Perioral Dermatitis in Children, Toddlers and Pregnancy: Causes and Gentle Treatment
Family skin guide
Part of our Perioral and face rash guide
Perioral dermatitis in children causes small red bumps around the mouth, nose and sometimes the eyes, and is often linked to steroid creams, asthma inhalers or nasal sprays, or to drooling and lip licking. Gentle home care, stopping facial steroids and keeping the skin clean and dry are the first steps, with metronidazole cream or age-appropriate antibiotics if needed. In pregnancy, start with gentle care and avoid tetracyclines and isotretinoin.
- Perioral dermatitis has been reported in babies as young as 3 months.
- Steroid creams, inhalers and nasal sprays, drooling and heavy creams are common triggers in children.
- Do not stop a prescribed inhaler because of a rash; ask the doctor.
- Tetracycline antibiotics are avoided in young children and in pregnancy.
- Gentle care, patience and a doctor's plan clear most cases over weeks.
What does perioral dermatitis look like in children?
In children, perioral (periorificial) dermatitis causes small red, skin-coloured or yellowish bumps around the mouth, nose and sometimes the eyes, usually sparing a thin rim of skin right next to the lips. It has been described in babies as young as 3 months, is slightly more common in girls, and many children have a personal or family history of eczema, asthma or hay fever (Kellen and Silverberg, 2017).
What causes perioral dermatitis in toddlers and children?
- Steroid exposure: steroid creams on the face, and also inhaled or nasal steroids for asthma or allergies (Kellen and Silverberg, 2017).
- Heavy creams and ointments on the face.
- Lip licking, drooling, dummies and thumb sucking, which keep the skin wet.
- Irritation from fragranced products, toothpaste residue or food around the mouth.
Do not stop a child's prescribed asthma inhaler or nasal spray because of a rash. Ask the doctor; rinsing the mouth and wiping the face after inhaler use may help.
How do you treat perioral dermatitis in children at home?
- Stop steroid creams on the face unless a doctor has told you otherwise.
- Wash the face with water only or a very mild, fragrance-free cleanser, and pat dry.
- Use a bland barrier only where needed for drool or lip licking, rather than thick layers over the bumps.
- Wipe food, drool and toothpaste from around the mouth promptly.
- Avoid fragranced wipes, lotions and bubble bath on the face.
- Expect a few weeks for improvement, and a possible flare at first if steroids are stopped.
What will a doctor prescribe for a child?
Topical metronidazole has been used successfully in children. For more severe or widespread cases, doctors may use antibiotic tablets chosen for the child's age: tetracyclines such as doxycycline are generally avoided in young children, so erythromycin or azithromycin may be used instead (Kellen and Silverberg, 2017). The overall evidence for treatments in children is limited (Gray et al., 2022).
Why does perioral dermatitis appear in pregnancy?
Hormonal changes, new skin care products and the use of steroid creams for pregnancy-related itch or rashes may all play a part. The rash looks the same as at any other time: small red bumps around the mouth, nose or eyes (DermNet).
How is perioral dermatitis treated safely in pregnancy?
- Start with gentle care: stop facial steroids, simplify skin care and use a mild cleanser and bland moisturiser.
- Some common treatments are avoided in pregnancy. Tetracycline antibiotics and isotretinoin should not be used. Ask your doctor before using any prescription cream or tablet.
- Topical options such as azelaic acid or metronidazole are often considered by doctors in pregnancy; your doctor will weigh up the options for you (Searle et al., 2021).
- Avoid essential oils and strong home remedies on inflamed facial skin.
Can you use herbal creams for perioral dermatitis in children or pregnancy?
For adults, our perioral dermatitis home treatment guide covers natural remedies in detail.
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Frequently asked questions
What is the best natural treatment for perioral dermatitis in a child?
Gentle care: stop steroid creams on the face, wash with water or a mild cleanser, wipe away drool and food, and avoid fragranced products and heavy ointments. If it persists, a doctor may prescribe metronidazole cream.
Can a toddler get perioral dermatitis from an inhaler?
Yes, inhaled and nasal steroids have been linked to periorificial dermatitis in children. Keep using the inhaler as prescribed and ask the doctor; rinsing the mouth and wiping the face afterwards may help.
Is perioral dermatitis in children contagious?
No. It is not an infection that spreads to other children, so they can go to school or daycare.
What can I use for perioral dermatitis while pregnant?
Start with gentle skin care and stop facial steroids. Ask your doctor about topical treatments such as azelaic acid or metronidazole, and avoid tetracycline antibiotics and isotretinoin.
Will perioral dermatitis go away on its own?
Mild cases sometimes settle once triggers such as steroid creams are stopped, but this can take weeks or months. Treatment usually speeds recovery.
Related articles
References
- Kellen R, Silverberg NB. Pediatric periorificial dermatitis. Cutis. 2017;100(6):385-388. PMID 29360899
- Gray NA, Tod B, Rohwer A, et al. Pharmacological interventions for periorificial (perioral) dermatitis in children and adults: a systematic review. J Eur Acad Dermatol Venereol. 2022;36(3):380-390. PMID 34779023
- Searle T, Ali FR, Al-Niaimi F. Perioral dermatitis: diagnosis, proposed etiologies, and management. J Cosmet Dermatol. 2021;20(12):3839-3848. PMID 33751778
- DermNet. Periorificial dermatitis.
Educational information only. This article does not replace medical advice. Rashes in babies, young children and during pregnancy should be assessed by a doctor before using any medicated product.
