Seemingly out of nowhere, a tiny pink bump appears on your chin or your cheek. It might look a little like a miniature pimple - but not quite. This bump is followed by another similar one, then another, and another still. As one spot disappears, others continue to form in small crops around the mouth on the chin, the smile lines, the cheeks, or even around the eyes. The spots might look like tiny pus bumps, and they might be a little itchy, stingy or scaly - or they might not feel like anything at all.
If you’ve noticed a skin problem like this, you could be experiencing the most common rash most people have never heard of: perioral dermatitis, also called periorificial dermatitis (you can see it here). This harmless, but annoying (and potentially cosmetically distressing) condition usually appears in young women, but can occasionally affect children, men, and older folks, too.
While doctors don’t fully understand why this condition develops, we know it can be triggered or worsened by various factors. Common culprits include steroid creams (such as hydrocortisone, triamcinolone, or clobetasol) applied to the face regularly for days or weeks (this is one reason why cortisones should be used sparingly and infrequently). Other contributing factors include the body’s natural hormones, birth control pills, certain cosmetics, some inhalers, toothpastes containing fluoride, and normal, microscopic mites that live on the skin (it’s not fun to think about, but everyone’s complexion harmlessly harbors Demodex mites!).
The good news is that perioral dermatitis is highly treatable. There’s a good chance your dermatologist can help you clear the rash completely. Improvement typically requires prescription creams or gels (such as metronidazole, clindamycin, or pimecrolimus), pills (such as a low-dose tetracycline medicine), and a slow, gradual taper off of any cortisone creams (they may calm the rash temporarily, but it typically riles up again as soon as we stop). If you’re considering over-the-counter options - such as clotrimazole cream, topical washes or creams containing sulfa, benzoyl peroxide, tea tree oil, or adapalene gel - be aware that they’re not backed by significant research, and they might actually worsen skin irritation. What may help, at least a bit, until you get to a dermatologist: removing any skincare product that makes you suspicious, applying sparing amounts of over-the-counter hydrocortisone cream to the bumpy or rashy area when needed, and sticking to gentle skincare products like a mild facial cleanser and a soothing, fragrance-free moisturizer with SPF.