Seborrheic dermatitis around the mouth: Causes, symptoms and treatment

Seborrheic dermatitis around the mouth, also called perioral seborrheic dermatitis, can be embarassing and even painful, especially when it causes fissures around your lips. However, there are things you can do to relief the symptoms and heal your skin. 

Let’s take a deep dive:

Does seborrheic dermatitis affect the lips?

Theoretically, seborrheic dermatitis can affect any skin area with sebaceous glands. However, it has a predilection for the face, scalp, neck and upper chest.

It’s pretty common for seborrheic dermatitis to affect the skin around the mouth, especially the chin. SD can also affect the outer lip.

The edges of the lips are covered with reddish skin called vermillion. For the most part, SD leaves this area alone. However, it can affect your vermillion at the angles of the mouth.

Thankfully, SD usually leaves the main areas of lips alone.

Symptoms of seborrheic dermatitis around the mouth

During the inflammed phase, seborrheic dermatitis can cause redness, swelling and itch when it affects areas around the mouth. Sometimes it looks a bit like acne, with small bumps or blisters on the surface of the skin.

However, it’s the scaling phase that hurts. When your SD rash starts to scale and crust, the skin around your mouth can dry up and tighten. I’ve had my skin crack so badly that it bled. There were times when it hurt to talk and eat because my skin was so dry and tight.

What are the causes of seborrheic dermatitis around the mouth?

The factors and triggers that lead to perioral seborrheic dermatitis are similiar to the rest of your face. However, there are a few reasons SD could be only affecting your mouth area and they can be easily prevented:

• oily skin – when you eat a greasy fried chicken and don’t wash your mouth, it’s not only gross but it introduces oil to your mouth area, aggravating SD.
• dry skin – conversely, if you wash your mouth way too often and live in a cold, dry environment, you can dry the area out. This leads to overproduction of sebum, causing the area to be more oily.
• Using the wrong skincare products – the skin around our mouths tend to be oiler than other parts of our face. If your moisturizer is too rich or you’re using facial oils that encourage Malassezia growth, this can cause peri-oral SD
• Wearing a non-breathable mask for too long – this was never a problem for regular people before COVID but face masks are now a way of life. When your skin is trapped under a hot, stinky mask for most of the day, it can aggravate perioral SD and other rashes.

It’s worth mentioning (again) that if you don’t have the risk factors predisposing you to seborrheic dermatitis, you can have the oiliest skin in the world and still won’t be affected by SD.

How is seborrheic dermatitis around the mouth treated?

The principles of treating perioral seborrheic dermatitis is the same as for the rest of your face – ‘erradicate’ Malassezia, help your skin heal and prevent another flare.

Even though you can fully erradicate Malassezia, reducing its numbers with an antifungal cream does wonders in improving an SD flare an preventing another one. I look into your topical antifungal options here but a good over-the-counter option is good old clotrimazole:

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Apply clotrimazole in a thin layer twice a day for 2 weeks, even after your flare has died down. Make sure you don’t get it too near your mouth. Accidentally ingesting a little bit is fine but swallowing antifungal cream everytime you eat or drink cannot be good for you.

Allow your antifungal cream of choice to absorb before applying a gentle moisturizer. During the inflammed phase, the only moisturizer I use now a days is the Moogoo Scalp Cream (I found that it was the only one that didn’t sting).

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During the scaling phase, I often use a moisturizer with collagen and hyaluronic acid (for example, Dr Lewinn’s Ultra R4 Collagen Surge Plumping Gel – read my detailed review) to keep my skin moisturized and provide the raw material needed for healing the skin barrier. If I find that the skin is way too dry, I also apply NIOD Hydration Vaccine to protect from moisture loss. I go into detail in my review here.

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Don’t use steroid creams if at all possible. And if you do, make sure you don’t apply it to close to your lips. Accidentally ingesting steroid cream can be even more detrimental than antifungal cream.

I go into a deep dive on SD treatment here. 

What are the complications of seborrheic dermatitis around the mouth?

Perioral seborrheic dermatitis may not be life-threatening but it can certainly cause a lot of mental, emotional and physical angst.

During the inflammed phase, your mouth and chin area can be itchy, red and weepy. You feel self-conscious, your self-esteem plummets and you imagine people are focusing on your rash instead of what you have to say. I encourage you to accept it and ignore tactless people but if you want to learn how to cover up your SD rash, read Makeup for seborrheic dermatitis: How to make yourself look beautiful.

When your rash starts scaling and your skin becomes tight, that’s when the pain happens. Your skin can be so tight and dry that fissures can happen around your lips. It can hurt everytime you eat or talk. Thankfully, applying a rich moisturizer and a hydrating lip balm multiple times in the day can help with this.

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Can you use lipstick with perioral seborrheic dermatitis?

As seborrheic dermatitis doesn’t affect your lips, you’re free to use any lipstick you want. However, the outer parts of your lips may be dry. A hydrating, moisturizing lipstick or lipbalm can do wonders in this case.

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Also, you may have small fissures and cracks around your mouth. If that was the case, use a lipliner to prevent bleed lines.

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To wrap up

While perioral seborrheic dermatitis may be embarassing and painful, there are plenty of ways you can help the situation. The key is to keep the skin around your mouth moisturized and protected.