Dear Doctor
I have 2 patches of small, rough bumps on both sides of my chin. They are very rough to the touch, not itchy, but hurt when I rub them and will not go away. They are also not present anywhere else on my body.
Dear Patient
This condition is known as Perioral Dermatitis.
Perioral Dermatitis Causes
The cause of many cases of perioral dermatitis is unknown. However it has been associated with the following:
Steroid Creams
Application of corticosteroid creams to the face is a major trigger of perioral dermatitis. These steroids are usually applied to treat skin conditions like eczema and psoriasis. Inhaling steroids through the nose has also been associated with this condition.
Makeup
Applying makeup is also associated with perioral dermatitis since one study found that applying foundations together with moisturizer and night cream increased the risk for developing perioral dermatitis 13 fold.
Sunscreens
Physical sunscreens have also been associated with the development of perioral dermatitis in children.
Toothpastes
Fluorinated toothpastes are also suspected to trigger it.
Skin Care Products
Skin care products with petrolatum and isopropyl myristate are suspected to cause perioral dermatitis.
Hormones
Hormonal factors are thought to play a role in the development of perioral dermatitis since the rash worsens just before the monthly periods in some women. Oral contraceptive hormones are also suspected to contribute to this condition.
Perioral Dermatitis Treatment
The treatment of perioral dermatitis includes:
Stop Using Corticosteroid Creams
Stop applying corticosteroids creams to your face. As you do so, understand that the skin condition will first worsen before it improves.
Stop Applying Makeup and Skin Care Products
Stop using makeup and all other skin care products to your face. Clean your face with plain water.
Stop Using Physical Sunscreens
Stop using physical sunscreens with ingredients like titanium dioxide and zinc oxide. Start using chemical sunscreens with ingredients like octylcrylene, avobenzone, octinoxate, octisalate and oxybenzone.
Stop Using Fluorinated Toothpastes
Start using non-fluorinated toothpastes.
Topical Antibiotics
Antibiotics which are applied on the face like Metronidazole, Clindamycin and Erythromycin are used to treat perioral dermatitis.
Systemic Antibiotics
Antibiotics which are taken by mouth like Minocycline, Doxycycline and Erythromycin are also prescribed for 6 to 12 weeks to treat perioral dermatitis.
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