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Perioral Dermatitis 101: The Ultimate Guide

Perioral Dermatitis: The Ultimate Guide

Perioral means “around the mouth”.
Periocular means “around the eyes”, and dermatitis means “skin inflammation”.

Are you concerned about that stubborn red rash around your mouth?

Has your skin become extremely dry, flaky, and itchy?

Then, chances are, you could be suffering from perioral dermatitis.

We’d go as far as to say that there is a silent epidemic going on right now.

And finding the cause of this frustrating condition can be like navigating through a minefield.

Why?

Because it’s often mistaken for eczema or seborrheic dermatitis, which compete for the world’s most dreaded skin conditions.

Over the years, we have done a great deal of research on this condition, helping hundreds of people heal their skin.

And that’s why we are here to guide you today.

To help you understand what it is, what it isn’t, and how you can achieve clear, rash-free skin.

Plus, it’s always good to have a plan of action to get your skin back to its beautiful, natural state.

So, buckle up your seatbelts.

Let’s take a crash course into deciphering and getting rid of that peculiar-looking rash on your skin.

What exactly is Perioral Dermatitis?

Perioral dermatitis is a relapsing inflammatory condition.

Perioral Dermatitis on the face: If you have a red rash around your mouth and the folds of your nose, then perioral dermatitis could be your problem – especially if your skin is dry and flaky. Clusters of 1–2 mm papules or pustules bordering your lips, mouth, or the creases of your nose may also be present.

Granulomatous Periorificial Dermatitis: If yellow pimples are the problem, you may be battling a granulose infection, which can occur from a disease caused by invasive treatments like microneedling.

Periorbital Dermatitis around the eyes: Are the corners of your eyes red? You might have this condition.

Periorificial Dermatitis: This could be the culprit if you are experiencing irritation and rashes on your chest or even your groin area.

Other symptoms include:

  • burning and irritation on your skin
  • rash around the eyes and mouth, or under your nose
  • dry and flaky skin, especially around the mouth
  • corners of your eyes may be inflamed, and in some cases, your eyelids
  • clusters of 1–2 mm pimples and a lip rash that doesn’t look like a typical breakout

If these conditions sound suspiciously like something you are experiencing, read on to learn how to heal your skin.

What is Causing my Condition?

Whilst your symptoms may look like the image above, it is crucial to understand that each person’s underlying cause is unique to them.

It could be related to a dysfunction in your protective barrier or an altered state in your skin’s microflora that disrupts the delicate acid mantle, which keeps your skin healthy.

The exact reason why you have perioral dermatitis out is not entirely understood; there are several theories:

One is that follicular fusiform bacteria may be causing your skin to flare.

This study found that those presenting with perioral dermatitis had rod-shaped bacteria in their skin lesions, and when the patients took antibiotics, the symptoms disappeared.

Another theory is that parasites may be behind your condition. Yikes!

In this study, those with perioral dermatitis had more Demodex follicularum mites in their skin than those in the control group. Interestingly. The study found that those treated with topical steroids also had mites on their skin.

This 2014 study monitored participants who regularly applied an anti-parasite cream on their skin affected by perioral dermatitis and found that it significantly calmed their symptoms.

Below, we have compiled a list of symptoms that could be the reason your skin is suffering:

  • if you are under a lot of stress
  • if you have an immune dysfunction
  • if you drink an excessive amount of coffee
  • if your diet is poor, this can cause inflammation in your skin
  • if you regularly use nasal steroids, oral steroids, or steroid inhalers
  • using fluorinated toothpaste or mouthwash can be a big culprit
  • pregnancy, oral contraceptives, and hormonal fluctuations may be the cause.
  • using harsh ingredients on your skin
  • hidden food sensitivities to sugar and gluten
  • gut dysbiosis can cause a bacterial and fungal imbalance
  • use occlusive skin creams, petroleum jelly, or paraffin ingredients on your skin
  • laundry detergent is a trigger: consider changing to a hypoallergenic one
  • Using steroids or any anti-inflammatory medication. In this study, around 9% of those who used a steroid cream for over a month developed perioral dermatitis
  • some spices and salty foods could be causing your skin to react. This study found that a woman developed perioral dermatitis from bay leaves, whilst another developed it after eating marjoram and another from cinnamon; when they ceased eating these spices, their skin improved dramatically.

We are often asked if perioral dermatitis is contagious. Please take it from us; you did not catch this from someone else; it is not infectious.

Why Can’t I Get a Correct Diagnosis?

If you’re struggling to get a diagnosis, we hear you; perioral dermatitis is often misdiagnosed and can even go undiagnosed.

