What Is Perioral Dermatitis? A Doctor's Guide to the Rash Around Your Mouth

By Dr. Tahani Williams, MD, 

If you've noticed small red bumps forming around your mouth that look like acne but won't clear up with acne treatment, you may be dealing with perioral dermatitis. It's a common, non-contagious skin condition, and while dermatologists don't know its exact cause, it's strongly linked to certain skin care habits and products you may be using every day.

What Does Perioral Dermatitis Look Like?

Perioral dermatitis usually shows up as small, red, acne-like bumps clustered around the mouth, often in the creases between your nose and mouth.

It can also spread to the skin around your nose or eyes, which is why dermatologists sometimes call it periorificial dermatitis.

• Small red or skin-colored bumps, sometimes filled with fluid or pus
• Dry, flaky skin in the affected area
• Itching or a burning sensation (though some people feel neither)
• A clear ring of normal skin right around the lips

It's easy to mistake for acne or rosacea, which is one reason it often gets treated with the wrong products.

What Causes Perioral Dermatitis?

The honest answer is that dermatologists don't fully know. But research points to a few common triggers, and the strongest evidence by far points to one of them.

Topical steroid creams

Using a steroid cream on your face, even one prescribed for something else, is the trigger with the strongest evidence behind it. The rash often improves at first, then comes back worse when you stop, which can trap people in a cycle of reapplying the cream.

Fluoride toothpaste

Several sources list toothpaste with fluoride as a suspected trigger. The mouth area is in constant contact with whatever is in your toothpaste.  If you use toothpaste with fluoride and you have symptoms of perioral dermatitis, try a fluoride-free toothpaste.

Heavy or occlusive skin care

Long-term use of thick facial creams has been linked to a weakened skin barrier, which may set the stage for perioral dermatitis. Simpler is often better for this part of the face.

Cosmetics, sunscreens, and face coverings

Cosmetics, sunscreens, and prolonged face mask use are also on the suspected-trigger list, likely because they trap moisture, heat, and product residue against the skin.

How Is Perioral Dermatitis Treated?

Talk to a dermatologist for an actual diagnosis. Perioral dermatitis looks a lot like acne and rosacea, and treating it like acne can make it worse.

If a steroid cream is the likely cause, your dermatologist may have you stop it, but this usually needs to happen gradually. Stopping suddenly can cause a rebound flare, so this is a "work with your doctor" step, not a do-it-yourself one.

Beyond that, dermatologists generally recommend simplifying your routine: fewer products, gentler formulas, and patience. Clearing takes weeks, not days.

Where a Simpler Routine Comes In

None of this is a cure, and we want to be upfront about that. But if you're trying to remove suspected irritants while you work with your dermatologist, a few swaps are worth knowing about.

• Fluoride-free, unflavored toothpaste. Our Cleure Toothpaste (Unflavored) skips fluoride entirely and cleans with dicalcium phosphate, xylitol, and baking soda instead. There's no mint, no flavoring agents, and no SLS, so it avoids several of the ingredients dermatologists flag around the mouth.
• A short-ingredient facial cleanser. Cleure Lotion Cleanser is fragrance-free and formulated without dyes, so you're not adding scent or color chemicals to skin that's already irritated.
• A lighter moisturizer, if you moisturize at all.  Oil-Free Face Moisturizer and Day Cream are fragrance-free with short ingredient lists, which fits the "less is more" approach dermatologists often recommend for this area. Ask your dermatologist whether moisturizing helps or hinders your specific case, since this varies person to person.

As always, patch test any new product on a small area first, and give a routine change 8 to 12 weeks before judging whether it's helping. If your rash isn't improving, or you're using a prescribed steroid, loop your dermatologist in before changing anything.

Frequently Asked Questions

Is perioral dermatitis contagious?

No. Perioral dermatitis is not contagious. It's a reaction related to your own skin, not an infection you can pass to someone else.

Can toothpaste cause perioral dermatitis?

Toothpaste with fluoride, flavors and other harsh ingredients, including essential oils and botanicals are listed as a suspected trigger in the medical literature. It's not proven to be a cause for everyone, but it's a common enough suspect that many dermatologists ask about toothpaste habits during diagnosis.

How long does perioral dermatitis take to clear up?

It varies, but improvement is typically measured in weeks to months, not days, especially once a steroid cream is tapered off under medical guidance. Patience matters more than switching products quickly.

Can I wear makeup if I have perioral dermatitis?

Cosmetics are on the suspected-trigger list, so many dermatologists recommend minimizing makeup over the affected area while it heals. Ask your dermatologist for guidance specific to your skin.

Should I moisturize if I have perioral dermatitis?

This depends on your skin. Heavy creams have been linked to the condition, but very dry or flaky skin may still need a light, oil-free moisturizer. Your dermatologist can advise on what's right for your case.

This article is for general education and is not a substitute for a diagnosis or treatment plan from a licensed dermatologist. If you have a persistent rash around your mouth, see a dermatologist, especially before starting or stopping any prescribed medication.

References

1. American Academy of Dermatology. "Red rash around your mouth could be perioral dermatitis." aad.org/public/diseases/a-z/perioral-dermatitis
2. Tolaymat L, Hall MR. "Perioral Dermatitis." StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing. ncbi.nlm.nih.gov/books/NBK525968/
3. MedlinePlus Medical Encyclopedia. "Perioral dermatitis." National Library of Medicine. medlineplus.gov/ency/article/001455.htm
4. Barbieri JS, Eichenfield LF, et al. "Periorificial dermatitis: Pathophysiology, diagnosis, and management." Journal of the American Academy of Dermatology (2025).
5. Systematic review. "Perioral dermatitis: Diagnosis, proposed etiologies, and management." PubMed ID 33751778.
6. Case series, topical ivermectin for perioral dermatitis, noting skin barrier and toothpaste factors. PMC12152510.