Perioral dermatitis is an inflammatory facial eruption characterized by erythematous papules and/or pustules typically sparing the vermilion border. While it is more common in young women, its occurrence in older adults warrants attention due to its more prolonged and relapsing course, frequent misdiagnosis, and distinct precipitating factors. Topical and inhaled corticosteroids remain the most frequent and consistent triggers in this population. Other contributors include fluoride toothpaste, cosmetics, occlusive products, continuous positive airway pressure masks, habits involving repetitive contact between the tongue and perioral area (such as lip licking or drooling), and the impaired skin barrier function associated with aging. The clinical presentation mirrors that in younger patients but is often more subtle and tends to occur on atrophic or pigmented skin. Diagnosis is primarily clinical, supported by exclusion of mimickers such as rosacea, seborrheic dermatitis, and contact dermatitis. Treatment involves discontinuation of steroids and irritants, use of nonsteroidal topical anti-inflammatory agents, and oral tetracyclines in recalcitrant or extensive disease. Early recognition and patient education are key to effective management and relapse prevention in older adults.