facial cosmetics and heavy or fragranced products. Wash gently with lukewarm water or a mild fragrance-free cleanser and avoid scrubs, exfoliating acids and picking at the bumps.
Do not start a steroid cream on the rash without medical advice. If a prescribed facial steroid may be involved, ask the prescriber how to reduce or stop it safely. Abruptly stopping a potent steroid can cause a temporary rebound flare.
If a steroid inhaler or nasal spray is medically necessary, continue it as prescribed. Rinse the mouth and gently clean the skin around the mouth or nose after use, and discuss technique with a healthcare professional.
Treatment
Mild cases may improve after triggers and irritating products are removed, but recovery can take several weeks. A clinician may prescribe a topical treatment such as metronidazole, erythromycin or pimecrolimus. More extensive or persistent disease may require an oral antibiotic, often from the tetracycline group.
Antibiotics are used partly for their anti-inflammatory effect. The choice depends on age, pregnancy, breastfeeding, other medications and the severity of the rash. Complete treatment as directed and do not use another person’s medication.
When to seek medical advice
Arrange an assessment if the rash persists, spreads, affects the eyes, causes significant discomfort or began after using a steroid cream. Seek prompt advice for eye pain, light sensitivity, vision changes, marked eyelid swelling, rapidly spreading redness, fever or feeling seriously unwell.
Sources
- DermNet: Periorificial dermatitis
- American Academy of Dermatology: Perioral dermatitis
- NHS: Hydrocortisone for skin
Using this information
This information supports, but does not replace, diagnosis and treatment by a qualified healthcare professional. Facial rashes can look similar, and steroid treatment that helps one condition can worsen another.
Reviewed: 28 August 2026