How long does perioral dermatitis last?

How long does treatment take?

Treatment often starts with a course lasting 4 to 8 weeks, but 6 to 12 weeks or 2 to 3 months can be needed. Longstanding cases and persistent redness can require longer treatment. The rash can improve before the prescribed course ends, so clearer skin is not a reason to shorten treatment yourself. Treatment that is too short can allow the rash to return.2345

Expect gradual improvement rather than an overnight change. Complete clearance can take months even when treatment is helping. A clinician can prescribe a medicine applied to the skin for milder cases, or oral antibiotics for more severe cases or those that do not respond to topical treatment. Sensitive facial skin can make topical treatments difficult to tolerate.126

Why does it get worse after stopping steroid cream?

Steroid creams can briefly make perioral dermatitis look better while making the rash more extensive and inflamed over time. Stopping them can cause a rebound flare. Restarting hydrocortisone for relief can repeat that cycle, with another flare when you stop again. An initial worsening after withdrawal does not necessarily mean the treatment plan has failed.15

If you have been using hydrocortisone without medical advice, stop using it for this rash. If a steroid cream was prescribed, speak to the prescriber before changing it; they can arrange gradual withdrawal or another medicine when needed. Continue medically necessary inhaled, nasal or oral steroids. These can lengthen recovery, and rinsing your face and mouth after nasal or inhaled steroids can help.123

What should you do while it clears?

A minimal skincare routine is part of treatment, so the bathroom shelf can take a brief leave of absence.6

1. 1Remove unnecessary facial cosmetics and irritating products. Avoid heavy creams and ointments that form a barrier over the skin.
2. 2Wash gently with warm water alone while the rash is active. If your clinician advises a cleanser, choose a mild, fragrance free option without exfoliants.
3. 3If dryness needs moisturising, use a bland, unperfumed product rather than a heavy cream. A gel or liquid sunscreen is an option during treatment.
4. 4Do not pick or squeeze the bumps. Once the rash clears, reintroduce skincare gradually, one product at a time.

Products can return individually; the cosmetics collection does not need a reunion.6

When should you see a doctor?

Arrange an assessment if bumps around your mouth do not go away, or if simplifying your routine is not helping. Do not assume every rash around the mouth is perioral dermatitis: acne, rosacea and contact dermatitis can resemble it. A clinician usually diagnoses perioral dermatitis by examining the rash, with tests reserved for uncertainty or another suspected cause. Tell them about facial steroid creams, inhalers and nasal sprays, including medicines bought without a prescription.2346

Pregnancy changes which antibiotics are appropriate. Tell your clinician if you are pregnant; erythromycin is one option used when treatment is needed. Do not start an antibiotic or use someone else's prescription to try to speed up clearance.5

Will it come back or leave marks?

Most people recover well, and the rash usually stays clear after treatment, particularly when facial steroid creams are avoided. Recurrence is possible, including after antibiotics stop. Contact your clinician if it returns; the same treatment can often be used again. Ordinary cases usually do not leave scars or lasting pigment changes, although severe forms can.24