Perioral Dermatitis was one of my biggest wellness foes for over a decade.
If you’ve read my book The Wellness Project, then you also know that getting fed up with the bumpy pixilated rash around my nose and mouth was the biggest catalyzing event that got me to turn my life upside down.
And yet, if I’d known how quickly and easily my skin could change for good with just a few changes to my diet and routine, I would have gone on this makeover journey so many years before.
I am constantly getting questions from people asking for advice on how to heal Perioral Dermititis naturally and what I did to finally move the needle. So I thought I’d take the time to put my biggest tips into one post.
Of course, if you want the full story, I’d recommend picking up a copy of the book, since I’d assume that the habits I put into place over the course of my year of health—balancing my hormones, fixing my gut, overhauling my product pantry, etc.—were a big part of the long-term solution.
In other words, some of these recommendations below were what cleared up my PD immediately and quickly, but likely it was a more diverse toolkit that kept it away for good.
After annual relapses that took me from middle school through college and into early adulthood, and the revolving door of the dermatologist’s office that blasted my gut with every antibiotic under the sun, I can proudly say that I’ve been more or less perioral dermatitis-free for 6 years.
Below is what I looked like at the beginning of January 2014; what I looked like two weeks later thanks to my lifestyle and diet changes; and finally, what I looked like at the end of my first month of the new protocol. I took a selfie every morning to check my progress, and you can really see the inflammation slowly going down and my skin smoothing. By the end, there’s just a little subtle scarring above the lip and a faint shadow where the rash used to be around the mouth. All the other pictures in this post are of my skin as it stands today, albeit with a little bit of makeup.
Every once in a while when my body is run down or there’s extreme changes in the weather (mostly the East Coast wintery mix) I see faint Perioral bumps creeping back into their old habitat. But for the most part, referring to the list of practices below helps me nip it in the bud before true havoc can fully take hold on my face.
When I look at “before” pics like the ones above, it feels like a distant memory. And I’m so grateful for that, since my reflection in the mirror caused me so much undue frustration and pain and dollars spent on foundation over the years.
If you’re in the weeds dealing with Perioral Dermatitis and all your dermatologist has offered you is a prescription pad of antibiotics, I can offer you a little bit of hope. There is so much you can do on your own to uncover your root causes and fix them. Sadly most doctors in charge are not going to navigate this journey for you, so let the tips below be your guide.
With health and hedonism,
WHAT IS PERIORAL DERMATITIS
Perioral dermatitis is a facial rash, most commonly occurring in women. It usually sticks to the areas around the mouth and sides of the nose, and presents as small raised pink bumps.
Both the color and the texture of the rash, in addition to the great amount of real estate it can take up, can make it particularly annoying to cover up with creams and powders. Meaning, it can be a real source of self-consciousness and misery.
It’s also known as a recurring condition, and many dermatologists will offer the same treatment over and over again.
Though one common precursor is overuse of steroid creams and nasal sprays, the cause of recurring perioral dermatitis is unknown. As my dermatologist put it: it means there’s something out of balance in the body. She just had no interest in helping me discover what that was.
PERIORAL DERMATITIS TREATMENTS, MEDICATIONS AND CURES
When traditional dermatology is faced with a case of perioral dermatitis, it usually turns to a bevy of oral antibiotics and antibiotic creams. These treatments can be very effective in getting the rash to go away. But as I learned the hard way through countless rounds of them, it is only a temporary relief and the rash will eventually come back.
Meanwhile, the broad spectrum antibiotics prescribed do untold damage to the health of your underlying bacterial ecosystem.
Each course of one such medication can wipe out 1/3 of your beneficial gut bacteria.
When you consider that perioral dermatitis is being caused by some sort of imbalance in the body (most likely associated with a gut issue), you can see how these short term benefits can only feed the fire of your underlying condition long-term.
My podcast interview with Dr. Amy Bader on the subject of the skin-gut connection does a great job of explaining why antibiotics can show results, and also why they are so damaging to the health of your skin and the body it covers in the long run.
If you’re here reading this post and dealing with these skin issues, I’d recommend giving the episode a listen for more information on the underlying narrative in your body.
Luckily, there are plenty of simple changes you can make to your lifestyle, over the counter products, and natural remedies that can help you manage your perioral dermatitis and kick it to the curb for good.
MY TIPS AND NATURAL TREATMENTS FOR CURING PERIORAL DERMATITIS
Give your liver a rest: go caffeine, sugar and alcohol-free for a few weeks.
When I began my wellness project in 2015, the first thing I did was give up alcohol, caffeine and sugar for 1 month. This came after advice that the easiest way to clear my skin from PD was to give my liver a rest. If you think about the connection between perioral dermatitis and women with hormonal imbalances and autoimmune conditions, it’s only logical that the liver would be the best one stop shop to get things running smoothly again. It’s responsible for clearing excess hormones, antibodies, and other toxins. If it’s not doing an efficient job in this realm, inflammation is inevitable. Though there are also common correlations to fungal or bacterial imbalances in the gut, starting with giving your liver a rest can also have a positive downwind effect for other digestive organs.
I’m not saying that this will be the case for everyone, but when I gave up these three vices I noticed a remarkable difference in my PD within a few weeks. At the end of the month, it was almost healed entirely. And though I did reintegrate these substances back into my diet in moderation, my PD never fully came back. I attribute this to the big boost I gave my liver and microbiome with this month of detox, and also implementing the changes below thereafter.
