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Perioral Dermatitis: A Goatee Skin Rash

Updated on April 30, 2011

Perioral Dermatitis

You get a bump or two around your mouth. OK, no big deal until they start spreading. Slowly but surely the bumps spread around your lips, under your nose, and on your chin. It looks like you have a goatee, but instead of hair it is small red or pink bumps. What in the world is it? You may have a skin disorder called perioral dermatitis.

What are the symptoms?

  • Redness around the lips or mouth
  • May have a light colored ring around the lip area
  • Small red or pink bumps
  • May look like acne
  • May have some skin pealing
  • Mild itching and burning

One of the main problems with this skin disorder is that it waxes and wanes, meaning it comes and goes. The rash is there and then it is much better, almost gone. No need for the doctor. And then bam, it is back. The cycle begins again, and it will continue, perhaps up to a year, until it is treated. The bad news is that once you have it, it can come back even if treated.

What causes it?

There are several beliefs of what causes this rash. Some say it is a form of rosacea. While others say it is a bacterial infection. Yet others believe it is caused by ingredients found in your toothpaste. In addition, it may be caused by hormonal changes.

Who gets it?

Children from 7 months to 13 years of age and mainly young adult and middle-aged women are susceptible to this skin rash. Men are rarely affected.

What can be done about it?

The first action you need to take is to eliminate any new products such as toothpaste, facial cream, facial cleansers, and make-up that you use. Some people claim the only change was sensitive toothpaste. The difference between regular toothpaste and sensitive toothpaste is the ingredient potassium nitrate.

Interestingly, most toothpastes use a synthetic form of potassium nitrate. The only found toothpaste that uses authentic potassium nitrate is Tom’s of Maine Natural Toothpaste for Sensitive Teeth . However, it is expensive and hard to find. Yet, one source stated that over the counter products are not as effective in helping sensitive teeth as dentist-prescribed Clinpro. How this affects perioral dermatits is unknown. Yet, Dr. Levin, Nikki A. Levin M.D. Ph.D., associate professor of medicine in the Division of Dermatology at University of Massachusetts Medical School, states that toothpaste with fluoride and anti-tar may cause this unsightly rash.

The second step is to visit your doctor or a dermatologist. Perioral dermatitis will not go away if it is not treated. The doctor will prescribe an oral or topical antibiotic and sometimes a cortisone cream. However, the use of cortisone, warns Dr. Levin, may actually contribute to this skin disorder. In addition, she states that “Alternative oral medications include erythromycin, dapsone, clotrimazole, and isotretinoin. Topical therapy consists of metronidazole cream, erythromycin solution or ointment, clindamycin gel, 20 percent azelaic acid, adapalene gel, benzoyl peroxide, tacrolimus 0.03 percent ointment, and even 0.5 percent sulfur cream.”

But do not throw the antibiotic tube away. In most cases, you will need it again. Dr. Bernadette from Cornng, NY, stated that once you have perioral dermitis, it most likely will come back.


Finding Alternatives to Sensitive Toothpaste,

Is there an effective alternative to sensodine pronamel toothpaste?

Perioral Dermatits,

Perioral Dermatits: It’s not every rash that appears around the mouth,


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