Perioral Dermatitis - Eczema, Meet Acne

By Sarah Villafranco, MD
Posted in Blog, on April 18, 2014

I have a lot of medical words in my brain, but few have been on my mind as consistently over the last several years as perioral dermatitis. Having suffered with it myself, I have done extensive research, both didactic and practical, often with myself as the guinea pig, and I am happy to share what I have learned.

What is it?

Perioral dermatitis (PD) is a very common condition of the facial skin (perioral = around the mouth), especially in women of menstruating age. It is frequently undiagnosed or misdiagnosed, and acts like a cross between acne and eczema. The fact that these two diseases behave very differently may, in part, explain why it is so poorly understood, and so troublesome to treat.  With continued research, and after talking to many people who suffer with the condition, I actually believe that PD is an endpoint that arises from a unique, fluctuating set of circumstances and predispositions in each patient.   As with a mathematical equation, different numerical combinations can add up to the same sum.  This is true of PD as well.  In some cases, it is clear cut, and directly linked to a particular cause.  But in most patients, the causes are multiple, uniquely combined,  and ever-changing  (making it even more difficult to treat!).

It varies in severity. In mild cases, it consists of patches of slightly bumpy, red or irritated looking skin, often with some mild flaking of the skin around the mouth, chin, and nose. (Some women experience symptoms near the outer corners of the eyes as well, though this is a less common location.) In more severe cases, the skin becomes very inflamed and angry looking in those areas, with flakes or scabs that can bleed or become infected.

Why does it happen?

There are many theories about the cause of perioral dermatitis, none of which are definitive. The most commonly proposed cause is the use of steroid facial creams, which are prescribed ubiquitously by western dermatologists. Other possible causes include fluoride toothpaste and sodium laureth sulfate. Exacerbating factors may include heavy creams or oils, cinnamon flavor/scent, and exposure to cold and sun.  I think we will probably learn in the future that there is a large hormonal component to the condition, as well.  It tends to resolve on its own as we age; it is fairly rare to see it over age 50, when our hormones simmer down and even out a bit.

My Story

I began having trouble with PD at age 36, a fairly typical age for women to have symptoms (generally age 20 to 45). My symptoms were also typical, and included redness, small bumps, and flaking of the skin around the chin, mouth, and nose.

When I first started studying natural skincare, especially with regard to this issue, 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 seemed to help consistently, and some (oils and heavy creams) made things worse. Hormone fluctuation definitely affected my symptoms, which were unfailingly worse in the days before my period.

I went to a local dermatologist after about 4 months. I told her I had perioral dermatitis. She agreed, and prescribed a topical antibiotic. As she wrote the prescription, I asked her if she had any experience with natural remedies, such as green tea extract, probiotics, and apple cider vinegar. She told me she was unfamiliar with homeopathy.  

I tried the antibiotic lotion for four days, and my symptoms got so much worse that I decided to be a bad patient and stop the medication. That’s when I got serious about figuring out a plan. Granted, this was not a randomized, controlled experiment. I made a bunch of changes at once, and could not tell you which one made the difference in my skin.

But here are the things I changed:


  • I stopped fluoride toothpaste (I switched to this one, which is also free of sodium laureth sulfate- Seafresh Toothpaste by Jason)
  • I stopped using sodium laureth sulfate in my hair care products.
  • I started evening primrose oil supplements (I like these - Barlean's Evening Primrose Oil. They also helped moderate my PMS symptoms, and who can complain about that?)
  • I took a less-is-more approach with my skin, which I continue to follow. I use this soap once or twice a day - Osmia Organics Black Clay Facial Soap - and I limit exfoliation in the perioral region (counter-intuitive, I know). After cleansing, I follow with this water-based serum -Osmia Organics Active Gel Toner. I leave the serum on for 30 seconds, and then follow with this cream - Osmia Organics Purely Simple Face Cream - applied sparingly around the mouth and chin.


While I make no claims about whether these steps will work for a person with PD, these minimally invasive changes have improved my symptoms dramatically. It took about 6 months (less invasive measures often require more patience), and I occasionally have symptoms around my cycle, when the dermatitis is visible up close in a mirror. Most of the time, people squint and stare when I tell them I have the condition, which tells me it is not usually noticeable. Wearing makeup (even a dab of powder, as I don’t wear any foundation) will make the dermatitis more visible, as well. 

