Perioral Dermatitis, Acne, or Eczema: How to Tell the Difference

Skin conditions often present with similar symptoms, making it challenging to distinguish between them. Perioral dermatitis, acne, and eczema are three inflammatory skin conditions that commonly affect the facial area, each with distinct characteristics and it’s my job to educate you on diagnosing these 3 common skin conditions, to prevent misdiagnosis, which can often lead to incorrect treatment and worsening of the condition, along with prolonged discomfort - think more red, inflammed, itchy and sore. 

Here, we will explore the key differences between these 3 common inflammatory skin conditions, with the aim to empower you with the knowledge to care for your skin, as needed, long term.

Understanding the Conditions

Perioral Dermatitis

Perioral dermatitis refers to irritation around the mouth. Shutterstock

Characterised by a rash around the mouth, which may spread to the nose and eyes. Perioral dermatitis features small, red, sometimes pus-filled bumps and can often be mistaken for acne. It can be accompanied by sensations such as mild itching or heat or burning. Unlike acne, these bumps are more uniform - rash like in appearance and mainly localised around the mouth.

Acne

Acne typically presents as some type of texture to the skin - often in the case of a blocked pore such as blackheads or inflammation, caused by oil being trapped in the hair follicle - causing bacteria to build up and swelling to form. This can come in the form of:

• Whiteheads or Pustules - just as the name suggests - this acne presents with a white head or puss. This whitehead is a sign that your skin is healing the bacteria in the area - so no picking is a must!

• Papules - under surface lumps without a head

• In severe cases, cysts - sore to touch, red and inflamed. These often take time to heal due to the amount of inflammation in the area.

Unlike perioral dermatitis, Acne can appear anywhere on the face, chest, and back. 

Eczema (Atopic Dermatitis)

Key Differences:

Location

• Perioral dermatitis: Primarily around the mouth, and possibly the nose and eyes.

• Acne: Can occur anywhere on the body but commonly on the face, chest, and back.

• Eczema: Often found on the cheeks, forehead, and limbs.

Appearance

• Perioral dermatitis: Small, raised, red bumps, sometimes with a clear or yellowish centre.

• Acne: A mix of blackheads, whiteheads, and larger, inflamed pustules or cysts - often red, inflamed, may present with a white head and can be more sparse in appearance. 

• Eczema: Red, inflamed, dry patches of skin, which may be cracked or scaly.

Sensation

• Perioral dermatitis: Mild itching or burning, overall sensitive. Textured, rash like to touch. 

• Acne: Can be painful, especially when touching more inflamed areas.

• Eczema: Intense itching, with skin feeling dry and sensitive. Often textured and dry to touch.
  
  

Diagnosis and Treatment

The best way to differentiate between these conditions is through a skin professional - either a qualified dermal skin therapist or dermatologist.

It’s important to understand that any inflammatory skin conditions such as the ones mentioned today, often start from an internal trigger. This trigger could be imbalanced hormones, gut imbalances, internal inflammation and internal stress levels.

It’s important that we understand and treat the internal trigger, to then clear the surface condition, long term.

When it comes to treating the condition on the surface, this will change depending on the condition.

All 3 conditions discussed today, can often be recommended topical steroids or antibiotics. As much as this medication will treat the condition, it’s important to understand that often, this will only ‘mask’ the condition, providing a short-term skin response and improvement, with often long term side effects - often causing further skin sensitivity, barrier impairment, while restricting healthy blood flow and natural skin immunity - which can often lead to a skin that flares more easily and regularly, flushes & reacts more easily.*

For all 3 of these conditions, the most important thing to do is to strip back your skincare! Less is more when it comes to the products and ingredients that you are applying to the affected area, daily! 

Products that are high in ceramides (omegas) to help nourish and protect the skins barrier, will help to calm inflammation and dryness, allowing the skin to protect itself. Extracts that are anti-inflammatory, will help to calm the uncomfortable heat and/or itching sensations that some of these conditions can present with, while easing the redness and swelling in the area, to allow the skin to begin to heal.

How to treat these skin conditions holistically, from the inside-out and topically, using the power of nature, for long term skin results!

Internal Supplements recommendations

Supporting the gut microbiome, stress and hormone levels, will help to prevent these flare ups from occurring and this all starts with diet and supplements to assist with bringing balance back to your internal body functions.

Some of our top picks:

Hormone & stress support

Dosage: To be taken 2 x daily for the first initial 2-4 weeks, then just once daily thereafter.
Simply add 1 drop per 10kg of body weight in water with Omegas, lemon juice, smoothies, juices or hot and cold beverages.

External skincare recommendations

For all inflammatory skin conditions, our number one recommendation is to ensure that the barrier is strengthened and remains protected.

Our top products to improve overall barrier function to help calm surface inflammation, balance oils and reduce skin flare ups and sensitivity are:

Soother treatment

Soother cleanser

Recovery mask

All available in our new Barrier bundle - purchase and save. 

Then, depending on the condition, the below products will further assist with treating the skin - providing the skin with different extracts that assist with different skin needs.

Perioral Dermatitis: 
Acne: Treatment may include topical retinoids, benzoyl peroxide, or oral medications for more severe cases.

Eczema: Management focuses on moisturising, avoiding triggers, and possibly topical steroids or other anti-inflammatory medications.

Professional Skin Treatments

When it comes to treating an inflamed skin professionally, this will depend on the type of condition that presents. It is always best to treat the skin after we have professionally assessed it and the best way to do this - is to book a consultation with your skin specialist.

Here at Fresh Face Skin salon - we offer a ‘New client treatment + consult’ aimed at clients we have never treated, to ensure we can sit down with you and discuss your skin concerns, goals, while properly assessing your skin's health via our skin analysis machine. We can then provide you with a treatment on the day, to immediately give your skin some relief, as well as set you up with a customised skincare routine and in-salon treatment plan, best suited for your individual skin needs, to get you the best skin results possible. 

We offer various treatments such as our Herbal peel, LED and Enzyme flow treatments, that aim to calm surface inflammation and bring balance back to the skin and it functions, reducing inflammatory flare ups while treating the condition.