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Overview

Perioral dermatitis (POD) is a disorder of the follicles in which pink bumps (papules) appear around the mouth and sometimes around the eyes. POD is most common in 20- to 50-year-old women, but occurs in men and children as well.

Causes and Risk Factors

The causes of POD are not well understood. There is some evidence that fungi and bacteria may be underlying causes of the disorder. However, this has not been proven.

People who use topical corticosteroids (anti-inflammatory drugs) for other skin disorders on the face have a higher rate of POD than the general population. Stress also plays a role, as does repeatedly touching the skin on the face.

Signs and Symptoms

Dermatologists usually diagnose POD by the occurrence of pink papules around the mouth. Often the papules develop around the eyes and nostrils as well. The next stage of POD brings scaling and reddening. Some patients experience burning and itching. POD has a tendency to improve and worsen at variable intervals.

In the laboratory, skin biopsy samples look similar to those of rosacea patients. Sometimes a bacterial infection is present with POD.

Treatment

Topical and oral antibiotics are usually the most effective treatment for POD. Patients should be careful not to touch or scratch the affected area, as this can make the disorder worse.

With treatment, most POD patients experience complete clearing. However, this process may take 2 or 3 months. Even among those who do not experience a cure, most have only mild recurrences.

Prevention

People predisposed to POD should avoid using corticosteroids on the face or use lower concentrations. Physicians should be judicious in prescribing corticosteroids, especially for long-term treatment using potent formulations.

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