Perioral dermatitis (PD) is a common skin condition that affects the face — perioral means “around the mouth." Though it can vary in severity, it's never fun. Mild cases result in patches of slightly bumpy, red or irritated-looking skin, often with some mild flaking, like an angry skin goatee. With more severe cases, skin becomes very inflamed, with flakes or scabs that can bleed and become infected.
In short, it's pretty awful.
I should know: I began having trouble with PD at age 36. My symptoms were typical: redness, small bumps, flaking of the skin around the chin, mouth, and nose. It was a stressful time in my life (career change), and I was monkeying around with hormonal birth control, so my body chemistry was in flux.
I experimented a LOT on my own face. From yogurt masks to apple cider vinegar to nourishing oils to heavy creams, I explored options. None of the “cures” I tried seemed to help consistently, and most made things worse (especially oils and vinegar). My symptoms were unfailingly worse in the days before my period.
A dermatologist prescribed a topical antibiotic cream, but my symptoms got so much worse that I decided on my own to stop using it after only four days. That’s when I got serious about figuring out a plan that would heal my skin for the long term, rather than temporarily diminishing the symptoms, only to have them come galloping back once I stopped treatment. I needed to start at the beginning, which meant getting to the bottom of why it was happening.
Since PD acts like a acne had a baby with eczema, it's frequently misdiagnosed, poorly understood and troublesome to treat. The truth is, PD is a symptom that arises from a fluctuating set of circumstances unique to each patient, just as fever can be a symptom of countless different diseases. In some cases, the cause of PD is fairly clear: stress or pregnancy or steroid creams. But in most patients, the symptoms are caused by a combination of factors that push the skin into a state of distress.
Here are the most common causes of PD: