Introduction

Perioral dermatitis is a common skin condition in individuals of all ages. It is usually seen in individuals between the ages of 20 and 45, including pregnant people. It is characterised by the development of red, inflamed bumps or papules around the mouth, nose, and sometimes eyes. It typically presents as a rash that looks like acne or eczema but has distinct features that set it apart. The term "perioral" refers to the area around the mouth, where the condition primarily occurs. However, it can also affect other areas of the face, such as the chin and cheeks.^1,2

Symptoms and characteristics

Patients with perioral dermatitis usually experience:

• Redness
• Scaling
• Small, raised bumps

These lesions may cause itching or discomfort and sometimes lead to a burning or stinging sensation. Additionally, the affected skin may become dry, flaky, or sensitive to certain skincare products.

Development and causes of perioral dermatitis

Perioral dermatitis is thought to be influenced by various factors, including:

• Changes in skin barrier function
• Dysbiosis (an imbalance of microorganisms e.g., bacteria in the body)
• Environmental triggers

Although the cause of this disease is not fully understood, hormonal fluctuations, the use of topical corticosteroids (e.g., hydrocortisone), and harsh skincare products are commonly associated with its onset or exacerbation.^1,2

Maternity and perioral dermatitis

The prevalence of perioral dermatitis varies among different populations, but it is generally considered a relatively common dermatological (skin) condition. Pregnant people may be particularly susceptible to developing perioral dermatitis due to hormonal changes and increased sensitivity of the skin during pregnancy. Understanding the definition, symptoms, and prevalence of perioral dermatitis is essential to recognise and effectively manage this condition, especially in the context of pregnancy. 

Causes of perioral dermatitis during pregnancy

Perioral dermatitis during pregnancy can be influenced by several factors, including:

• Hormonal changes
• The use of certain skincare products
• Topical corticosteroids 
• Stress-related factors

Hormonal changes and their impact on skin health

Hormonal changes play an important role in perioral dermatitis development during pregnancy. Changes in hormone levels, particularly increased progesterone levels, can affect the skin's oil production and barrier function, making it more susceptible to inflammation and irritation.³ These hormonal changes may contribute to the onset of perioral dermatitis in pregnant people, and make managing skin conditions more difficult.

Use of certain skincare products during pregnancy

Certain skincare products can also contribute to the development of perioral dermatitis. Some skincare products, including topical corticosteroids, may contain ingredients that irritate the skin or disrupt its natural balance. Pregnant people are advised to avoid using products containing potential irritants or allergens, such as fragrances, dyes, and harsh chemicals, to reduce the risk of skin irritation and inflammation. See more information about toxic chemicals to your skin on the British Skin Foundation.

Stress and lifestyle factors

Stress and lifestyle factors may play a role in the development of perioral dermatitis during pregnancy. Stress can trigger inflammatory responses in the body, including the skin, leading to flare-ups of existing skin conditions or the development of new ones. Lifestyle factors such as poor diet, lack of sleep, and inadequate skin care practices can also contribute to skin problems during pregnancy.⁴

Risks and complications

Potential effects of perioral dermatitis on pregnancy

Perioral dermatitis during pregnancy can pose certain risks and complications, both for the expectant pregnant parent and the developing foetus. Understanding these potential effects is crucial for managing the condition and ensuring the well-being of both mother and baby.

One risk of perioral dermatitis during pregnancy is the potential impact on maternal mental health and quality of life. Skin conditions can cause discomfort, embarrassment, and psychological distress, particularly during pregnancy when hormonal changes and stress levels are already heightened. Addressing the symptoms of perioral dermatitis and seeking appropriate medical care can help to reduce these concerns.

Besides these psychosocial impacts, perioral dermatitis may affect the course of pregnancy itself. Although the condition is typically benign and does not directly affect foetal development, severe or persistent cases may require medical intervention or treatment that could impact pregnancy management. If left untreated, perioral dermatitis may worsen over time, leading to more significant discomfort. Severe cases of perioral dermatitis may also result in blepharitis or conjunctivitis (pink eye).²

Impact of pregnancy on the course of perioral dermatitis

Pregnancy can influence the course of perioral dermatitis. Hormonal changes, increased blood flow, and immune system alterations during pregnancy can affect the severity and frequency of perioral dermatitis relapse. Some people with perioral dermatitis may experience improvement in their skin condition during pregnancy, while others may find that their symptoms worsen or become more challenging to manage.

