Red flags & when to go in person for Perioral Dermatitis

Audience: pediatric

Perioral dermatitis is a skin condition that causes a red, bumpy rash around the mouth, sometimes extending to the nose or eyes. It is common in children and often linked to skin irritation or use of certain creams. While it can often be managed with simple skin care changes, some signs mean you should see a healthcare provider in person. These include worsening rash, signs of infection, or if the rash spreads beyond the face. Telemedicine can help assess mild cases and guide care, but some situations require a direct exam. This guide explains when to seek in-person care, what telemedicine can and cannot do, and how to prepare for a virtual visit. Remember, this information is educational and not a substitute for professional diagnosis or treatment.

Red flags — go in person / ER

• Rapid worsening of rash or swelling — seek urgent in-person care.
• Signs of infection such as pus, increased warmth, or fever — see a healthcare provider promptly.
• Rash spreading beyond the face or accompanied by difficulty breathing — seek emergency care immediately.

What telemedicine can do

• Initial assessment of mild rash and symptoms.
• Providing skin care advice and education.
• Recommending over-the-counter treatments.
• Deciding if in-person evaluation is needed.

What telemedicine cannot do

• Performing physical exams or skin tests.
• Treating severe infections or allergic reactions.
• Managing rapidly worsening or spreading rash.
• Providing emergency care.

What is Perioral Dermatitis?

Perioral dermatitis is a skin rash that appears as red bumps or small pimples around the mouth. It may also affect the areas around the nose and eyes. It is not caused by infection but often by skin irritation, such as from creams, toothpaste, or weather changes. The rash can be itchy or cause mild discomfort but usually is not painful.

When to Seek In-Person Care

See a healthcare provider in person if your child has:

How Telemedicine Can Help

Telemedicine can be useful to:

It is a convenient way to get initial guidance without traveling.

Limitations of Telemedicine

Telemedicine cannot:

Preparing for a Telemedicine Visit

Before your virtual visit:

After the Telemedicine Visit

Follow the healthcare provider's advice carefully. This may include:

How to prepare for your tele-visit

• Take clear photos of the rash from multiple angles.
• Note the start date and progression of the rash.
• List all skin products, medications, and recent exposures.
• Prepare your child's medical history and allergy information.
• Ensure a quiet space with good lighting for the video call.
• Test your internet connection and device camera beforehand.

After your tele-visit

• Follow the treatment and care instructions given by the provider.
• Avoid using irritant skin products as advised.
• Watch for any worsening symptoms or new signs.
• Schedule an in-person visit if symptoms do not improve or worsen.
• Keep a record of any changes to share with your healthcare provider.

FAQs

What causes perioral dermatitis in children?

Perioral dermatitis is often caused by skin irritation from things like steroid creams, certain face products, toothpaste, or environmental factors. It is not usually due to infection.

Can perioral dermatitis go away on its own?

Sometimes, mild cases improve by avoiding irritants and using gentle skin care. However, it may take weeks, and some children need medical treatment to clear the rash.

Is perioral dermatitis contagious?

No, perioral dermatitis is not contagious and cannot be spread from person to person.

When should I stop using steroid creams?

Steroid creams can sometimes worsen perioral dermatitis. It is best to follow your healthcare provider's advice about stopping or tapering these creams safely.

Can telemedicine replace in-person visits for this condition?

Telemedicine is useful for initial advice and mild cases but cannot replace in-person exams when the rash is severe, spreading, or shows signs of infection.

Sources

1. Perioral Dermatitis — MedlinePlus, U.S. National Library of Medicine.
2. Perioral Dermatitis: Overview and Treatment — Mayo Clinic.
3. Skin Conditions in Children — American Academy of Pediatrics.
4. Dermatitis and Eczema — Centers for Disease Control and Prevention (CDC).

This telemedicine guidance is for educational purposes only and is not a substitute for professional in-person medical care, diagnosis, or treatment. If your child has severe symptoms or red flags, seek immediate medical attention.