In our clinic, many of our clients mistake perioral dermatitis for other skin conditions such as acne; it does take a trained eye to determine the cause of your skin condition.

We’ve put together the following comparisons to help you with your diagnosis:

Acne: Perioral dermatitis bumps are generally inflamed and don’t contain liquid. Acne breakouts often contain pus or fluid, and rarely is your skin itchy with acne.

Seborrheic Dermatitis: This condition can affect similar facial areas; Seborrheic dermatitis is caused by Malassezia yeast, and your skin will be oily in some areas. A dermatologist would need to give you a correct diagnosis as these conditions are closely related.

Steroid rosacea: This is a condition induced by steroids; if you have extensive facial papules, pustules, or broken capillaries, especially around the nose area and are taking steroids, this could well be the reason for your condition.

Rosacea-like dermatoses: Facial flushing, thickening of the skin – especially around your nose – and acne-like symptoms are just some of the conditions you may experience if you suffer from rosacea. This condition usually occurs just around your nose and cheeks, not your mouth.

Eczema: While both conditions will cause a red, irritated rash, eczema tends to manifest as thick, scaly patches on your skin and severe, painful bumps that ooze liquid and crust over when you scratch them may be present. Eczema can appear anywhere on your body, which is not typical of perioral dermatitis.

Impetigo: This type of skin infection is more common among young children and quickly spreads. You may have impetigo if you have an oozing rash or sores around your mouth or nose.

If you are confused about your condition, it is essential to see a dermatologist.

They will perform a thorough consultation and look at the location and distribution of your skin to give you the correct diagnosis.

Now that you understand what perioral dermatitis is and what causes it, you can determine the best course of action to take when treating your skin. As you’ll see below, there are a few different options.

What are the Best Treatments for Perioral Dermatitis?

So far, we have covered a lot of ground, and I think it’s safe to say that none of us wants to deal with this condition if we don’t have to!

As we have seen, medications, lifestyle practices, and specific ingredients can do more harm than good. But the good news is, it’s never too late to start being more responsible for your health.

There are essentially two types of treatment paths you can explore:

Medical treatment

Topical antibiotics such as erythromycin, sodium sulfacetamide, or doxycycline are often prescribed, which can be effective in the short term. But long-term, without implementing a natural approach and lifestyle changes, many of our clients have noticed a flare-up in conditions.

Steroids are also prescribed for this condition. Unfortunately, we have seen many people in our clinic who have become reliant on corticosteroids.

This study in 2017 explored the effects of the misuse of topical corticosteroids on the face. Interestingly, it was found that perioral dermatitis was one of the adverse effects.

If you are using topical steroids, begin to withdraw from them slowly – especially if you have experienced a severe flare after steroid cessation.

Other perioral dermatitis treatments include antifungal creams and topicals such as immunomodulators like pimecrolimus.

Natural treatment

It is possible to heal your skin away from the dermatologist’s office, as stubborn as this condition is.

First things first, we recommend stopping the use of steroids and switching to natural skincare products and fluoride-free toothpaste, if you haven’t already.

Next, go to our article treatments for perioral dermatitis, where we created an entire treatment protocol on how to treat your skin naturally, inside and out.

Conclusion

So there you have it, guys and gals.

If you are concerned about that red, flaky rash around your lips and nose or other areas of your face and body, it could be perioral dermatitis.

Whilst your skin may look the same as the next person’s, the underlying causes are multiple, variable, and unique to each individual.

While there isn’t a medical test to diagnose your skin condition, your dermatologist will be able to identify it based on your symptoms.

Causes can vary, from stress, using the wrong products and toothpaste with fluoride to the withdrawal of topical steroids. 

As we discussed, there are two routes you can go down to treat your skin.

The medical route usually involves antibiotics or steroids; if you choose this method, it may seem like your skin is healing, but it may flare up again when you stop treatment, especially if the lifestyle practices we recommended aren’t implemented.

If you are treating your skin naturally, fluctuations in your hormones, a stressful event, using fluoride toothpaste, or the wrong products may cause your symptoms to resurface.

If that happens, don’t panic! It’s your skin trying to tell you that you need to understand what shifted to bring it back into balance again.

Perioral dermatitis acts as a barometer for your body, often appearing when something is out of balance; we strongly recommend taking a holistic approach.

Making these modifications will get you the results you need to heal your skin, and whilst these changes may be slow, they can last a lifetime.

Bottom line? Be gentle with your skin — whilst learning a few lessons in patience along the way.

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