Spots Around the Mouth: Causes, Symptoms, and Treatment Options

Several factors can contribute to developing spots around the mouth, each with distinct causes and characteristics. Understanding these can help you identify the problem and seek appropriate treatment.

Acne

Acne is a common cause of spots around the mouth, particularly in teenagers and young adults. Hormonal changes, particularly during puberty, menstruation, or stress, can lead to increased oil production, resulting in clogged pores and the formation of spots. Acne around the mouth can also be triggered by certain cosmetics, skincare products, or face masks, which trap moisture and bacteria against the skin.

Perioral Dermatitis

Perioral dermatitis is a rash that appears as red bumps around the mouth, nose, and sometimes the eyes. It is often linked to the prolonged use of topical steroids or heavy skin creams. Fluoride toothpaste and certain skincare products can also irritate the skin, leading to perioral dermatitis. This condition is more common in women and can persist if not treated correctly.

Cold Sores (Herpes Simplex Virus)

Cold sores are fluid-filled blisters caused by the herpes simplex virus (HSV-1). These painful lesions typically appear around the lips and mouth and are highly contagious. The virus can be triggered by factors such as stress, illness, or exposure to sunlight. Cold sores tend to recur in the same area, often preceded by a tingling sensation before the blisters appear.

Impetigo

Impetigo is a bacterial skin infection commonly caused by Staphylococcus aureus or Streptococcus pyogenes. It is more prevalent in children but can affect adults as well. Impetigo around the mouth appears as red sores that quickly rupture, ooze and form a yellow-brown crust. This condition is highly contagious and requires prompt treatment to prevent spreading to others.

Other causes

Other factors contributing to spots around the mouth include irritation from shaving or waxing, ingrown hairs, and certain dental products. Environmental factors like pollution and harsh weather conditions can also exacerbate skin issues in this area.

The symptoms associated with spots around the mouth can vary widely depending on the underlying cause. Recognising these symptoms is key to determining the best course of action.

Common symptoms of spots around the mouth include redness, swelling, and the appearance of small bumps or pimples. These spots may be accompanied by itching or mild discomfort, particularly in allergic reactions or perioral dermatitis. In acne, you might notice blackheads, whiteheads, or pimples forming in the affected area.

Cold Sores

Cold sores begin with a tingling or burning sensation around the lips, followed by painful blisters. These blisters can break open, ooze, and form a crust as they heal. The area around the cold sore may be tender and sensitive to touch.

Impetigo

Impetigo typically presents as red sores or blisters that burst and develop a yellowish crust. The sores can be itchy and may spread through contact with other parts of the body. The skin around the sores may feel warm to the touch, indicating the presence of an infection.

Perioral Dermatitis

Perioral dermatitis appears as clusters of small red bumps around the mouth, often extending to the nose and eyes. The rash may be itchy or cause a burning sensation, and the skin may feel dry or flaky.

In more severe cases, such as a spreading bacterial infection, symptoms may include fever, chills, and the rapid progression of redness and swelling. These symptoms warrant immediate medical attention.

Diagnosing the Cause of Spots Around the Mouth

1. Medical history is taken to diagnose the cause of spots around the mouth accurately, and a healthcare provider will first review your medical history. This includes discussing your lifestyle, skincare routine, and any recent changes that could have triggered the outbreak. Factors such as diet, stress levels, and exposure to allergens or irritants are crucial in identifying the underlying cause.

2. Physical examination is essential in the diagnostic process. A GP or dermatologist will assess the spots' appearance, distribution, and characteristics. They will note whether the spots are red, filled with fluid, or have any crusting, which helps differentiate between conditions like acne, cold sores, and impetigo.

3. Additional tests may be necessary to confirm the diagnosis. Patch testing can help identify allergic reactions contributing to the spots, while swabs may be taken to check for bacterial infections like impetigo. Blood tests might be conducted to rule out underlying systemic conditions or to identify viral infections such as herpes simplex, which causes cold sores.

4. Cold Sores & Impetigo diagnosis - Specific diagnostic markers identify conditions like cold sores and impetigo. For cold sores, the presence of the herpes simplex virus is a crucial indicator, often diagnosed through visual examination or, if necessary, a swab test. Impetigo is typically diagnosed by identifying the bacteria responsible, usually Staphylococcus or Streptococcus, through a swab culture.

