Our founder, Dr. Sarah Villafranco, has been there, done that, and gotten the perioral dermatitis tee shirt. Her own experience with PD led her to create products that finally allowed her skin to heal while she supported the healing with lifestyle modifications to create meaningful, lasting change. For our printable Natural Skin Solutions guide, click here.
WHAT IS PERIORAL DERMATITIS?
Perioral dermatitis (PD) is a very common condition of the facial skin (perioral means “around the mouth,” and dermatitis means “inflammation of the skin”). It varies in severity, and normally affects women of childbearing age, but can also affect men, older women, and children. In mild cases, it consists of patches of slightly bumpy, red, or irritated looking skin, often with mild flaking and tightness of the skin around the mouth, chin, and nose. Some people may experience symptoms near the outer corners of the eyes as well, which is called periocular dermatitis. In severe cases, the skin becomes very inflamed and angry looking in those areas, with flakes or scabs that can bleed or become infected. Many cases of perioral dermatitis look like simple acne, but are focused around the chin and the smile lines around the mouth and nose.
Perioral dermatitis is frequently undiagnosed or misdiagnosed, and often acts like a cross between acne and eczema, making it especially troublesome to treat. It’s helpful to think of PD as a number—let’s say the number 50. You can get to fifty by adding 49+1, or 48+2, or 20+25+5, or countless other combinations. The same is true for PD: while one person’s symptoms may be from stress and pregnancy, another person’s may be from fluoride toothpaste, and yet another’s from topical steroid withdrawal. The symptoms look the same, but the underlying causes are multiple, variable, and unique to each person’s case.
WHAT DOES PERIORAL DERMATITIS LOOK LIKE?
These are photos sent in by people with PD who have approved them for anonymous use in this article. We hope they give you a sense of how different the condition can look on each person.
WHAT CAUSES PERIORAL DERMATITIS?
One of the leading causes of perioral dermatitis is withdrawal from topical steroids. Dermatologists prescribe steroid creams and lotions for various conditions, and when patients try to stop using them, they find that their skin responds by bursting into an angry rash. Many dermatologists are becoming aware of this and decreasing their liberal use of topical steroids.
The other main causes of perioral dermatitis, which often occur in combination, are these:
- Sodium lauryl/laureth sulfate in hair care, laundry detergent, and toothpaste
- Fluoride in toothpaste
- Heavy creams and facial oils
- Hormonal fluctuations
The condition can also be exacerbated by excessive consumption of coffee or cinnamon.
HOW IS PERIORAL DERMATITIS TREATED?
For many years the condition was treated with topical steroids, which created an endless, miserable cycle. Most dermatologists are up to speed now, and will not recommend steroids. They often recommend tacrolimus and picrolimus, which are immunosuppresive creams similar to steroids, although with less of a withdrawal effect. Other options in the dermatologist’s office include topical or oral antibiotics. Topical antibiotics can sometimes contain other ingredients to exacerbate PD, but oral antibiotics may be effective in the short term. Outside the dermatologist’s office, there are many simple ways to heal your skin, from natural skincare products to switching your laundry detergent.
HOW CAN I TREAT PERIORAL DERMATITIS NATURALLY?
The trouble with most dermatology visits is that the solutions are temporary. By making a few modifications to your life, your home, and your skincare routine, you can create lasting change. Here are ten critical steps, with lots more detail in the next section.
- Switch your skincare gradually to Osmia’s Black Clay Facial Soap and Purely Simple Face Cream. Do not use facial oils or balms of any kind. Do not exfoliate if your skin is not healed.
- Wean any topical steroids or immunosuppressants very slowly, with the approval of your healthcare provider. You can blend them with the Purely Simple Face Cream, decreasing the amount of prescription cream over the course of seven days.
- Remove all sodium lauryl/laureth sulfate from your home. This includes shampoo, toothpaste, laundry detergent, and hand soap or body wash. You’ll have to read every label because even natural brands use SLS.
- Switch to a non-fluoride toothpaste.
- Limit coffee and cinnamon products.
- Limit makeup as much as possible initially.
- Maintain excellent hydration and work toward an anti-inflammatory, plant-rich diet.
