If you think you have acne, but the treatments don't help - maybe it isn't acne. Perioral dermatitis is a chronic inflammatory condition that appears around the mouth (and sometimes near the eyes and nose) and looks almost identical to acne - red papules, inflammation, itching, burning. The difference is in the causes and especially in the treatment.

Dermatologist Dr Cristina Garcia Millan warns: "We are seeing rising cases in younger people due to overuse of cosmetics, often without professional guidance." Main causes of perioral dermatitis: prolonged use of topical corticosteroids, excessive rotation of skincare products, hormonal changes, and occlusive products (petroleum jelly, wet compresses). The paradox: corticosteroids - the standard treatment for ordinary inflamed skin - actually make perioral dermatitis worse.

Proper treatment includes: topical metronidazole or ivermectin, oral antibiotics (doxycycline at anti-inflammatory doses) and azelaic acid. Restoring the skin barrier with gentle, non-occlusive products is also key. If your skincare routine is long and frequent - that is the first thing to scale back.

The distinction matters: acne treatment and perioral dermatitis treatment are not the same - and the wrong one can make things worse. If something is not responding to standard acne therapy, it is worth seeing a dermatologist before reaching for the next product.