Is perioral dermatitis chronic?

How long does it take to clear?

Expect gradual improvement rather than an overnight change. Complete clearing can take a few weeks to a few months. Treatment commonly lasts 4 to 8 weeks, sometimes longer. A treatment course and the time needed for complete clearing are not necessarily the same.13

Recurrence can happen if treatment is too short, after antibiotics are stopped, or later on. If the rash returns, a clinician can consider using the same treatment again. Some mild cases clear with changes to the facial routine alone.1

Why does it flare when I stop steroid cream?

Corticosteroid creams, including hydrocortisone, can contribute to perioral dermatitis. Stopping them can temporarily worsen the rash. Restarting the cream brings only temporary relief, and the rash can flare again each time you stop. Continued use can also eventually worsen the rash.3

Stop nonprescription hydrocortisone that you have been using without your doctor's knowledge. For a prescribed steroid cream, contact the prescriber before changing it. A dermatologist sometimes uses a mild steroid briefly alongside other medication. Potent facial steroids can require gradual withdrawal rather than abrupt stopping.13

Continue medically necessary inhaled, nasal or oral steroids. They can lengthen recovery time. Rinsing your face and mouth after nasal or inhaled steroids can help.1

What should I change in my skincare routine?

Review facial cosmetics and skincare with your dermatologist. Skincare changes can be part of treatment, and gentle washing matters.13

A minimal routine can mean washing with warm water alone until the rash clears, then considering a cleanser without soap. Another approach uses a mild, fragrance free cleanser and fragrance free skincare, which leaves the perfume counter out of the planning meeting. Avoid heavy, occlusive creams and ointments that seal over the skin; these can worsen the rash. A gel or liquid sunscreen is an option, which saves cream from having to represent the entire sunscreen department.13

The exact cause is unclear. Skincare products or toothpaste can irritate the skin, and an allergy to something touching the skin is another possibility. Skincare belongs on the review list, even when the packaging has already awarded itself essential status.3

When should I see a dermatologist?

See a dermatologist if the rash is difficult to clear or you are unsure what it is. Perioral dermatitis can look like acne, but a similar appearance does not make it the same condition. A dermatologist can examine the breakouts, identify the condition and tailor treatment rather than treating every bump as acne.34

The rash can also appear around the nose or eyes, where the broader name is periorificial dermatitis. Dermatitis means inflammation of the skin; it is not a diagnosis of eczema by default. Eczema, also called atopic dermatitis, is one particular type. Perioral dermatitis is not contagious.35

Treatment can include medication applied to the skin or an oral antibiotic. Tell the clinician if you are pregnant or treatment is for a child, because antibiotic choices differ. Facial sensitivity can make topical treatments difficult to tolerate.1