Perioral Dermatitis: What’s Going On With My Skin?

If you've noticed a stubborn red rash, small bumps, or flaky patches around your mouth (and sometimes near your nose or eyes), you're not alone, and it might be perioral dermatitis (often called POD). This common inflammatory skin condition can be frustrating, itchy, or even burning, and it often gets mistaken for acne, rosacea, or simple irritation. At Nashville Dermatology Physicians in Brentwood, Tennessee, Dr. Jeffrey Berti and Dr. Toula Berti, Mayo Clinic-trained with over 40 years of combined experience, see this condition frequently and help patients get clear, comfortable skin again.

We're proud to serve the greater Nashville area from our convenient location in Brentwood. Our practice focuses on honest, compassionate, personalized care for medical, surgical, and cosmetic dermatology needs. Whether you're dealing with persistent rashes or other skin concerns, our team is here to provide expert diagnosis and treatment in a welcoming environment.

What Is Perioral Dermatitis?

Perioral dermatitis is a benign but chronic rash that typically appears as clusters of small red papules (bumps), pustules, or pink scaly patches circling the mouth, similar to a larger "ring" around it (hence "perioral," meaning around the mouth). It can spread to the areas around the nose, eyes, or even more rarely other facial zones. The skin often feels dry, tight, or irritated, sometimes with mild itching or burning. Unlike true acne, it usually lacks deep blackheads, but the resemblance can lead people to try the wrong treatments, which sometimes makes things worse, a lot worse.

What Causes Perioral Dermatitis?

The exact cause isn't always clear, but several common triggers play a role:

- Topical steroids: Overuse of corticosteroid creams (even mild ones like hydrocortisone) on the face is one of the biggest culprits. They may help short-term but often cause a rebound flare when stopped.

- Procedures such as microneedling:  If already have a small infection the action of microneedling can spread the infection.

- Irritating skincare or cosmetic products: Heavy moisturizers, foundations, sunscreens, or occlusive (pore-clogging) items can disrupt the skin barrier.

- Toothpaste and oral products: Some people are sensitive to fluoride, certain flavorings, or tartar-control ingredients in toothpaste, which can irritate the skin around the mouth through contact.

- Other factors: Inhaled or nasal steroids, hormonal changes, stress, or even bacterial/fungal imbalances on the skin can contribute.

It's not contagious, and it affects people of all ages and skin types, though it's more common in women aged 16-45.

Why Identifying the Cause Matters for Treatment

Treatment success depends on pinpointing what's triggering your specific case because one-size-fits-all approaches often fail. 

For example:

- If topical steroids are involved, the first (and most important) step is usually to stop them gradually under medical guidance to avoid a worsening rebound.

- Bacterial involvement might require a short course of topical or oral antibiotics (like metronidazole, erythromycin, or tetracycline derivatives).

- Fungal elements (less common but possible) could need antifungal treatments.

- Product-related triggers often resolve by switching to gentle, fragrance-free, non-fluoride toothpaste or simplifying your skincare routine to basics (mild cleanser, light moisturizer, and sunscreen).

- In many cases, a combination approach works best, sometimes including anti-inflammatory topicals or addressing underlying factors.

Trying over-the-counter acne products (like benzoyl peroxide or strong retinoids), harsh scrubs, or random "spot treatments" from non-experts can irritate the already sensitive skin further, prolong the issue, or even lead to scarring in severe, untreated cases.

Don't Wait—Make an Appointment Today

Perioral dermatitis doesn't usually go away on its own and can linger or worsen without proper care. Self-treating risks making the rash more stubborn or causing permanent changes like scarring or pigmentation issues. A board-certified dermatologist can accurately diagnose it (often just by looking, though sometimes a biopsy helps rule out similar conditions), identify your triggers, and create a tailored plan for safe, effective clearing, often within weeks to months.

At Nashville Dermatology Physicians, Dr. Jeffrey Berti and Dr. Toula Berti are dedicated to getting to the root of your skin concerns with genuine, evidence-based care. We're conveniently located in Brentwood and proudly serve patients from across the greater Nashville area.

If you're wondering "What's going on with my skin? please don't guess. Schedule an appointment today for personalized evaluation and relief. Your clearer, calmer skin is worth it!

Contact us to book: Visit our website or call our office. We look forward to helping you!

Nashville Dermatolgy Physicians

1001 Health Park Dr.

Suite 470

Brentwood, TN

615.212.2517

Thank you for reading, feel free to share this if it's helped someone you know dealing with a similar rash!