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

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

Posted by Amelia Goff on

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.
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 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)


fresh face skin recovery mask for dermatitis
Eczema is often red, inflamed and dry/cracked in appearance and can be itchy. It can appear anywhere on the body but commonly affects the cheeks, forehead, and limbs. This often appears in a skin prone to sensitivity and can be genetic, often first appearing in childhood years. Unlike perioral dermatitis, eczema patches are usually larger and flatter in texture.

Key Differences:


  • 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.


  • 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.


  • 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:

Omega 3 - Taking a high quality omega 3 supplement daily, will ensure that your skin cells are nourished internally, with the quantity of omegas needed, to support healthy skin and cell function - allowing your skin cells to absorb and hold nutrition, allowing for internal nourishment and anti inflammatory benefits, from the inside out.
    Our top picks for a high quality omega 3:
    JS Health - taking a high dose daily after food
    Nordic Naturals liquid omega - taking a high dose daily after food 

    Hormone & stress support

    Stress directly impacts our hormone levels, which when imbalanced, can have direct impact on our skin - causing blockages and congestion and inflammation to form.

    Our top Aussie made & owned picks for internal hormone, stress and cell support:
    Fem21  has been designed by an Australian naturopath, aimed for women as a natural alternative to balance their hormone levels, supporting women's health holistically. Using 21 powerful plant extracts, this supplement supports female hormones, while also balancing liver health, gut health, adrenal function (stress)  and alkalising the body (removing internal inflammation).
    Dosage: Simply add ½-1x scoop to water and juice, daily.
    *This supplement cannot be taken if you are pregnant, breastfeeding or on medical contraception. 
    Cell charge is the worlds’ most potent source of Fulvic Acid which delivers the essential nutrients your cells need to function optimally, every day. Working at a cellular level, Cell Charge feeds your body with ultra-concentrated and naturally occurring; Minerals, Vitamins, Amino Acids, Organic Acids, Flavonoids, Antioxidants, to assist with immunity, sleep, stress levels, gut health and overall cell health.

    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. 

    Designed for sensitive, dry, and inflamed skin, this effective pack strengthens the skin's barrier

    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. 

    Content disclaimer
    Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances. Fresh Face Skin shall not bear any liability for reliance by any user on the materials contained on this website.

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