Managing perioral dermatitis during pregnancy requires careful consideration of the potential risks and complications. Pregnant people should work closely with their healthcare providers to develop a personalised treatment plan that addresses their specific needs and minimises any adverse effects on pregnancy. 

It is important for pregnant people with perioral dermatitis to discuss their condition with their GP or healthcare professional to ensure appropriate management. Regular monitoring and timely intervention can help ensure the best possible outcomes for both parent and baby.

Management and treatment options

Managing perioral dermatitis during pregnancy requires careful consideration of treatment options that are safe for both the pregnant person and the developing foetus. 

Skincare recommendations for pregnant women with perioral dermatitis

Skincare recommendations often involve gentle, non-irritating products that do not contain potentially harmful ingredients. This may include avoiding harsh cleansers, exfoliants (face scrubs), and fragrances that can trigger or increase inflammation. Instead, pregnant people may benefit from using mild, hypoallergenic skincare products specifically formulated for sensitive skin.

Safe topical treatments during pregnancy

If your perioral dermatitis is caused by topical corticosteroids then you may be advised to stop using it. However, this may lead to a flare-up and cause the rash to worsen. Your healthcare provider may prescribe milder topical corticosteroids to use instead.

Safe topical treatments for perioral dermatitis during pregnancy may also include non-prescription options, such as gentle cleansers, moisturisers, and mineral-based sunscreens. Calamine lotion or zinc oxide cream may provide relief from itching or irritation associated with perioral dermatitis lesions. It is important to consult with a healthcare professional before using any topical treatments to ensure they are safe to use during pregnancy.

Lifestyle adjustments to alleviate symptoms

In addition to skincare recommendations and topical treatments, lifestyle adjustments can help to reduce symptoms of perioral dermatitis during pregnancy. This may include avoiding certain factors, such as the consumption of spicy foods, hot beverages, or stress that can trigger inflammation or irritation. Practising stress-reduction exercises, such as going for a walk, yoga, or deep breathing may help manage perioral dermatitis.

Prevention strategies

While perioral dermatitis cannot always be completely prevented, there are steps that pregnant people can take to reduce the risk of developing this condition or experiencing onset during pregnancy.

Consultation with a healthcare provider

Discussion of treatment options

Your healthcare professional will offer you various treatment options suitable for pregnancy and explain the potential risks associated with each option. They may recommend topical treatments, oral medications, or lifestyle modifications based on the severity of your symptoms and any other existing health conditions. They can also provide valuable advice on managing perioral dermatitis that minimises potential adverse effects on pregnancy.

Remember, open communication with your healthcare professional is key to effectively managing perioral dermatitis during pregnancy and ensuring the best possible outcome for you and your baby.

FAQs

What are the symptoms of perioral dermatitis?

Perioral dermatitis symptoms include:

• Redness
• Rash
• Small bumps
• Mild itching around the mouth, nose, or eyes

Is perioral dermatitis contagious?

No, perioral dermatitis is not contagious (infectious). It's a skin condition that typically arises due to factors like hormonal changes, skincare products, or environmental triggers.

Can perioral dermatitis go away on its own?

Perioral dermatitis may resolve on its own, but treatment is often needed to manage symptoms effectively and prevent relapse.

What are the treatment options for perioral dermatitis?

Treatment options for perioral dermatitis include:

• Topical antibiotics
• Mild corticosteroids
• Avoiding triggers
• Maintaining proper skin care hygiene

Consulting a healthcare provider is essential for personalised treatment recommendations.

Summary

Perioral dermatitis is a common skin condition that usually causes a red, bumpy rash around the mouth and can be triggered by hormonal changes, skincare products, stress, and certain lifestyle factors. Perioral dermatitis during pregnancy can be a challenging condition to manage, but it can be effectively addressed with proactive measures and proper treatment.

It is essential to take precautions to prevent perioral dermatitis onset, such as avoiding potential triggers and irritants and maintaining good skincare hygiene, lifestyle, and positive mental well-being. It is always a good idea to consult your GP or healthcare professional as soon as possible if symptoms occur. With the right approach and guidance, expecting parents can effectively manage perioral dermatitis, ensuring their own health and that of their developing baby.