With any of the lifestyle changes or products mentioned above, results may not be visible for 3-6 weeks - it is a condition that takes a long time to change, and requires patience and commitment on your part.  

How should I treat?

Dermatologists will treat this condition with topical or systemic (oral) antibiotics, over a course of 6-12 weeks. There is a moderate success rate with this course, as well as a relatively high relapse rate.   Avoid steroid creams at all cost, as they are suspected of having a causative relationship to PD. I have found, whether antibiotics are involved or not, that relapse is very likely without lifestyle modifications.

The first two changes I suggest are eliminating fluoride in toothpaste, and sodium laureth sulfate (SLS) in oral, facial, and hair care products. A healthy, plant-based diet, with appropriate supplements, such as evening primrose oil, and attention to beneficial fats and grain or legume-based proteins will make a positive change in almost any skin type. And, sufficient water intake (spring water is the best) will help maintain intracellular water levels in the skin, as well.

As for skin care, I choose my products because I love my products, and I know who made them and with what ingredients. But, the point is that you need to RESIST the urge to scrub your face and heap products on it. Perioral dermatitis wants to be left ALONE. It does not like heavy creams or oil-based serums. It wants water-based, simple products, and some peace and quiet.  

I can't promise you our products will work for you!  But, we have had a LOT of people say their symptoms have decreased substantially (if not dramatically).  Whether you purchase product from us or not, I am available by email for questions any time, and will do my best to respond to them within a week or so.  And, if you've purchased our products and want to touch base about how they're working for you, we are here to listen, and help you make adjustments if necessary.

Remember, above all – do less.  And, for your own sanity, keep track of the things you do, and try to think of them as pieces of a management strategy for PD, rather than looking for one "miracle cure".  It will likely be a condition that does not fully go away until it is good and ready, so it can feel more frustrating than it needs to if you are out to CURE it, rather than decrease the symptoms and render them manageable.  Make sense?

And, now that you've read the basics, maybe our blog post about PD Frequently Asked Questions will help with any other questions you may have - thanks for reading!


Related Products:


I got diagnosed with PD sometime in my 30’s…maybe around 36. and I’m 47 now. I have it pretty much under control and have regular little flare ups but can make everything look better in about a day or so. Initially I got the antibiotic rounds, antibiotic creams and even a few cortisone (hydrocortisone?) shots but none of that seemed to really help. Through trial & error I got my PD under control with a gentle olive oil bar soap…..I wash my face every morning & night and even a few extra times during flare ups and then spot treat with salycilic acid (I use the Clean & Clear…for some reason it works better than the generic although the ingredients look identical). Anything drying is worse: so no tea tree oil products, benzoyl peroxide, or harsh astringents…. For flare ups I make sure so spot treat heavily with the salycylic acid gel.

My question is about an itching that I have near my eyes. I was told when I was first diagnosed that this could possible move toward my eyes and that it could be dangerous if it did. I did have an itchy patch near my right eye but when the dermatologist checked it out she said she could see nothing….even under magnification. This itching has never gone away and it still looks like nothing but it is intense and it is on both sides now. I guess I’m lucky that there is nothing to see but I worry about my vision. Sometimes it feels like the itching goes right up to the tear duct and it is constant and intense. Actually, I am surprised that there is not some kind of outward mark because I scratch constantly and very hard with my nail. Do you think this is PD near my eyes or something else?? I’m really worried since I’ve let it go on for so many years, but the ithing is maddening and definitely worse.

Also, I agree that the PD is hormonal (I’ve been hypothyroid for the last 12yrs) and am curious what will happen with the PD after menopause…fingers crossed.

Cynthia on September 26, 2015

I’m 19 and I’ve had a red rash, severely dry skin, occasionally little bumps, and sometimes dry skin on my eyelids and the sides of my eyes for about 6 months now. I’ve tried many different types of anti-fungal creams, eczema lotions, and cortizone 10 lotions and none of them seemed to work. I have two new creams i am about to start using to see which works best but after today i’m not sure that they will. Have you heard of or tried Metronidazole Gel or Ketoconazole Cream? I was doing some research on the gel and found that it is typically used for Rosacea, so I’ve been crying for at least an hour hoping it’s not that. That’s when i just typed in my symptoms and found your video. If you could please tell me your EXACT diet on how you help your PD and your thoughts on the gel/cream i have i would greatly appreciate it! I will make any changes in my diet and the soaps I’ve been if it will just make this go away. Thank you so much. <3

