Acne around the mouth: causes and treatment

Acne around the mouth is common, and it usually comes from something that touches that skin: lip balm, lipstick, makeup, shaving products, a face mask or your own hands. Its place on the face cannot prove a hormone problem. Bumps that sit only around the mouth may also be a different rash, perioral dermatitis, which needs different care. This guide covers the causes the American Academy of Dermatology (AAD) and studies name, how to treat acne in this area, and the look-alikes to know. It is part of Skinli's guide to acne by face area.

Skinli gives general education and is not a doctor. This page names no brand. Pimples on the lip line and cold sores are covered in pimple on the lip, and chin acne in forehead and chin acne.

How common acne around the mouth is

Studies that count acne by area put the mouth near the top. In a 2021 study of 208 women aged 25 or older with acne, the most common sites were both cheeks (87.0 percent) and the area around the mouth (81.7 percent). A 2014 study of 102 acne patients treated the area around the mouth as its own zone, the "O zone", because it behaved differently from the rest of the face. In that study, men had more acne spots in the O zone than women, and patients aged 21 to 30 had the most. Its authors say their patients do not represent all acne patients, so larger studies are needed.

What causes acne around the mouth

Lip products. The AAD says that tiny breakouts around the lips can come from your lipstick or lip balm. It describes this under acne cosmetica, acne caused by cosmetics. The AAD's face mask page gives one more lip rule: "To prevent breakouts, take care to apply the petroleum jelly only to your lips."

Makeup. The AAD says acne cosmetica usually appears on the cheeks, chin or forehead, and that "It can take anywhere from a few days to 6 months for blemishes to appear." That delay is why people often blame the wrong product.

Masks. The AAD says: "Beneath a mask, makeup is more likely to clog your pores and lead to breakouts." The rest of its mask advice is in maskne causes and treatment.

Shaving products. On its hair product page, the AAD warns: "Even shaving creams and aftershave can contain oil." Oil from products can clog pores. Men who shave around the mouth and chin can check these labels too.

Rubbing and pressure. The AAD describes acne mechanica, acne from gear that traps heat and sweat and rubs the skin. Its first sign is small, rough bumps that "may appear where a chin strap, helmet, or other piece of equipment rubs."

Hands. The AAD says: "Touching your face throughout the day can cause acne to flare." Resting your chin or mouth on your hand counts.

Is acne around the mouth hormonal?

It can be, and the sources describe a pattern in adult women. A 2018 review says acne in adult women tends to sit on the lower third of the face, which it lists as the jaw line, the area around the mouth, and the side of the neck. A 2010 study describes adult acne the same way: "frequently involving the lower third of the face, the jawline, and the neck."

The same 2018 review also says most of these women have no hormone disease that causes their acne. In the 2021 study of 208 women, the factors linked to polycystic ovary syndrome (PCOS), a hormone condition, were younger age, acne that flared before periods, and irregular periods. Acne around the mouth was not on that list.

The AAD says women "often experience fluctuating hormones" around their periods, during pregnancy, perimenopause and menopause, and after stopping or starting birth control pills. The AAD also says women with PCOS "usually have other signs of a hormone problem, such as hair loss on their head, noticeable hair growth on their face". If you have those signs, see a doctor. The jawline acne and PCOS acne guides cover hormones in more depth.

Stress plays a part. The AAD says: "While stress cannot cause acne, stress may worsen existing acne." In the 2021 study, 53.8 percent of the women named stress as something that made their acne worse.

Acne or perioral dermatitis?

Perioral dermatitis is a rash that looks like acne and gathers around the mouth. It needs different care, so it helps to know the signs. The AAD's clue is "a breakout that looks like many small pimples, but it develops only around the mouth." The skin may burn or itch, and the AAD says "You'll likely have dry and flaky skin where you have the rash, though."

A 2014 review of acne look-alikes gives one more clue: "in contrast to acne, there are no comedones (whiteheads or blackheads)." So a mix of blackheads, whiteheads and pimples around the mouth points to acne, and many small bumps with no blackheads or whiteheads point to a look-alike.

Do not put hydrocortisone cream on bumps around the mouth unless a doctor tells you to. The AAD says: "Many people develop this rash when they apply a corticosteroid medicine to their skin for too long." Hydrocortisone is a corticosteroid. The full guide is perioral dermatitis, and azelaic acid for perioral dermatitis covers one treatment a doctor may use.

Other bumps around the mouth

Two infections also show up around the mouth, and both spread to other people.

Cold sores. The NHS says: "A cold sore usually starts with a tingling, itching or burning feeling." Painful blisters follow, and "Cold sores should start to heal within 10 days, but are contagious". A pimple is different: the NHS lists a "Painful red spot on the face filled with pus" as a spot or a boil. Pimple on the lip explains how to tell them apart.

Impetigo. The NHS says: "The sores and blisters of impetigo commonly affect the face (around the nose and mouth) and hands." They "quickly burst and often leave crusty, golden-brown patches." The NHS says impetigo spreads easily but is not usually serious, and a pharmacist or GP can treat it.

What you see around the mouth	What it may be	Source
Blackheads, whiteheads and pimples	Acne	AAD
Tiny bumps around the lips after a new lip product	Acne cosmetica	AAD
Many small bumps only around the mouth, dry and flaky, may burn or itch	Perioral dermatitis	AAD
Tingling, then painful blisters that heal in 10 days	Cold sore	NHS
Sores that burst and leave golden-brown crusts	Impetigo	NHS

How to treat acne around the mouth

Stop what may cause it. The AAD's advice for acne cosmetica is to read the labels on makeup, skin care and hair care products. It says: "Make sure you see one of the following terms on your products: Oil-free, won't clog pores, or non-comedogenic." Non-comedogenic means made so it does not block pores. Add lip products, shaving cream and aftershave to that check. The AAD says acne cosmetica "tends to clear once you stop using what's causing it."

Treat the whole area. The AAD's acne cosmetica page names three acne treatments sold without a prescription: benzoyl peroxide, salicylic acid and adapalene. It advises using them over the whole area: "spread a thin layer of the acne medication evenly over your acne-prone skin." How to start adapalene covers the first weeks of that gel.

Wash gently and after sweating. The AAD says: "Gently wash your face up to twice daily and after sweating." It advises against astringents, toners and exfoliants, which can irritate the skin. If you wear makeup, the AAD also says: "Clean your makeup brushes every week and make sure you're the only one who uses them." It adds that sharing makeup, brushes or applicators can also pass on infections such as cold sores.

Leave the spots alone. The NHS says "do not pick or squeeze spots because this can cause scars". Should you pop a pimple explains why.

Give it time. The AAD says: "It can take 4 to 8 weeks to see some improvement."

When to see a doctor

See a doctor or a dermatologist when:

• the bumps sit only around the mouth, burn or itch, or leave the skin dry and flaky,
• the rash started or got worse after using a steroid cream on the face,
• sores blister, crust over, or spread to other people in your home,
• acne has not improved after 4 to 8 weeks of steady care, or it is leaving scars,
• you also have irregular periods, new hair growth on the face, or hair loss on the head.

Get medical help soon if a bump becomes hot, swollen and red. The NHS lists "hot, swollen and red skin" as signs of a skin infection.