How To Get Rid Of Perioral Dermatitis Naturally

Does your acne look more like a rash?

Does it itch, too?

Is it mostly around your mouth and chin area?

Then it could actually be perioral dermatitis and not acne.

Perioral dermatitis (PD) looks like flesh-colored or red bumps around the mouth and sometimes even the nose and eyes. There may even be some clear fluid discharge. Slight itching and burning are also common.

So, if you have been trying many different skincare products and treatments, but nothing has worked or has even made things worse, it may not even be acne you are dealing with!

So, let’s see what causes perioral dermatitis, what to avoid and how to treat it.

WHAT CAUSES PERIORAL DERMATITIS?

There is most likely more than one cause of perioral dermatitis. For some people, it can be a bacterial infection, while for some others, there could be other underlying issues.

A Japanese study, for example, has found that some perioral dermatitis patients had rod-shaped bacteria in their PD lesions.

On the other hand, one Slovenian study found that people with perioral dermatitis were more likely to have more Demodex follicularum mites in their skin than people in a control group. The presence of these mites might have been a result of the patients’ exposure to topical steroids.

The exact causes of PD are still unclear, and they probably differ from patient to patient, which makes it more difficult to treat.

However, inflammation, disrupted skin barrier and imbalanced skin microbiome (which fungi, mites, and bacteria are a natural part of) seem to be at the core of the problem.

HERE ARE SOME PERIORAL DERMATITIS TRIGGERS:

• Prolonged use of topical steroid creams (probably the nr. 1 cause of PD)
• Nasal sprays containing corticosteroids
• Overuse of heavy face creams, too occlusive foundations and sunscreens (especially in hot and humid climates)
• Use of irritating products such as those with fragrance, essential oils or comedogenic oils (like coconut oil)
• Use of strong beauty actives such as retinoids, chemical exfoliants and strong vitamin C serums when the skin cannot tolerate them well
• Use of flavored lip balms and other potentially irritating products that reach the area around your mouth
• Fluoridated toothpaste and/or mouthwash
• Fluoride in your drinking water (check for this!)
• Toothpaste and other oral hygiene products that contain skin irritants such as menthol
• Harsh surfactants in your toothpaste, mouthwash and skincare products (most commonly cleansers, facial wipes, scrubs, etc) such as Sodium Lauryl Sulfate (SLS) or Sodium Laureth Sulfate (SLES)
• Oral antibiotics (which negatively affect the good bacteria in our gut and on our skin)
• Birth control pills (which negatively affect our the good bacteria in our gut, deplete vital nutrients from our bodies and switch off our natural hormones)

WHAT TO AVOID IF YOU HAVE PERIORAL DERMATITIS:

• Steroid creams. Even nonprescription hydrocortisone and nasal sprays
• Heavy makeup products and even sunscreen. In fact, avoid makeup or minimize makeup as much as possible while healing perioral dermatitis
• Abrasive face scrubs and overly stripping cleansers. Instead, use only warm water or a very gentle toner during PD flare-ups. You can also brew some chamomile or green tea and use that on a cotton pad to gently go over your face instead of cleansing (see more natural remedies below)
• All sources of fluoride. Check whether drinking water in your area is fluoridated. Use a water filter to remove fluoride (and other contaminants) if necessary
• Products that contain sulfates, such as Sodium Lauryl Sulfate (SLS) or Sodium Laureth Sulfate (SLES), including cleansers, shampoos, conditioners and others
• Toothpaste and mouthwash with SLS and/or fluoride and other irritants such as menthol
• Facial brushes and tools (such as Beauty Blender), konjac sponges and others which can accumulate bacteria
• Spray on hair products because they come into contact with your face, too
• Fragrance in all skincare and makeup products (labeled as Parfum or Fragrance)
• Chemical exfoliants (especially those in higher concentrations)
• Vitamin C serums
• Retinoids
• Essential oils
• Oils (especially comedogenic ones!) and heavy creams (perioral dermatitis will likely flare under anything too occlusive)
• Finally, don’t rub your skin with anything!

FIRST STEPS TO REDUCING THE PERIORAL DERMATITIS

1. SIMPLIFY YOUR SKINCARE

You need to first simplify (super simplify!) your routine for at least 2-3 weeks (preferably until PD heals completely), using an absolute minimum amount of products.

The reason for this is that anything could be a cause of irritation when your skin barrier is disrupted and your skin inflamed. Sometimes the skin is able to bounce back on its own when we remove all sources of irritation and inflammation.

Use just a super gentle cleanser in the evening and a gentle toner or herbal toner in the morning. Use a light moisturizer if necessary. Choose a hypoallergenic, oil-free one without irritants and fragrance. Some readers of mine had success with Avene Cicalfate cream, but light moisturizers with niacinamide and skin-identical ingredients (like ceramides) can also be of help.

2. GET ENOUGH PROTEIN AND HEALTHY FATS TO HEAL THE SKIN BARRIER

Bioavailable animal protein and healthy fats (which naturally come with animal protein) are amazing in building healthy skin cells, which translates into a healthy, robust skin barrier. Choose foods such as grass-fed meat, eggs, fatty fish, avocados, ghee, coconut oil, etc.

Do your best to cut out the usual suspects such as processed sugar, alcohol, vegetable oils and processed foods in all forms (those with extensive ingredient lists).

