- body {font-family: 'Verdana';}

Main menu


Small Pimples Around Mouth: Perioral dermatitis and Others

  • If you’ve noticed small pimples around your mouth you may be wondering what’s causing them. There are a few different things that can cause this including hormonal changes allergies and even certain medications. 
small bumps around mouth

  • If you’re not sure what’s causing your pimples it’s best to see a dermatologist so they can help you determine the best course of treatment.


Perioral dermatitis

  • Perioral dermatitis (POD) is an inflammatory and chronic papulopustular and vesicular dermatitis that primarily affects youngsters and middle-aged females.
  • In addition to identifying the probable causes, topical or systemic therapy is frequently performed. 
  • Most dermatologists are aware of its link with corticosteroid use, but less is known about other associations such as infectious, cosmetic, disrupting skin barrier, dental fillings, and toothpaste.


1. Symptoms

  • Perioral dermatitis appears as pruritic or sensitive erythematous papules in the perioral (sparing the vermillion) and periorbital areas, with rare vaginal involvement.


2. Causes of Perioral dermatitis

  • There is no single known cause of perioral dermatitis. However, there are a few things that may contribute to the development of the condition.


1. Corticosteroids 

  • Chronic use of topical, nasal, inhaled, and oral corticosteroids has been linked to Perioral dermatitis. 
  • Perioral dermatitis is frequently successfully treated with topical steroids at first, but relapse occurs with corticosteroid removal.
  • Topical steroids may change the microbiota of hair follicles, resulting in a microflora imbalance that contributes to Perioral dermatitis.


2. Infections

  • Perioral dermatitis has been linked to infectious by some researchers.
  • Fusobacteria, Demodex folliculorum, and Candida albicans are possibly involved in the pathogenesis of perioral dermatitis.


3. Sunscreens, Cosmetics, and Moisturizers

  • The relationship between cosmetics, moisturizers, sunscreens, and POD was examined. Experts believe that POD was caused by an occlusive mechanism.


4. Skin Barrier Dysfunc Tion and Allergy

  • Perioral dermatitis patients are considered to be "hyper-reactive," with poor skin barriers, particularly in the perioral area.


3. Treatment Of Perioral Dermatitis

  • There are many different treatments for perioral dermatitis including over-the-counter creams, ointments prescriptions, and medications. Treatments are chosen based on the severity of symptoms, the treatments that have already been tried, and the patient's personality.
  • Topical treatment efficacy is evaluated after 3 weeks. Systemic therapies should be used for no longer than 8 weeks.


1. First line treatment

  • In terms of topical treatments, treatment abstinence is an alternative.
  •  If this strategy is unsuccessful, patients may be given topical antibiotics (metronidazole or erythromycin) or pimecrolimus.


2. Systemic medications

  • Systemic medications should be avoided in first-line therapy a positive response is usually obtained quickly when steroid creams or cosmetics are stopped or when topical treatments are prescribed.
  • Systemic medication should be reserved for instances that are resistant to topical therapies.
  • Tetracycline or one of its derivatives is the therapy of choice if systemic treatment is required. 
  • Erythromycin should only be used in pediatric cases of the disease or when tetracyclines are contraindicated. 
  • The use of retinoids is an intriguing treatment option for granulomatous forms of the disease.


Other Causes of Small Pimples Around Mouth

  • Steroid-induced rosacea, lupus miliaris of the face, and acne should be ruled out because they can have a similar distribution to POD.


1. Rosacea

  • Rosacea typically has a centrofacial distribution with no comedones and, in certain cases, rhinophyma or ocular symptoms, which are uncommon in POD. 


2. Lupus miliaris disseminatus faciei

  • Red-brown papules and nodules, as well as atrophic tiny scars, are seen in lupus miliaris disseminatus faciei, with spontaneous regression.


3. Acne vulgaris

  • Acne vulgaris is distinguished by the presence of comedones, papules, pustules, nodules, and cysts, which are not typical of POD. 


4. Sarcoidosis

  • Sarcoidosis can also appear with red-brown papules on the periorificial parts of the face, comparable to perioral dermatitis. Sarcoidosis can also appear with red-brown papules on the periorificial parts of the face, comparable to perioral dermatitis.  
  • Sarcoidosis lesions are typically more widespread and can occur in other areas of the skin, and patients frequently experience systemic sarcoidosis symptoms. 
  • A biopsy can help differentiate sarcoidosis.


5. Seborrheic dermatitis

  • Seborrheic dermatitis is characterized by red patches with greasy scales on the brows, glabella, paranasal skin, nasolabial folds, and chest.


6. Allergic contact dermatitis

  • Allergic contact dermatitis is another possibility, however, it typically manifests as patches with probable lichenification. 
  • If traditional therapies fail to improve perioral dermatitis, patch testing should be considered to rule out allergic contact dermatitis from skincare or oral care products.


7. Lip licker's cheilitis

  • Lip licker's cheilitis, for example, is characterized by erythema and scaling of the cutaneous lip. 
  • This often affects the vermillion lip as well as the vermillion border. Perioral dermatitis, on the other hand, spares the vermillion border.



  • Perioral dermatitis has been linked to a variety of causes, including the overuse of topical or inhaled corticosteroids, infection with fusobacteria, reactions to cosmetics, dental fillings, toothpaste, and even skin barrier disorder.
  • New research is needed to thoroughly evaluate promising therapeutic possibilities such as tetracyclines, topical metronidazole, topical azelaic acid, adapalene gel, and oral isotretinoin.



You Will Read