If you have allergies or asthma, think about switching your meds. As with steroid creams, Dr. Sprague said, inhaled or spray steroidal medications commonly used to treat allergies or asthma — like Flonase, Nasacort or Symbicort — are thought to trigger perioral dermatitis, perhaps because they modify the body’s immune response.
If you use any of these medications and are worried about perioral dermatitis, talk with your doctor about your treatment plan. Some allergy or asthma sufferers may need to remain on steroid medications, Dr. Sprague said. However, others may be able to consider other nonsteroidal drugs, like cetirizine (Zyrtec), which are not thought to cause perioral dermatitis.
Streamline your skin-care products. Using too many skin care products can throw off your skin’s natural balance, according to Dr. Bowe, increasing the risk of an outbreak. In one study of 232 people in Australia, those who used foundation, night cream and moisturizer were 13 times more likely to develop perioral dermatitis than those who used moisturizer alone.
Similarly, if you’re managing a flare, minimalism is key. “The best thing you can do is baby your skin,” Dr. Sprague said. “Stop any thick cosmetics, serums, etc.”
Dr. Jennifer Holman, a dermatologist in Tyler, Texas, recommended washing your face twice a day with a gentle cleanser, such as a sulfur face wash, and following up with a fragrance-free moisturizing lotion. It’s OK to use a little mineral makeup, she added, because it doesn’t tend to aggravate the rash.
Don’t dabble in unproven treatments — see your dermatologist. Plenty of alternative treatments for perioral dermatitis are available on the web, from swabbing the skin with apple cider vinegar to taking supplements of certain herbs, like neem. But those haven’t been scientifically proven to work, Dr. Holman said. And since the rash is notorious for sticking around, it’s important to seek professional help.
Dr. Sprague said she’ll often start by prescribing a topical antibiotic, like metronidazole — not to banish an infection per se, but to reduce the inflammation and give the skin a chance to heal. Pimecrolimus, a nonsteroidal anti-inflammatory cream that is commonly used to treat rosacea and eczema, can also help clear up the rash.