Perioral Dermatitis: A Sensible Guide

We all know skin is our largest organ, but did you know it makes up about 1/7 of our body weight and has a surface area of up to 2 square meters? Holy cow! Our skin does so much for us, including acting as barrier to the outside world. Think of your skin’s barrier like a hard-working bouncer at a nightclub. Usually, it keeps everything in order – good in, bad out.

But sometimes, the bouncer gets overwhelmed with something and…enters Perioral Dermatitis (PD). The bad news is that PD doesn’t have one single cause you can focus on: it’s more like a perfect storm of irritation, sensitivity and timing. But the good news is that there are some things you can do about it.

What Exactly is Perioral Dermatitis?

Perioral dermatitis, or PD for short, is usually a cluster of tiny, red bumps that show up usually around the mouth, nose, chin area. It tends to be red, rashy, inflamed and irritated, and can sometimes be flaky and scaly too. It’s often confused with eczema, acne and even seborrheic dermatitis, which are different things altogether. But unlike acne, it doesn’t react well to drying agents. Unlike eczema, it sometimes gets worse with rich creams. And unlike seborrheic dermatitis, it’s cause is still a mystery and shows up on the face in symmetry.

PD is common, stubborn and loves sensitive skin. It tends to show up uninvited, sticks around way past its welcome, and is extremely finicky – sounds like a few people we know... But despite all this, PD is manageable. It just seems to run by its own rules, but once you learn these rules, things tend to get easier. It just takes a bit of patience, gentleness, a “less is more” attitude and a few key gentle products, of course.

When Less Is Definitely More

One thing we know for sure is that PD loves simplicity. When trying to treat it, it’s important to not only consider what to use, but also, what needs to be taken away to best foster healing. Let’s look at some of the most common triggers for PD, or rather, the usual culprits that poke the proverbial skin bear:

1. Topical Steroid Creams

This is probably the most common trigger, often kick-starting PD, even when used in tiny amounts. If you’ve been using one and PD has shown up, now might be the time to start discontinuing it (keep your doctor in the loop, of course).

If you’ve been using one for a while and when you stop using it you notice some worsening symptoms, you might be experiencing Topical Steroid Withdrawal (TSW); here’s some information about that.

Try: Skin Calming Cream – a moisturizing, skin irritation relief cream for red, dry, itchy skin. This gentle formula was designed specifically to calm and protect dry, ultra-sensitive, distressed skin. A natural alternative or complement to steroid creams, this formula comes  with a mix of skin-soothing superstars including Chamomile, Gotu Kola, Sage, Aloe Vera and Allantoin. It’s also made with Sweet Almond Oil, Olive Squalane and Vitamin E to improve hydration levels and restore healthy skin barrier function. It's also Dermatologically Tested and designed to be used on the face and the body. 

2. Harsh Cleansers

Now is the time to throw away anything harsh, stripping or artificially fragranced. Any cleansing product made with synthetic cleansing ingredients, particularly sulphates like SLS and SLES, are much too harsh and irritating to the skin as they strip out our natural oils leaving skin overly dry, tight and most certainly irritated. Instead, only use skin-friendly, gentle cleansing ingredients that support your skin barrier instead of breaking it down. Cleansing too often and too aggressively can keep skin in an irritated state, which keeps PD hanging around.

Try: Milk Wash – a gentle, creamy cleanser made specifically for dry, sensitive skin, and is 100% soap-free. We use a combination of non-irritating cleansing ingredients to keep skin clean while supporting the skin barrier and keeping your skin’s natural moisture right where it needs to be. It's also Dermatologically Tested for use on sensitive skin and designed to be used on the face and the body. 

Tip: While you’re in the shower, it’s also a good idea to make sure you’re not rinsing any shampoo and conditioner over PD affected areas. This is only important if you using shampoos make with harsh sulphates and/or conditioners made with silicones. These ingredients can cause additional, unwanted irritation to this already affected area. Switch to healthy and natural hair care already!

3. Heavy Creams

Keeping skin hydrated is more important than you think. When skin is dry, it's much easier for irritants to pass through. Rich, thick, luxurious creams can feel comforting on the skin, and it can feel like you’re giving your skin some TLC, but using heavier, oilier ointments, balms or lotions can make PD worse. Instead, give your skin some breathing room.

To do this while also giving it the moisture it needs to heal, we suggest avoiding occlusive moisturizers and barrier creams made with petroleum-based ingredients like petroleum jelly or mineral oil because these tend to sit on top of the skin rather than being absorbed into it and can cause unwanted congestion and keep PD popping up. Products made with skin-compatible, natural oils can provide the skin with the hydration it needs because these will sink into the skin.

