Perioral dermatitis and acne are two different skin conditions, though they have a lot of similarities and can easily be mistaken for each other. Sometimes, they occur simultaneously, making treatment more complex. 

Perioral Dermatitis vs. Acne
Perioral dermatitis is a non-contagious facial rash that tends to occur around the mouth (peri = around = the mouth), though sometimes it can extend to the nose and eyes. It appears as red, scaly, dry skin, often with inflamed bumps, like papules and pustules. Though not always, the rash can be itchy and burn. Anyone can get perioral dermatitis, but it’s most common in women aged 25-45. 

One of the most frustrating things about perioral dermatitis is that we don’t quite know what causes it, though overuse of topical steroids is the leading theory or fungal infections are thought to possibly play a role. Fluoride toothpaste, sulfates, chewing gum, dental fillings, hormone changes and stress may also contribute. 
Perioral dermatitis and acne are similar in that they are inflammatory skin conditions and may have papules and pustules, though they have different root causes and overall presentations on the skin.

Both conditions have triggers that may cause flare-ups and are helped by gentle, skin-barrier supporting routines. Perioral dermatitis may be recurring and can take months to clear up if not addressed quickly. Managing both conditions requires a careful and gentle approach to avoid exacerbating either condition. 

Treating Perioral Dermatitis and Acne
During perioral dermatitis flare-ups, you want to do as little as possible to your skin. Limit your routine to an acne-safe gentle cleanser, lightweight moisturizer and sunscreen. Avoid anything scrubby and be very gentle when washing your face. 
Stop using steroids. Even though the steroids may appear to initially help, they will quickly worsen the condition. Stick to fluoride-free toothpaste and avoid chewing gum. 

Topical acne treatments, like exfoliating acids, benzoyl peroxide and retinoids can greatly irritate and exacerbate perioral dermatitis, so though it might be hard, you want to eliminate those products while you have active perioral dermatitis. (It’s ok to use spot treatments if you have a pimple that is nowhere near the rash and you’re certain it’s a pimple.) Wait until the perioral dermatitis is completely resolved before slowly reintroducing any of these products.

Luckily, part of acne management is reducing inflammation and supporting your skin barrier, which are two things that will also greatly improve perioral dermatitis. Use fragrance-free moisturizers with ingredients like ceramides, lipids and hyaluronic acid. Icing can provide relief and reduce inflammation, as well as LED devices. 

Of course, sunscreen is of the utmost importance to protect your skin and to reduce inflammation, as well as other safe sun practices, like wearing hats and seeking shade. Heat and humidity can exacerbate symptoms. 
Your dermatologist may prescribe a topical or oral antifungal or antibiotic if the rash isn’t resolving. But remember: no steroids! 

Avoid Triggers
Just like acne, perioral dermatitis can flare-up when triggered, so keep these things in mind, even once the perioral dermatitis has subsided. Once it’s happened once, it is more likely to happen again.

  • Limit or completely eliminate use of topical steroids and inhaled steroids.
  • Use fluoride-free toothpaste and sulfate-free shampoo.
  • Keep skin cool and dry.
  • Always use barrier-supporting, soothing and reparative products in your routine.
  • Try your best to keep stress levels down, get enough sleep and be mindful of hormonal changes.