Perioral Dermatitis: What It Is & Natural Remedies & Skin Care Products

Founder of Osmia Organics By Sarah Villafranco, M.D.
Founder of Osmia Organics
Sarah Villafranco, M.D., is a natural skin care expert and practiced emergency medicine for 10 years. She received a B.A. from Georgetown University, and then went on to get her M.D. from Georgetown University School of Medicine.
Woman Smiling with Dewey Skin

Image by Leandro Crespi / Stocksy

Identifying skin conditions—especially inflammatory skin conditions—isn't an exact science. In fact, there are a few diseases that have overlapping symptoms and causes but may require different treatments.

What is perioral dermatitis?

Perioral dermatitis (PD) is a common inflammatory 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. At any point, these inflamed patches can feel itchy or tight and even sting. Since PD acts like acne had a baby with eczema, it's frequently misdiagnosed, poorly understood, and troublesome to treat.

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What causes perioral dermatitis?

The truth is, perioral dermatitis is a symptom that arises from a fluctuating set of circumstances unique to each patient, just as fever can be a symptom of numerous diseases. In some cases, the cause of PD is fairly clear: periods of intense stress, 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 perioral dermatitis:

  • Steroid creams on the face (prescribed ubiquitously by Western dermatologists)
  • Steroid inhalers in children
  • Fluoride toothpaste
  • Sodium laureth/lauryl sulfate (foaming agent) in toothpaste, hair care, laundry, and skin care products
  • Stress (this is a big one, from causation to long-term management)
  • Immune function (people with overactive or underactive immunity may develop PD)
  • Diet (food intolerances may manifest as skin issues)

Once you have perioral dermatitis, here's what will make it worse or trigger flare-ups:

  • Heavy creams and oils
  • Overexfoliation
  • Topical antibiotics (in some cases)
  • Excessive coffee drinking
  • Cinnamon or cinnamon flavoring
  • Monthly hormone fluctuations or pregnancy
  • Stress
  • Inflammatory diet (high in refined sugar, meat, and gluten)
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How do you ease perioral dermatitis?

There's no one-size-fits-all cure, which will likely mean you have to treat it in the short term and long term. Another key factor in treating perioral dermatitis: It's often just as much about what you're not doing as what you are.

Short term:

  • The first move is to eliminate fluoride in toothpaste, due to the substance's ability to cause and aggravate inflammation. The second is to stop using oral, facial, and hair care products that contain SLS, as it's a known skin irritant. You should even get rid of it in your laundry detergent.
  • To help soothe inflamed patches, you need to resist the urge to scrub your face and heap products onto your skin. PD wants to be left alone; it doesn't like heavy creams or oil-based serums. Instead, make the switch to water-based, simple products.
  • In general: Do less.
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Long term:

For your own sanity, keep track of what you're trying, and think of the changes you're making as pieces of a management strategy for perioral dermatitis rather than looking for one miracle cure. It'll likely be a condition that does not fully go away until it is good and ready, so it's more frustrating than it needs to be if you are out to cure it rather than decrease the symptoms and render them manageable.

  • The best way to treat any chronic condition is to treat the root cause, which means getting to the bottom of why it is happening. Try to identify your trigger (or triggers) and limit your exposure to them as much as possible. Some triggers are easier than others: For example, if a steroid cream caused your PD, you can slowly wean yourself off the steroids (though it may get a bit worse right after you stop, so be patient). Others, like stress, are harder to manage as sometimes it's unavoidable.
  • A healthy, plant-based diet and attention to beneficial fats, grains, and legume-based proteins will also make a positive change in almost any skin type but especially inflamed skin.
  • Sufficient water intake will help maintain intracellular water levels in the skin.
  • Managing your stress—both in general and regarding your skin—is critical.
  • As we know that the gut-skin connection is very strong, consider taking a probiotic to manage your gut flora and overall inflammation.

Perioral dermatitis skin care products

While everyone's case will be unique to their skin are a few general skin care guidelines when finding a product for you. The most important thing though is to keep the ingredient list simple, so you're not bombarding your skin with potentially irritating ingredients.

  • Face wash: Like noted above, skip harsh surfactants like SLS. Look for simple, minimal ingredient face washes so you are less likely to come into contact with an irritating active. If you have otherwise oily skin, black clay can help treat the oily parts without irritating the inflamed parts. If you have dry skin, look for things with colloidal oat or manuka honey.
  • Moisturizers or treatments: Look for ingredients that help soothe and repair the skin barrier. A few include: phytoceramides, naturally derived fatty acids, colloidal oat, manuka honey, various antioxidants, like vitamin E or vitamin B3.
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The bottom line:

If you're hunched over your computer in the wee hours of the night, compulsively searching for "cures," you need to stop, take a breath, and do a perspective check. You have people who love you, access to fresh water (and the internet), and you are beautiful in a much-more-than-skin-deep way. With education, patience, and consistency, you can help your skin come back to a state of optimal health that will last much longer than any miracle cure—especially steroids—could provide.

Ready to learn how to fight inflammation and address autoimmune disease through the power of food? Join our 5-Day Inflammation Video Summit with mindbodygreen’s top doctors.

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