Try: Soothing MSM Moisturizer – a natural, calming moisturizer to nourish dry, sensitive skin. This formula contains 10% MSM (organic sulphur) a super, skin-soothing compound to help reduce redness and inflammation. It’s also made with Aloe Vera, Vitamin E and Honey to nurture reactive skin, as well as Sweet Almond, Olive and Coconut Oil to improve hydration levels. It's also Dermatologically Tested for use on sensitive skin and designed to be used on the face and the body. 

Tip: It's also a good idea to avoid formulas with strong and artificial perfumes, as well as all synthetic preservatives as they are well-known irritants for sensitive skin. This is why we only use natural and non-irritating fragrant oils in our formulas and stick to natural preservatives. Read more: Why Natural Preservatives Matter.

4. Too Many Products

Skincare simplicity is key when PD is involved. During a PD flare-up, we think less is more so sticking with a simple skincare routine is best while your skin sorts itself out. This probably means shelfing some products until things clear up. 

This includes any physical exfoliating products like scrubs etc. and all enzymatic exfoliators like AHA and BHA until you skin has returned to a healthy state. Toners, astringents, primers, chemical sunscreens and even makeup should also be avoided, if possible, until PD has left the building. If you do plan on being out the sun, always use a Zinc-based sunscreen to provide protection, but remove it as soon as you can as they tend to be thicker in nature and sit on top of the skin.

5. Hot Water

Everyone loves a hot, steamy shower, but hot water dries out the skin more than cooler water and can cause damage to an already compromised skin barrier. The heat strips natural oils out of the skin making it drier, itchier and more prone to irritation and PD. Use lukewarm water, at least on affected areas, and keep it out of any steam as well.

Tip: Make sure you’re using a water filter on your shower. Chlorine found in tap water can be very irritating to the skin at the best of times, and even more so in a warm environment like a hot shower.

6. Active Ingredients

Ingredients in your skincare that can have a strong effect on your skin are usually great, but their terrible for PD. This includes things like retinoids, peptides, benzoyl peroxide and vitamin C, to name a few.

PD is essentially a stressed, inflamed skin barrier, and actives are designed to stimulate the skin. That’s fine for healthy skin, but for skin in the middle of a PD episode, it’s like adding fuel to a raging fire. Most actives are acidic, potent, or delivered with penetration enhancers that increase the likelihood they’ll cause skin irritation. The result? More redness, more bumps, more burning, and a longer road to recovery.

7. Fluoridated Toothpaste

Surprisingly, this is a common trigger for some people. When you brush your teeth, a small amount of toothpaste inevitably gets on the skin around your mouth and nose. Fluoride, along with other common toothpaste ingredients like SLS (a harsh ingredient we suggested avoiding above) and strong flavouring agents, can be surprisingly irritating to a compromised skin barrier. For PD-prone skin, that irritation can quickly snowball into inflammation, bumps, and redness.

Many people don’t realise toothpaste is contributing until they switch to a fluoride-free or SLS-free option and notice the rash improves within a few weeks. When it comes to remineralizing your teeth, Fluoride is the most common ingredient of choice, but it’s not the only one. There are quite a few natural toothpastes out there made with Hydroxyapatite, the strongest fluoride alternative available. It’s the same mineral that makes up 97% of your tooth enamel.

A Little Patience Goes A Long Way

It can get frustrating when it seems like nothing is working, but it’s important to resist trying new things if you don’t see results right away. Piling on “solutions” could end up setting you back even more; simpler steps done consistently often fare best. Once you've cleared the irritant clutter, your goal is to support the skin without overwhelming it. PD often improves noticeably in 1–3 weeks once triggers are removed, but it’s normal for deeper recovery to take a few months. Skin likes routine, and once it realizes you're not hurling new irritants at it every day, it settles down.

Perioral dermatitis heals fastest when you strip things back to the skincare equivalent of quiet time. No harsh cleansers, no rich creams, no actives, no exfoliants, just a minimal 3 step routine with a gentle cleanser, a natural moisturizer and a super soothing cream to help the skin barrier rest and repair. Our Skin Calming Set contains everything your skin needs during this frustrating time. And save 10%! 

If symptoms worsen, spread or don’t improve after a few weeks, another trip to your doctor or dermatologist is best. Sometimes a short course of antibiotics is needed to reset things. The solution for PD isn’t glamorous, it’s simple simplification. Less stuff. Gentler stuff. Consistency. And products designed for sensitive, easily annoyed skin. If your skin has been yelling lately, our Skin Calming Set might just be the quiet, soothing voice it needs.