Rosacea and perioral dermatitis: what’s the difference?

Perioral dermatitis and rosacea both cause redness of the face. While rosacea tends to affect the nose and cheeks, perioral dermatitis is most common around the mouth. Both conditions can respond to oral antibiotics, although topical treatments differ.

Rosacea and perioral dermatitis are two common skin conditions that can cause redness and bumps on the face. While they share some similarities in symptoms, causes, and treatment options, there are also important differences between the two.

Similarities

• Redness: Both rosacea and perioral dermatitis can cause redness around the nose and mouth.
• Bumps: Both conditions can also cause small bumps or pimples on the affected area.
• Triggers: Certain triggers such as sunlight, stress, and certain foods or drinks can worsen symptoms in both conditions.

Differences

• Causes: While the exact causes of rosacea and perioral dermatitis are not fully understood, they are believed to have different underlying causes. Rosacea is thought to be caused by a combination of genetic and environmental factors, such as sun exposure, heat, and alcohol consumption. Perioral dermatitis, on the other hand, is thought to be caused by the prolonged use of topical steroids or other irritants.
• Location: Rosacea tends to affect the central part of the face, including the cheeks, nose, and forehead, while perioral dermatitis usually appears around the mouth and chin.
• Symptoms: Rosacea is often characterised by flushing, visible blood vessels, and a thickened or bumpy texture of the skin. Perioral dermatitis is characterised by small red bumps or pustules, often surrounded by scaling or dryness.
• Treatment: Treatment options for both conditions are similar, but may differ in the specific medications used. A rosacea specialist may recommend topical creams or oral antibiotics, such as metronidazole or doxycycline, or laser/IPL therapy, to treat rosacea, while perioral dermatitis may be treated with topical antibiotics, such as doxycycline, or non-steroidal anti-inflammatory creams. However, discontinuing the use of topical steroids or other irritants is also an important part of treating perioral dermatitis.