Cierra on September 21, 2015

I suffered from PD for almost 2 years, trying everything from RX to OTC treatments. Like many of you, I was extremely frustrated with the little results that came of these treatments and the contradicting and ever-changing diagnosis’ my doctors made. They would tell me they simply did not know how to treat it because PD is the perfect storm between eczema and acne. Great! Occasionally the RX drugs would temporarily “heal” my PD or minimize the outwardly signs, but like clockwork, it would also reappear and with vengeance! I do not think highly of oral antibiotics and would prefer to not take them, and the topical treatments left my PD more flaky, scaly and irritated. FINALLY, after almost 2 years I decided to take my ailment into my own hands and research natural ways to heal PD. By some miracle I stumbled upon Dr. Sarah’s blog on PD. At first, I felt the reviews were “too good to be true”. There are many claims to fame on the interwebs about ways to cure PD naturally, and as we all know, only about 2% of them ever work. Well, I took a chance on Sarah’s recommended Starter Kit (at this point I had nothing to lose) and not even a week after using it I was nearly in tears (of joy!). The starter kit moisturized my face, reduced the redness, and calmed the flames of my PD! I have been using the Starter Kit, the Black Clay soap, and the Clarification Serum (newly added to my arsenal) for 8 months now, and my skin is completely clear, without even one flare up of PD. (I also use the Spot treatment on occasion and that stuff is perfect for healing pimples before they ever truly become pimples :D). Sarah: thank you for taking a leap of faith and starting this wonderful company. I am so very grateful to have come across your article and tried your products. It is liberating to be free from the stress, embarrassment, and self-negating image I created as a result of my PD. I will be a life-long customer!

Kim Stoutenburg on August 21, 2015

I have had a few episodes of perioral dermatitis over last 10 years. In the past I have used doxycycline and topicals such as aczone and fanecia. This treatment had worked well, however I cannot tolerate those antibiotics anymore. I have severe gastrointestinal SE and headaches that keep me home from work! I just started taking evening primrose and switched to Jason’s toothpaste. I also purchased osmia sample kit- now I hardly cleanse my chin area and only put Rx topicals on affected areas. What exactly should I do to affected area with osmia products? Should I d c Rx topicals ?

Lexie on August 18, 2015

Help!!!! I’ve recently self diagnosed pd thanks to an Esthetician who performs laser treatments. My skin is so enflamed, and I am getting married in 19 days. I am on an oral antibiotic. It’s so dry and scaly and hurts. I am resisting putting anything on it and need to know what else can I do on such a limited amount of time.

Jarita on August 16, 2015

Hi Sarah. Thanks for your info. Yours is one of the only sites on the internet that appears to have reliable credible information about PD and I like your black clay soap. I have struggled with PD for a number of years. Stress certainly seems to make it worse and I agree with you that there is probably a hormonal factor, as for me it got worse after child birth. I have been on numerous rounds of antibiotics which only work for a period of time. It has driven me literally insane!
My PD has improved immensely in the last three weeks (the first time without antibiotics). I wanted to share with you one possible reason for this. I have been diagnosed with ‘pyrrole disorder’ which I had never previously heard of. In brief: it means that I produce too much of a product called HPL which binds with zinc, B6 and Biotin making them unavailable to my body, causing deficiency. It also means that I require extra Omega 6 fats (found in primrose oil etc). Interestingly, HPL production increases in times of stress, thereby also increasing the deficiency. I mention all of this as your webpage states that you too find primrose oil helpful. The supplements Im taking (especially geared towards pyrrole disorder i.e.: not just your usual zinc but an easily absorbed version) have been amazing for many aspects of my life, not just the PD. Anyway, given the body is so complex I no longer believe in miracle cures but Im hoping these benefits are long term. Feel free to get in touch with me if you want to discuss further.

Alexandra on August 12, 2015

I have been suffering with all the same symptoms for about 8 months. I have tried everything possible to try and eliminate/sooth this extremely irritatable and frustrating problem and nothing is helping. My GP told me to use a steroid cream which helped but the problem came straight back and was a lot worse. Also it lightened the skin around my mouth leaving a white patch when the redness sometimes goes away. I have tried E45 creams literally everything possible! I have noticed this problem has also appeared around my eyes and have cracks within the outer corners which is extremely uncomfortable. Please help me as it’s making my day to day difficult and very upsetting to deal with and now I’ve started being awoken within the night due to extreme itching!

