Is perioral dermatitis contagious?

Why does the rash spread if it is not contagious?

A rash spreading across your own face is different from an illness spreading between people. Perioral dermatitis can extend from around the mouth to the nose, chin, eyes or forehead. That change in location does not make it contagious. When several facial openings are involved, the condition is also called periorificial dermatitis. The medical vocabulary offers two names for the same condition.123

Is it a bacterial or fungal infection?

Perioral dermatitis is an inflammatory skin condition, and its exact cause is unknown. Bacteria, yeasts and mites have been found in affected skin, but their role remains unclear. Steroid use is the most common association. Cosmetics, heavy moisturizers and irritation from products such as toothpaste can also contribute. These possible triggers do not change the answer about transmission: perioral dermatitis does not pass between people.45

Make sure the rash really is perioral dermatitis

A rash around the mouth is not automatically perioral dermatitis. Typical signs include clusters of small bumps, dry or flaky skin, and sometimes itching or burning. Bumps can look flesh colored on darker skin. The lips and a narrow strip of skin immediately beside them are often unaffected. Unlike acne, perioral dermatitis usually lacks blackheads and whiteheads.234

A clinician usually diagnoses perioral dermatitis by examining the skin. Other conditions, including contact dermatitis and impetigo, can resemble it. If the diagnosis is uncertain, swabs or skin scrapings can help rule out bacterial or fungal infections. The answer about contagion applies to diagnosed perioral dermatitis, not every unexplained mouth rash.15

What should you do about it?

Treatment starts with reducing products that irritate the affected skin, especially heavy or oily cosmetics and moisturizers. A full skincare lineup is not a treatment plan, however convincing the matching bottles look, which is unfortunate for the packaging department.2

1. 1Remove irritating cosmetics and heavy creams from the affected area. Avoid exfoliants and fragranced products.
2. 2Use minimal cleansing. Warm water alone is an option during a flare; if using a cleanser, choose a gentle one without fragrance or exfoliants. For dryness, use a bland, light moisturizer rather than an occlusive cream or ointment that seals the skin.
3. 3Ask your prescriber how to stop a facial steroid safely. Steroid creams can temporarily improve the appearance but worsen the condition, and stopping a potent steroid abruptly can cause a rebound flare. Do not restart it without medical direction.
4. 4Continue medically necessary inhaled, nasal or oral steroids. Discuss their use with your clinician; rinsing the face and mouth after inhaled or nasal steroids can help.
5. 5Once the rash clears, reintroduce skincare products gradually, one at a time.

Why are antibiotics used, and how long does recovery take?

Antibiotics can help reduce inflammation in perioral dermatitis; being prescribed one does not mean the rash is contagious. A clinician can prescribe topical treatment or, for more severe or persistent cases, oral medication. Pregnancy changes which medicines are suitable, so tell the prescriber if you are pregnant.145

Treatment commonly lasts four to eight weeks, sometimes longer. Without treatment, the condition can persist for months or years, and it can return after clearing. See a dermatologist or another trained clinician if simplifying your routine does not help. Seek assessment for associated pink eye, which can require referral to an eye doctor.145