This image displays acne-like red bumps around the mouth typical of perioral dermatitis. Tiny bumps and pus-filled lesions around the mouth are typical of perioral dermatitis. This image displays a child with pus-filled lesions around the mouth typical of perioral dermatitis. Perioral dermatitis can affect the eyelids as well as the skin around the mouth.
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Perioral Dermatitis (Pediatric)  A parent's guide to condition and treatment information

Picture of Perioral Dermatitis (Pediatric): This image displays acne-like red bumps around the mouth typical of perioral dermatitis. Divider line
This image displays acne-like red bumps around the mouth typical of perioral dermatitis.
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Overview
Perioral dermatitis is an acne-like problem commonly seen around the mouth in children.
  • Children are otherwise well, but they develop small pink bumps around the mouth and sometimes around the nose and eyes.
  • The rash may be mildly itchy (pruritic) and it may come and go (wax and wane) over time.
  • Using a topical steroid may trigger perioral dermatitis.
  • Fluorinated dental care products and skin products containing petrolatum, paraffin, or isopropyl myristate may also trigger the condition.
Who's At Risk
Perioral dermatitis commonly occurs in children (and in adults), and it is especially common in children with darker skin.
Signs and Symptoms
Small (1–2 mm), firm, pink-to-flesh-colored bumps and tiny, raised, liquid-filled lesions (pustules), with or without scaling skin, that appear around the mouth and sometimes around the nose and eyes.
Self-Care Guidelines
  • With your child's doctor's permission, stop using any medications (especially medium-to-high-potency topical corticosteroids) that may be triggering the problem.
  • Change to another type of cosmetic, toothpaste, or mouthwash product, since these may also trigger the condition.
When to Seek Medical Care
See your child's doctor or a dermatologist for evaluation of any unidentified, long-lasting rash around your child's mouth.
Treatments Your Physician May Prescribe
The doctor may prescribe:
  • Metronidazole cream (a topical antibiotic) applied up to 2 times daily, gradually decreasing use as the condition improves.
  • Oral tetracycline for children older than 9, gradually decreasing use as the condition improves.
  • Oral erythromycin for children less than 9 years old, gradually decreasing use as the condition improves.
  • Topical antibiotics may help mild outbreaks.

References

Bolognia, Jean L., ed. Dermatology, pp.227, 239, 253-256. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed. pp.697-698. New York: McGraw-Hill, 2003.
Last Updated: 22 Dec 2008