Perioral Dermatitis

Certain groups are more susceptible to developing perioral dermatitis:

• Women aged 25 to 45 — this group is affected most often, though the reasons aren't fully understood
• People using topical steroids on the face — including for conditions such as eczema or rosacea, where steroid use can inadvertently trigger perioral dermatitis
• Children — perioral dermatitis can also occur in children, sometimes linked to steroid-containing creams or, less commonly, fluorinated toothpaste
• People with a generally compromised skin barrier — from heavy skincare routines, over-exfoliation, or frequent product changes

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This is one of the most important things to understand about perioral dermatitis, because it runs counter to how most people expect a red, inflamed rash to be treated.

Topical steroids can temporarily calm the redness, which often leads people to keep using them — but with continued use, the rash typically returns worse than before once the steroid wears off, in a pattern known as steroid rebound or withdrawal. Each cycle of using and stopping the steroid tends to extend the condition and make it more resistant to treatment.

Because of this, the first step in treating perioral dermatitis is almost always to stop all topical steroids on the affected area — even though symptoms often temporarily flare for a period of one to a few weeks before they start to improve. This "worse before better" phase is a well-recognised part of treatment, and having medical guidance through it makes a significant difference to sticking with it and avoiding a relapse.

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It can, but usually only once the trigger — most often a topical steroid — is stopped, and even then it can take weeks to months to fully settle without further treatment. Continuing to use topical steroids, or reaching for a stronger one because the rash initially looks like it's flaring, keeps the cycle going and can make the condition more persistent and harder to treat.

There's no single cure, but perioral dermatitis responds well to appropriate treatment, and long-term remission is the norm once it's properly managed.

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We recommend seeking a dermatologist assessment if:

• You have a persistent rash around your mouth, nose, or eyes that hasn't responded to your usual skincare, or that you've been treating as acne without improvement
• You've been using a topical steroid on your face and notice the rash flares when you stop, or keeps returning
• You're unsure whether to stop a steroid cream you've been prescribed, or need support managing the flare that can follow stopping it
• The rash is spreading, persistent, or affecting your confidence
• You're uncertain whether what you're seeing is perioral dermatitis, acne, rosacea, or something else entirely — accurate diagnosis is the essential first step, since the treatments for each differ significantly and using the wrong one can make things worse

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