Sheniz Juri on July 31, 2015

I got diagnosed with PD by a dermatologist last week. He said lay off putting anything on your face at all. He prescribed me Lymecycline and Elidel cream. I apply the cream once a day before bed and take 1 pill a day. So far i have seen drastic improvements, but don’t expect it to be completely clear for a few more weeks.

Digs on July 18, 2015

I have recently broken out with a rash around my lower lip and chin. I went to the dermo who said I either have contact dermatitis or perioral dermatitis. He prescribed doxcycline and to use OTC cortisone, and told me it would probably get worse before it got better. That was 4 days ago and it certainly has gotten worse! I’m 56 and have always had good skin so this is very depressing. Tonight I decided to Google the two conditions and think it’s probably PD because of the small blister like bumps. That’s how I found your site. Will be trying some of your suggestions! Thank you! Can’t afford to buy any of your products to try right now but hope to in the future.

Tami on July 09, 2015

I have two now large almost circular patches of PD on my rt side at corner of mouth et just below mouth. The first one started out sligtly pink just irritated looking skin which is now the worst inflammed had bleed and cracked open to make longitudial sliced open like feasure. one under it started out just two small bumps then progressed to three, four now several. Dr put me on Clindamycin HCL 300mg 1q 6 hrs x’s 10 days. along with Metronidazole Gel USP 1% gel. No improvement , actually worse. areas are larger soreer, bright red. Had culture done, came back normal skin flora. Wondering since last dose ATB will be in two days what to do. Also is there any thing I can find in local store or my home to apply to prevent dryness, cracking,Scared eto try tea tree oil or coconut oil which several have suggested and said made theres worse. Is petrolium and petrolatum the same.Thank you in advance.

Mandy on July 07, 2015

I had pd for a year. I did more research on it than anything in my life. Tried antibiotics, home remedies, stopped the floride toothpaste, stopped laureth sulfate, tried apple cider vinegar, tried 10 different topical creams. It was horrible. It itched so bad around my mouth at night I couldnt sleep and then in the morning layers of skin would flake off. Sometimes bumps would appear other times my face would be so red around my mouth I looked like a clown. This went on for a year straight. Then my dermatologist gave me an allergy test. It was a patch test on my back that tested me for allergic reactions to about 20 different chemicals. My back itched like crazy for the few days it was on. My dr. Discovered im allergic to 3 chemicals that are in everything from cosmetics to cleaning products. She put my info into a database that compiled a list of what I can use. My pd was caused by an allergic reaction to chemicals in products I was using. My face started to heal that week and it has been clear for 3 months now. All due to a simple allergy test. It baffles me that every single website I have gone to about pd not one mentions that it could be caused by an allergic reaction and to get an allergy test done. I strongly encourage anyone going through this to go get an allergy test. If you come into contact with something you may be allergic to you can get pd. People suffer years with it because if they dont know they are allergic to something they keep exposing themselves to the allergen and pd will not go away. I wish I could post pictures of what I went through. Anyone reading this that finds that no home remedies work, antibiotics didnt work, changing everything didnt work, go schedule an allergy test with your dermatologist. It was the best thing my dr. Did for me.

sheila on June 29, 2015

i’ve been struggling with PD for 3 years _ it’s the worst. Just when I get it under control, I have maximum 2 weeks before another flare up!! I blog about my journey – what’s worked for me and what hasn’t. i recently found two products (selsun blue with selenium sulphide 1% and spectrogel blemish cleanser) which i wholeheartedly back and you can read about that in my blog! best of luck to everyone struggling with this nasty condition. I hear amazing things about Osmia, so when I finally have this flare up under control I’m going to give it a whirl and review it on my blog.

xoteets on June 28, 2015

So interesting to read all the comments – am 56 year old who has just gotten PD for the first time in my life and think it began with me using coconut oil on my face during the winter months when my skin felt so dry! So will be changing that for surel

