Why do we get spots around our mouth?

Spots around the mouth are common – but what causes them? And how you know when it’s perioral dermatitis? A consultant dermatologist explains all…

Spots can crop up anywhere on your face but one common area is the mouth. While it’s is usually associated with hormones, there are actually several potential causes. We asked Dr Alia Ahmed, consultant psychodermatologist and skin wellness expert, to break down the reasons behind spots around our mouths and how to tell when it’s actually perioral dermatitis…

Why do I get spots around our mouth?

“The most common ones include perioral dermatitis, allergic contact dermatitis, cheilitis, eczema, seborrhoiec dermatitis, fungal infection, folliculitis, rosacea and acne.”

Are spots around the mouth more common when you’re on your period?

“Spots around the mouth can flare with your menstrual cycle irrespective of the cause. For example, people with common skin problems like acne and rosacea, which can present as spots around the mouth, report flare-ups at certain times of their cycle, suggesting hormonal influences.”

What is the best way to treat spots around your mouth?

“Firstly, it is important to diagnose the cause. Treatment for spots around the mouth will vary with the diagnosis, some treatments will aggravate spots if the cause is not correctly diagnosed. For example, steroid creams can be used to treat spots caused by eczema but are in fact known to trigger or make perioral dermatitis worse.”

What is perioral dermatitis and how can you tell if you have it?

“Perioral dermatitis is an inflammatory skin condition that presents as several small spots or tiny blisters on a red background around the mouth (and around the eyes in some cases).

“It occurs mainly in adults between the ages of 16-45 years – though cases in children have been reported – and seems to affect females more than males.” If you suspect you have perioral dermatitis, you should seek advice from your GP or a dermatologist.

What causes perioral dermatitis?

“Perioral dermatitis is the result of inflammation around the hair follicles and blood vessels, which leads to the formation of small spots around the mouth, nose and eyes. The exact cause is unknown, but likely includes a combination of genetic, hormonal and environmental factors.

“It can be made worse by the application of potent topical steroid creams or contact with steroid inhalers. Other possible causative factors include yeasts (candida albicans) and mites (demodex) that live normally on the skin. Also, hormonal factors – but use of the oral contraceptive pill has been seen in some cases to improve perioral dermatitis.”

What’s the best way to treat perioral dermatitis?

Here, Dr Ahmed shares her tips…

1. Avoid topical steroids. These may have been used in error if a diagnosis other than PD was being considered, they may have even helped initially, but long-term can make the problem worse).

2. Azelaic acid. This acts as an anti-inflammatory and helps to unclog pores.

3. Topical antibiotics. Commonly used ones are metronidazole, clindamycin and erythromycin (though the latter needs to be prescribed by your GP or dermatologist).

4. Oral antibiotics. Longer courses are typically required (three to six months or longer). These also need to be prescribed by your GP or dermatologist.

5. Other treatments include topical immunosuppressants, topical or low dose oral retinoids and photodynamic therapy.

6. Psychological treatment. Visible skin conditions can be psychologically devastating for some people, addressing the impact of perioral dermatitis on quality of life is equally as important as medical treatment.

Main image: Getty

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