Rosacea – Perioral Dermatitis

Perioral dermatitis is a very common skin rash that I see on a daily basis in my The Woodlands dermatology and Conroe dermatology clinics.  Essentially, it is rosacea occurring around the mouth and is almost exclusively seen in women between the ages of 20 and 35.  It appears as papules and pustules arranged symmetrically around the mouth.  A characteristic finding is a 5mm zone of sparing between the rash and the vermillion border of the lip.  The most common cause of perioral dermatitis is topical or inhaled fluorinated steroids.  The treatment is the same as rosacea with a topical medicine twice a day such as metrocream and a two week course of doxycycline 100mg twice a day.  It is imperative to discontinue exposure to fluorinated steroids.  A similar condition can occur around the eyes called periorbital/periocular dermatitis.