- Consider an evening primrose supplement if you’re not trying to conceive. (If you do become pregnant, you can stop the supplement. It is safe for breastfeeding.)
- Keep a journal once a week about the changes you’re seeing in your skin so you can keep track of a timeline. If you like, you can take a photo in the same spot at the same time of day once a week to monitor changes in your skin’s appearance.
- Address the stress in your life. Stress management is critical in supporting your skin, since stress is one of the main triggers for PD.
WHICH PRODUCTS ARE BEST FOR PERIORAL DERMATITIS?
Osmia Black Clay Facial Soap Use once a day in the evenings to start. To use, splash your face and the bar with lukewarm water. Rub the bar vigorously between your hands until you have a thick, creamy lather. Place your soap on a soap saver, and begin to wash the skin with gentle, circular motions. Continue this for 30-60 seconds, using very light pressure. If you need to remove eye makeup as well, save it for the last few seconds of cleansing, and keep your eyes closed. Rinse thoroughly, and pat the skin dry with a clean washcloth. Increase to twice a day if your skin is improving.
Osmia Purely Simple Face Cream Apply after cleansing once a day, using it sparingly over the angry areas of your skin. Less than a full pump is required for your whole face and neck. Increase twice a day if your skin is improving.
Lip Doctor Use as needed for dry lips.
After three weeks of slow improvement, consider adding:
Osmia Active Gel Toner Apply as a middle layer between cleansing and moisturizing. Use only a tiny dot at first, then work up to a small pea-sized amount if skin is improving.
Osmia Nectar Vital Rose Drops Add 1-2 drops to your Purely Simple Face Cream once dermatitis has started to heal significantly.
If you are having trouble with any of these products, please email us at firstname.lastname@example.org. Often, we can adjust the routine to help you succeed.
W3LL PEOPLE Bio Tint SPF 30 (this is thick, so it’s best mixed with a bit of the Purely Simple Face Cream so it doesn’t pull the skin while you’re applying)
Shop this blog post for other makeup suggestions.
Mychelle unscented SPF 28 (you can also mix this with the W3LL PEOPLE Bio Tint for a little extra coverage)
Josh Rosebrook shampoo and conditioner (pick the ones that seem suited to your hair)
Just Nutritive shampoo and conditioner (pick by hair type, double check ingredient list for SLS or fragrance)
Jason Seafresh toothpaste
Whole, protein-rich grains like quinoa and millet
Black or green tea
Almond, oat, or hemp seed milk
Anything else that nourishes and supports your body during this time of healing
Deva Evening Primrose Oil Supplements (Start with two pills a day, decrease to one a day after one week or when skin begins to heal.)
LooHoo Dryer Balls
Supernatural cleaning products
Common Good dishwashing soap
Liquid melatonin to support sleep if needed.
Magnesium at bedtime can relax both mind and body.
Flower elixirs to ease anxiety.
Insight Timer meditation app
HOW LONG DOES PERIORAL DERMATITIS TAKE TO HEAL?
PD can heal quickly when treated with steroids, but as soon as you withdraw the steroids, your skin will likely become worse than ever. Oral antibiotics can produce results within 3-4 weeks, but if you have not made the lifestyle changes to support your skin, your symptoms will likely reappear as soon as your stress level increases.
Making changes more slowly gets results more slowly, but the results can last a lifetime. Remember, perioral dermatitis often acts as a barometer for your body, letting you know when things are out of balance. Your symptoms may go away entirely, but using the wrong products, a stressful event, or a hormonal shift can bring the rash back to the surface again. If that happens, it simply means your skin is telling you that you need to figure out what shifted, and gently bring it back into balance by following these steps again, carefully and completely.
One last note: the stress management piece of this puzzle must not be ignored. Stress causes the release of a number of hormones in the body, all of which can affect your skin. Because stress is a natural part of human existence, we all need daily, mindful practices to mitigate the effects of stress on your body and mind. If you’re not sure how or where to start, read this.
Please email us at email@example.com with any questions. Our team speaks the language of perioral dermatitis, and we would love to help you heal your skin so you can feel like your best self again.