Rule out food intolerances.
Though I had done an elimination diet prior to getting my perioral dermatitis under control, I can definitely say that being more diligent about fully giving up my problem foods was one thing that contributed to my long-term healing. We all have different sources of inflammation, and the foods we eat three times a day tend to be common culprits. For me, it was gluten (as it is for many Hashimoto’s folks). For you, it could be soy, dairy or corn. If you’ve never done a basic elimination diet, it’s worthwhile knowledge to have. I have a few meal plans that can help you cook for one.
Switch to natural skincare products.
Harsh chemicals like sulfates and parabens inflame already sensitive skin even more. If the ingredient list alone of many of your products—and the association to cancers, autoimmune conditions, and the like—doesn’t inspire you to switch to naturals, then the potential for clearing your PD should. Though some essential oils can be irritating, generally speaking, green beauty products tend to be much gentler on inflamed skin.
Definitely start by getting rid of anything with microbeads or exfoliants and creams or toners that burn. Here are some of my favorite products. You can also simply start at one of the fabulous retailers like Follain that curate the best of the naturals aisle for you.
Change your toothpaste: try fluoride-free.
Even traditional dermatologists admit that toothpaste can be a big trigger for perioral dermatitis. Just think about where on the face PD tends to crop up—right around your mouth where foamy excess toothpaste can often infiltrate. If you’ve never experimented with switching toothpastes, this is an easy place to start. In addition to fluoride-free options, you also want to make sure that there are no surfactants like sulfates that contribute to the foamy consistency. Some people also might be sensitive to mint varieties. My favorite natural brands are this and this. Experiment to see if this moves the needle for you.
Do a 24 hour product detox.
If it’s not toothpaste or chemicals in your skincare routine, there’s always a chance that one particular ingredient is irritating your face. Plants and herbs are strong substances and it’s totally possible despite their origin being the earth that you can react to one or another. The easiest way to uncover the culprit is to do a 24 hour detox where you use zero products. Add them back in one by one and take notes on if you notice any changes. If it’s an external trigger, the effects should become apparently fairly quickly. Interior inflammation and dietary triggers can be harder to pinpoint as their effects often occur days or even weeks after an exposure.
The fewer ingredients, the better.
For skincare, the fewer ingredients in your routine, the less your face will have to deal with, and the easier it will be for you to get to the bottom of any problem products. I love the brand SW basics because all of their products are 5 ingredients or less. You can also use honey as a cleanser and other singular ingredients from your kitchen to replace common items in your skincare routine.
Avoid face oils.
All that said about natural products, many moisturizers in the green beauty isle are oil-based. Contrary to popular belief, this does not cause more oil build-up in the skin and is completely suitable for those prone to acne or breakouts. However, face oils can tend to be too heavy for some people dealing with perioral dermatitis. Stick with a light cream moisturizer that includes calming ingredients. This blue chamomile moisturizer was the first one I tried, and I definitely owe my skin’s on-going happiness to it.
Choose a gentle, milky cleanser—not one that foams.
When my skin was at its worst, I’d revert to the Clean & Clear (and under control!) commercials of my adolescence and fiercely wash my face as often as possible. But by removing all the moisture, I had apparently just been causing more oil to appear as my skin desperately attempted to hydrate and protect itself. As someone with sensitive skin, I was told that I should use a gentle cleanser without foaming surfactants. I switched to this lavender cleansing milk and have since also tried this wonderful ocean milk cleanser—both are effective at getting off dirt without stripping your skin of its natural defenses or irritating it further. This black clay cleansing bar was formulated specifically for people with perioral dermatitis. Since it gets sudsy, if you have very dry skin, I would go with one of the milks instead.
Only wash your face once a day.
Per the above advice, it’s really not necessary to cleanse multiple times a day. At night before you get into bed, making sure you get all that dirt and grime off your face is obligatory. But in the morning? All you’ve been doing is laying under the covers. Just a few splashes of water will suffice to freshen up for the day ahead. After I made this small change, my skin ironically seemed a lot less oily and more balanced.
Wash (or change) your pillowcase weekly.
Of course, the only reason your skin might get dirty at night is if you’re sleeping on a pillowcase that’s been collecting dust and dead skin cells for weeks on end. If there’s one item in your bedding that could stand to be washed or rotated every week, it’s your pillowcases, or at least just the one you put your face on.
Use a clean face towel.
Especially if you share a bathroom with a roommate or significant other, make sure you have a dedicated face towel that is just yours. Otherwise, you’ll be washing your face and then immediately putting it into contact with remnants of your partner’s hand soap, deodorant, or other harsh products. This is also an item that should be washed as often as possible.
Take your makeup off at night and sanitize your makeup brushes.
When was the last time you washed your makeup brushes? A month ago? Two? Ever…? That’s what I thought. It is often the last thing on our hygiene list, and yet, we use the same pads and brushes every day to put on our face, and they can get just as grody as your face towel and pillowcase. Wash them once a week in unscented castile soap and lay them on a towel to air dry.
Give your skin time to breathe.
The irony of makeup is that the skin we feel most self-conscious about is often the same skin that benefits most from not being spackled with heavy powders and concealer. If you can allow yourself some make-up free days during PD flare-ups, it will help expedite things calming down and returning to normal.
Have you had any other success stories with natural perioral dermatitis treatments or lifestyle changes? Any inflammation-based condition is so individual. Some people might have food triggers, others environmental ones. I would love to hear any of your own experiences or advice in the comments.