Iben Giel on June 28, 2015

@ Jill – Thank you for sharing your triggers. It really is different for every single case, but the more we know about triggers, the more research we can do to find our own! I agree that you have to get to the root of the problem. That can be pretty tricky, though, especially when one of the triggers is “stress”, which fluctuates on a daily basis! Sending healing thoughts your way! -SV
@Renee – Stress is a HUGE factor in PD – this is very clear. And the worse your skin gets, the more you stress, so it turns into a vicious cycle! Finding ways to manage stress – from exercise to yoga to meditation to reading a great book – is an integral part of healing yourself. -SV
@Bree – Such a fantastic question about why antibiotics seem to help PD sometimes. There is no meaningful evidence regarding the connection with gut flora, but I think the two are probably related. Many PD people have intestinal issues, myself included! Antibiotics also have an anti-inflammatory effect, which may be part of their role in treating all sorts of skin ailments. And thank you for your words of support to other PD sufferers – when you’re in the thick of it, you feel like it is going to last forever! But, you must have faith in your ability to heal yourself, as well as a boat load of patience! XOXO – SV
@Lina – Sugar is a pretty common trigger, and I’m so sorry for your struggle. It sounds like you’re doing lots of research to try to figure out your triggers, and I’m sending you much hope and healing. Email us anytime with questions. – SV

@ Laura – I’m SO sorry for your trouble right now. It is just an awful feeling, and I really know how frustrated and low it can make you feel. But you are doing all the right things. You’re doing your homework to figure out what is making your skin upset, and seeing your doctor. It seems that you are avoiding steroids, which is critical. Elidel can be helpful, but may cause a slight rebound, so be sure to wean from it very slowly when you do. The oral antibiotics will probably help, too – if things are that bad, I think it’s a good idea to complete the course while you make the other adjustments in your daily routines and change products/diet/lifestyle as needed. Remember, you have just started making the required changes, and you will need 4-6 weeks before you see real change. So, breathe big, settle in for the long haul, and pat yourself on the back for doing what needs to be done. This IS going to get better. Sending much love your way – SV

Sarah Villafranco, MD on June 26, 2015

Dr Sarah – I have recently self diagnosed myself with PD which was recently confirmed by my GP after months of visits. I’ve had this rash on my chin for the last 2 years on and off since having my son. Last week the rash got so painful I gave in and visited my GP again. I’ve been given 3 months of antibiotics (Doxycycline) and topical cream (pimecrolimus). After reading so much about the main triggers of this condition I have replaced all my toothpaste, shower gel and shampoos with sls free products and kept my skin make up free for a week now. I have been trying to be positive but my breakout has now developed around my nose, eyes and on my head so practically all over my face! This has only seemed to have been the case since taken the antibiotics. Is this normal? I’m currently off work as its so bad and haven’t left my house for a week as I’m so embarrassed. I don’t usually let things get to me but I’ve never felt so low! Please help! Xx

Laura on June 23, 2015

Reading a lot of the comments and from personal experience sugar seems like a very common trigger. I really think there is a strong link with PD and candida in my case. Everytime I have a yest infection I’ll break out with PD. I Also breakout with it terribly after eating a diet very high in sugar. One thing that helps my breakouts is washing my face with Himalayan pink salt diluted in water but i might give these productsa try. Sometimes I feel so helpless with PD

lina on June 17, 2015

Hi Sarah, I find it so curious that an antibiotic, such as doxycycline, affects PD. It really leads me to believe that, for me, a PD breakout is linked to some sort of gut flora imbalance or overgrowth. Otherwise, why would doxycycline work for me every time I have a breakout? I am curious if you have heard any other thoughts or seen any research on this topic?

Also, I recently found a dermatologist’s website that listed these 2 potential triggers for PD, that I hadn’t really seen other places: not washing your face properly and sunblock. I did just get a PD breakout immediately after a trip to Central America where I was swimming in the ocean and definitely not washing my face on the regular and using sunblock (which normally I do not wear on my face). Perhaps I found my latest triggers?! Just wanted to share those with others. It is such a mystery!

And one last thing – I have been using Tarte concealer sticks, made from Amazonian clay, to cover up my breakout for work. It has not made mine worse and it covers it up to the point where you can barely see it unless you are very close or you are outside in the daylight (It always looks more noticeable outside, ugh). I have been having much success with the Osmia PD skincare. It is soothing for my breakout and it has made the rest of my face look healthy and youthful! I especially adore the black soap. When the humidity is high, I use only that and it does not dry out my skin.

Thanks you Sarah for sharing your experiences and for creating such a thoughtful line of products. I am a customer for life!

To all of the PD sufferers using this product and website – hang in there! It won’t last forever.

Bree on June 16, 2015

The stress contribute and make the PD worse.?