Choose only whole foods without an ingredient list in the first place!

Also, limit overly spicy foods. They can irritate the skin around the mouth and flare up perioral dermatitis.

3. GET PROBIOTICS DAILY

Probiotic-rich foods, such as kimchi and sauerkraut, repopulate and rebalance our gut microbiome, promoting gut health. A healthy gut microbiome (the good bacteria in our gut) is vital for the maintenance of healthy and clear skin.

In fact, we are just beginning to tap into the strong link between the gut and healthy skin.

On the other hand, certain probiotic bacteria can be a trigger for some people due to their histamine production and general effect on histamine metabolism.

Histamine is inflammatory, helping us ward off infections, so it’s not bad per se, but if you don’t break it down effectively, this can lead to histamine intolerance.

4. KEEP A FOOD DIARY

Even if you have no digestive issues, your gut may still need some help or you may have a food intolerance you are not even aware of. This could be causing or aggravating your PD.

I suggest either keeping a food diary so that you can track down what you ate days before a PD flareup and/or trying an elimination diet.

Related: Cycle Sync Your Diet For Clearer Skin

NATURAL REMEDIES FOR HEALING PERIORAL DERMATITIS

The following remedies have mostly anecdotal evidence when it comes to healing perioral dermatitis, but I included them because they help heal the skin barrier and balance the skin microbiome, which can hopefully help heal perioral dermatitis, too.

Before introducing any of the remedies recommended below, I recommend doing a double patch test first.

DO THIS FIRST: DOUBLE PATCH TEST

1. Apply a thin layer of the ingredient on a small area on your face without perioral dermatitis and leave overnight. Check for any reactions the next morning, and if everything looks fine, proceed to step 2.

2. Apply a thin layer of the ingredient on a small area on your face with perioral dermatitis. You can do this in the morning, so if any itching or other reactions occur, wash it away with lukewarm water.

If everything goes fine, proceed to daily use of the remedy. If you see that your skin is looking worse days or weeks later, stop the use.

Aloe vera

Aloe leaves contain a plethora of antioxidants including beta-carotene, vitamin C, and E that can help improve the skin’s natural firmness and keep the skin hydrated. It allows the skin to heal quickly and naturally with minimal scarring.

How to use it:

You can use a fresh aloe vera leaf, gently squeeze the juice from within it and apply immediately onto skin. However, sometimes a reaction to fresh aloe vera is possible while using a bottled aloe vera gel is fine (as it is purified of potentially irritating substances). You can pick an organic aloe vera gel containing minimal ingredients.

Organic plain yogurt

Organic yogurt contains probiotic bacteria (make sure it contains live Lactobacillus and/or Bifidobacterium species), strengthening your skin’s immune defenses. This helps to bring the skin microbiome back to balance, and hence make your skin healthier and more resilient.

It also gently exfoliates due to naturally occurring lactic acid and nourishes the skin.

How to use it:

Apply a thin layer as a mask onto the clean face and let it dry up slightly. This will normally take 10-15 min. Then rinse gently with lukewarm water. You can mix in a dash of turmeric into the yogurt before application as it has amazing anti-inflammatory properties. I suggest trying plain organic, full-fat yogurt (Stonyfield is a good brand) first to make sure it agrees with the skin.

Green tea or chamomile tea toner

Polyphenols are powerful antioxidants found in green tea. Among them, epigallocatechin gallate (EGCG) is the most researched one, providing great antioxidant and anti-inflammatory benefits.

How to use it:

To make a gentle toner, I suggest brewing a strong green tea (use 1-2 tea bags or a heaped tsp of organic green loose leaf tea for 1/2 cup of water), then put it into a container and let cool down before use.

Simply apply to the skin with your fingers or with a cotton pad. Keep in the fridge and use up within several days. Chamomile is very gentle and soothing so you can try organic chamomile tea as your toner instead of green tea (which can be more drying, so it’s more suitable for oily skin).

Related: 5 Popular Natural Ingredients That Are Actually Hurting Your Skin

Finally, you will need to listen to your skin and see which of these remedies (if any) works for you and then stick to it.

LAST RESORT: CONVENTIONAL TREATMENTS

If your perioral dermatitis is mild, the above steps and remedies can go a long way.

However, if your perioral dermatitis is pretty flared up, I suggest going straight to your dermatologist. Ask him to perform a skin culture test to rule out a possible infection.

Here are some of the treatments you may be prescribed:

• Topical metronidazole (antibiotic)
• Topical calcineurin inhibitors (tacrolimus or pimecrolimus cream)
• Oral tetracycline antibiotics (for more severe cases of PD)

If you are prescribed an oral antibiotic, make sure to support your gut health with healthy foods and probiotics during that time, too.

I work directly with clients who have perioral dermatitis, and you can work with me directly HERE.

I really hope this post was helpful and has given you some ideas on how to reduce or even completely eliminate perioral dermatitis naturally!

Much love,

Sara

Questions! Do you or have you ever struggled with perioral dermatitis? What helped you? What made it worse?

About Sara

Hi there! My name is Sara. I am a molecular biologist who has spent 15 years figuring out the perfect skin care for sensitive, acne-prone skin and now I want to teach you all about it!