Over-the-counter treatments

Various over-the-counter (OTC) treatments are available depending on the cause of the spots. Topical creams containing benzoyl peroxide or salicylic acid can be effective for acne. Hydrocortisone creams may help soothe dermatitis, while antiviral creams like aciclovir are commonly used to treat cold sores. These treatments are accessible and can help manage mild to moderate cases.

Prescription medications

For more severe or persistent cases, prescription medications may be necessary. Your local pharmacist often prescribes topical or oral antibiotics for impetigo to combat bacterial infections as part of the Pharmacy First Programme. Stronger antiviral medications may be needed for recurrent or severe cold sores. In stubborn acne cases, a healthcare provider might prescribe retinoids, potent vitamin A derivatives that promote skin cell turnover and reduce inflammation.

Home Remedies

Several natural remedies can soothe and aid in healing spots around the mouth. Aloe vera is known for its anti-inflammatory and moisturising properties, making it suitable for irritated skin. Honey, with its antibacterial properties, can be applied to impetigo-affected areas to help reduce infection. Tea tree oil, used sparingly, can also be effective in treating mild acne due to its antibacterial and anti-inflammatory effects.

Lifestyle changes

Adopting a healthier lifestyle can play a significant role in managing and preventing outbreaks. A balanced diet rich in vitamins and minerals supports skin health, while stress management techniques can reduce flare-ups, particularly for conditions like cold sores. Consistently following a gentle skincare routine that avoids harsh products is also crucial.

Managing Cold Sores & Impetigo

Specific management strategies are essential for conditions like cold sores and impetigo. For cold sores, it’s important to avoid touching or picking at the sores to prevent spreading the virus. Good hygiene practices, such as washing hands frequently and not sharing personal items like towels, are vital in preventing the spread of impetigo.

Prevention strategies

Skincare routines

Maintaining a gentle and non-irritating skincare routine is vital for preventing spots around the mouth. Use mild cleansers and moisturisers that are free from harsh chemicals and fragrances. Regularly exfoliating the skin can also help prevent clogged pores, but it’s important to avoid over-exfoliating, which can irritate the skin.

Avoiding triggers

Identifying and avoiding triggers that can cause flare-ups is an effective prevention strategy. For some people, certain foods, such as those high in sugar or dairy, can exacerbate acne. Harsh skincare products or specific shaving methods might irritate the skin around the mouth, leading to breakouts. Being mindful of these triggers can help reduce the frequency of spots.

Sun protection

Sun exposure can trigger cold sores and cause skin irritation that leads to spots. Applying a broad-spectrum sunscreen with at least SPF 30 can protect your skin from harmful UV rays. Choosing a lip balm with added sun protection can help prevent flare-ups for those prone to cold sores.

Healthy habits

Incorporating healthy habits into your daily routine can significantly improve your skin’s health. Staying hydrated, managing stress through relaxation techniques, and maintaining a balanced diet are essential. Eating foods rich in antioxidants, vitamins, and minerals supports skin regeneration and reduces inflammation, helping to prevent spots from forming around the mouth.

If spots around your mouth persist despite trying over-the-counter treatments and home remedies, it’s essential to consult a healthcare provider. Persistent spots may indicate an underlying issue that needs professional evaluation and treatment. A doctor can accurately diagnose the condition and recommend the most effective action. 

Seek immediate medical attention if the spots become severe, spread, or cause significant pain. Such symptoms could indicate a more serious infection or complication requiring prompt treatment, particularly if the spots are accompanied by fever or other symptoms.

For cold sores that don’t heal within a couple of weeks or impetigo that seems to worsen despite treatment, it’s crucial to see a doctor. These conditions may need more potent prescription medications or further evaluation to prevent complications and ensure proper healing.

Common myths and misconceptions

Debunking myths

There are many myths about what causes spots around the mouth and how to treat them. For instance, some people mistakenly believe that all spots are caused by poor hygiene when, in reality, factors like stress, diet, and even sun exposure can play a role.

Cold Sores vs. Acne

Cold sores and acne are often confused but are very different conditions requiring different treatments. The herpes simplex virus causes cold sores, while acne is typically due to clogged pores and bacteria. Understanding these differences is crucial for effective treatment.

Effectiveness of home remedies

Many popular home remedies are touted as cures for spots, but not all are effective, and some can even worsen the condition. For example, applying toothpaste to acne is a common suggestion, but it can irritate the skin. It's important to rely on evidence-based treatments rather than unproven remedies.