Renee on June 15, 2015

Dr., Thank you for all your helpful information. I have suffered from this rash off and on for four years. I personally have learned many things, during this period. First, I was my own detective. After going to four Dr,s every medicine I was put on,made me worse,besides, nobody really wants to listen to what you are saying. I am fifty-nine years old. I was chemically poisoned,in my early thirties,and I became very intolerant of foods. So when I got this rash on my face, I thought that it could be food related.To make a long story short, I was bound and determined to figure this out.
First,for me it was ,Dish soap, tooth paste, all oils including coconut oil! Although, I can take evening primrose oil. Not in a capsule though,only by spoon ,or on a spoon.Any foods with oil, and rice. I was doing real good if I stayed away from all of that until recently I tried two things which blew up my face!. The first was stevia, and barley syrup,in a chocolate pretzel I had been eating thinking that there was no oil,just the syrup. My face got so bad around my mouth on the left side. It hurts and burns .I think that maybe it was the stevia. but who knows. I am hoping that it gets better soon. First it is the baby blister like things,then it goes to red pimple looking marks with the burning for a couple of weeks. I absolutely hate having this. But please know, that I really believe that oils play a huge role in this PD, Lisa Fredrickson asked about oils making her face worse, Yes, I am sure of it coconut was my one of my worst things. that made it worse! I really wish someone could help us who have this,but I believe that each person reacts to different things which in turn why they have it. The antibiotics are just a mask for awhile,. you have to figure out where the root of the problem is coming from before the rash will go away. I have done this till eventually I try something that brings it back again. So maybe I can help someone by telling you my experience. I hope so,as I have spent the last four years trying to figure this out!

Jill Scicchitano on June 14, 2015

@Jessica – Congratulations on being pregnant! PD is one of many, um, changes that can occur during and after pregnancy – good thing we love our babies so much! As for safety, you should discuss it with your pregnancy practitioner. We use essential oils in small amounts in the products, and some people do not believe in using essential oils during pregnancy. There is really only strong evidence against using a few essential oils during pregnancy, such as wintergreen and pennyroyal, which we don’t use in any products. But, there are some people who would not use cedarwood or rose essential oils, either – we use both of those. Email us any specific questions, and chat with your provider to find your own comfort zone with using EOs in pregnancy. Warmest wishes for you and the bun in the oven – SV

@Brandy – I do not think there is a proven link between Candida and PD, but I would not call it impossible. Each person’s PD is caused by a unique set of factors, and candida could be one of them for you. A side note: I think the candida thing, in general, is a bit overblown and trendy. I have cared for patients with systemic candidiasis, and know what that looks like – it’s a dramatic, painful situation that occurs in immunocompromised patients. Sadly, I think there are some health practitioners who have latched on to this idea of “candida overgrowth”, and are making a lot of money prescribing supplements and special diets. Anyone who avoids alcohol, sugar, dairy, and caffeine for 6-8 weeks – regardless of the candida population in her body – is going to feel a lot better!! That said, if you are prone to yeast infections (which are definitely a candida overgrowth situation!), you might consider trying topical antibiotics before oral (the opposite of my usual advice to PD sufferers). If you end up needing to try oral antibiotics, you can support your system with probiotics taken several hours apart from the antibiotics. Hope that helps, and best of luck to you! SV

Sarah Villafranco, MD on May 31, 2015

@Dani – Steroids are so tricky. They are helpful when they’re truly needed, but get used way too often, and cause a good bit of trouble for people with PD. I saw that you ordered from us, and hope things are settling down a bit. Please feel free to email us on the site if you have any specific questions, and remember to be patient and kind toward yourself! SV

@Faye – Yes, SLS is a good thing to eliminate for PD sufferers – I’ve seen that one change be enough to make symptoms improve radically. So glad you have found products that seem to work for your skin! SV

@Amy – Getting rid of SLS in hair care and toothpaste, as well as fluoride in toothpaste may help your son’s skin a lot. I have seen petroleum jelly help with angry eyelid skin, but not as much with the skin around the nose and chin – it usually makes the red bumps and flakiness worse. Hopefully the changes you’re making will start to help soon. If not, you could order a sample of our Black Clay Facial Soap to see if it calms his skin down (it’s great for teenaged skin in general, too). Best to you and your son – SV

