A couple of weeks ago, I casually mentioned on Instagram that I’d been tackling a bout of perioral dermatitis without giving it much thought. The rash-like flare-up around my mouth happened after a significantly busy few weeks and looked red, irritated and angry-looking. Surprisingly, my DMs were quickly flooded with messages from other people – including fellow beauty journalists – saying that they too had been suffering from the condition. 

So, I started doing some research: what is perioral dermatitis and why does everyone suddenly seem to have it?

“I’ve definitely noticed an increase of patients with perioral dermatitis – a skin condition that affects mainly women between the ages of 20 and 50,” explains GP and aesthetician Dr Ahmed El Muntasar. “In most cases, there isn’t really a clear cause and there’s not a clear reason why it’s happening more and more. But we know it’s starting to affect more men too, and some are speculating that it could be because men are now using skincare more than ever, so they could be experiencing reactions from this overload.” 

Of course, skin flare-ups can happen to anyone at any time. Whether it’s acne, eczema, psoriasis, dermatitis or something else entirely, there’s often no rhyme or reason why it’s happening – the most important thing is that you try not to let it stress you out and make sure it’s treated accordingly – but that’s where things can get tricky with perioral dermatitis.

According to consultant dermatologist Dr Emma Craythorne, many of her patients are coming into the clinic with perioral dermatitis that’s been misdiagnosed as an acne flare-up. As a result, the wrong sorts of products are being used and, unsurprisingly, it’s making things a whole lot worse.

But the question remains: how exactly are you supposed to know the difference when both conditions present themselves in a similar way? We asked Dr Craythorne how to diagnose perioral dermatitis and discussed some of the main causes. Of course, if you’re concerned or confused about your skin, it’s always best to seek out a GP or a dermatologist for professional advice.

What is perioral dermatitis?

In short, perioral dermatitis is a common facial skin problem characterised by groups of small, red, itchy or tender papules confined to the skin in the lower half of the face, mostly around the mouth. “Some people with perioral dermatitis may only get a few bumps and their rash may not be very discernible, while others may have many bumps forming a noticeable rash,” says Dr Craythorne.

What does perioral dermatitis look like?

“The bumps may be skin coloured or hyperpigmented and may appear red or pink in people with fair skin,” says Dr Craythorne. “It’s important to note that although they might resemble pimples, the bumps are not the same as acne. However, the rash may look inflamed, with the underlying and surrounding skin appearing red, pink or flesh-toned.”

Does perioral dermatitis hurt?

Perioral dermatitis doesn’t usually hurt. “The rash can sometimes be itchy and some people may feel tightness or a mild burning sensation in the affected skin, which may be dry or flaky,” says Dr Craythorne.

How can you tell the difference between perioral dermatitis and acne?

“Although it can be quite difficult to know the difference between this and other conditions – often perioral dermatitis can go hand in hand with a rosacea diagnosis – it’s important to find out, especially when it comes to differentiating it from acne or eczema, because treatment for those conditions will make perioral dermatitis much worse, and then [you’ll end up in] a never-ending vicious cycle,” explains Dr Craythorne. “However, visible clues include the size of spots and how they are grouped together. There will not be any blackheads in the area, and take note of the location. Perioral dermatitis is most common on the chin, lower corners of the mouth and around the nose area.”

What causes perioral dermatitis?

Here’s the mystery – nobody really knows what causes perioral dermatitis and it’s also not contagious. “Certain skincare choices can aggravate the condition, such as using topical steroids or fluoridated toothpaste. Stress can also fan the flames,” explains Dr Sam Bunting, founder of Dr Sam’s.

Dr Craythorne adds: “The most common cause is topical or inhaled steroids, but other causes include a problem with the skin’s barrier, bacterial getting into hair follicles, an allergic reaction, irritation from a skincare product, irritation from fluoridated toothpaste around the mouth, hormone changes, strong winds and UV light.” 

How should perioral dermatitis be treated?

Most often, perioral dermatitis is treated by what Dr Craythorne calls a ‘null approach to therapy’, which essentially involves reducing almost all topical treatment. “Use very basic skin cleansers and moisturisers. I like La Roche Posay’s Toleriane Cleanser, £16, and Moisturiser, £21,” she says. “After that, to actively treat the area, it will require medical treatment with ingredients like azelaic acid, tretinoin and metronidazole, which are available via Klira, which prescribes customised actives for your skin and ensures they use the correct base for your skin – and in this case, wouldn’t contain any known triggers for perioral dermatitis.”

Images: Getty