@Andrea – I have had angular cheilitis as well – no fun! Glad you have a tip that works for you. I think something as harsh as Listerine would probably be a mistake over a larger area of skin like the chin or on the face, but a dab with a Q-Tip on the corner of your mouth can definitely help with angular cheilitis. Tea tree oil actually works pretty well the same way, for those looking for a more natural solution. Thanks for sharing! SV

@Alison – So sorry for how you’re feeling. It can be incredibly frustrating. I hope you have made a few changes suggested in this post, and are starting to see a bit of improvement. There’s another post on our blog with some FAQs that might be helpful, and please email us any time with questions. We are here to help in any way we can! Sending love – SV

@Patsy – These conditions, seborrheic dermatitis, atopic dermatitis, and perioral dermatitis – are not completely distinct from each other. There is crossover, and there are probably hybrids. Dermatitis just means “inflammation of the skin”, and it’s a pretty vague, catch-all term. So I’m not surprised when I hear that people have been diagnosed with one or two or all three at the same time! The trick is not to try to find a “cure” for any one specific condition, but to take steps to reduce inflammation in general. These include dietary changes, eliminating fluoride and SLS, and taking gentle care of the skin. I hope your son’s skin is improving as you learn more about his skin and the things that might be causing it to flare up. Please feel free to email us with any specific questions. Wishing you the best – SV

Sarah Villafranco, MD on May 31, 2015

Hi- I have self-diagnosed perioral dermatitis. I have a doctor appointment next week. I have already noticed a difference since I’ve switched toothpaste and hair care products. My face is also much less “angry” and irritated when there is nothing on it. It’s less red. the dryness really looks unattractive, though. Looking forward to trying some of your products.
My question is this: I’ve read that this condition is linked to candida. Makes sense since I am prone to yeast infections. I cannot take birth control for this reason. What concerns me is being put on an antibiotic to fight the skin issue,. We all know that antibiotics can (and most likely for me) cause yeast infections. Sounds counterintuitive to me. Any thoughts on this? Thanks!!

Brandy on May 21, 2015

Hi Sarah,

Thank you so much for sharing all of this information with us, this post is God-sent! I’m 28 and have been dealing with PD for a few years now and have been feeling quite hopeless! I will be ordering a sample pack of the soap, toner and face cream and cannot wait to try them! I am 4 months pregnant right now, so I just want to confirm that these three specific products are safe during pregnancy? Thanks so much! – Jessica

Jessica on May 19, 2015

During the dry winter this year I developed terribly dry skin and PD around my nose & chin. It got worse at the times of my cycle. Oils, moisturiser etc did not help at all. I was desperate, & could not figure out why this was happening as I was using the same skin products for 2 years. I tried out some different skin products from the same brand aimed at sensitive skin and it changed literally overnight! I have no trace of PD left on my face! The game changer proved to be my cleanser. My new cleanser has no Sodium Lauryl Sulphate, and contains soothing, non stripping ingredients. For those who have tried everything else with no success, I used Paula’s Choice Skin Recover cleanser. Hope you all find success!

Faye on May 18, 2015

Hi Sara, my son (10years old) was “diagnosed” with seborrheic dermatitis in early 2014, but the rash started around his nose in late 2013. They prescribed prescription strength hydrocortisone and athlete’s foot cream mixed together. He also recommended to use Head & Shoulders to wash the area. That seems to help a little bit. It never really went away and then he would get flare ups. Then the beginning of this year it spread to around his eyes. Dr. said it’s the same thing and prescribed tacrolimus. It won’t go away at all. He has had many flare ups. I’ve started to keep track of what he eats and the other day after playing with puppies his face was really bad. That had never happened before. My parents are visiting family in Florida and they talked to my cousin who is a pediatrician and he said it could be perioral dermatitis. When I looked it up, it really sounds like what he has and not the seborrheic dermatitis. It’s so frustrating. He has this sweet and cute face and now this crap is all over it. His shampoo, cleansers and lotions don’t have the SLS. I’ve used Aveeno Baby before and now an organic/hypoallergenic cleanser and Vanicream facial wash. He’s allergic to sunblocks, so we’ve been using Vanicream sunscreen since he was 3. We went back to see his allergist and have an appt. this week to do some skin testing. If nothing comes out of that appt. we will go see a holistic doctor. This post has been eye opening and helpful. I will try the black clay soap and praying it helps. Thank you for the information.

Patsy Prough on May 09, 2015

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