For a skin condition so common, there’s certainly a lot of confusion about the best way to treat it. Dr. Heather Rogers gives tips on ridding skin of this pesky rash.
Perioral dermatitis is a common and persistent form of rosacea that people get around their mouth. It is most prevalent in women in their 20s and 30s and presents as tiny red bumps on the chin, around the mouth and nose. Like many skin conditions, it isn’t limited to this area of the face. In some cases, it can present along the outer part of the eyelids and cheeks. These tiny skin eruptions can sometimes burn, but often they have no sensation at all. A number of other skin conditions can imitate perioral dermatitis, so it’s always best to see a dermatologist for a proper diagnosis. In the interim, read on to discover its potential causes and what to avoid, along with a simplified skincare routine that may help nix this facial rash in the bud.
Think of perioral dermatitis as a way of your skin telling you that your skin’s epidermal barrier has been disrupted. The cause of this form of skin inflammation varies and there is likely a genetic propensity that plays a role, too. It may be due to using a topical steroid in the area, an irritating toothpaste, or even overgrowth of yeast or mites. Other causes include too-rich skincare products, stress and anxiety, pregnancy, extreme temperatures or environmental changes, pH imbalance, poor diet or even a gut flora imbalance.
Dermatologists agree that while we don’t fully know why perioral dermatitis occurs, there are ways to treat it and hopefully prevent it from coming back. Because perioral dermatitis is really just a manifestation of irritated and angry skin, it can be difficult to treat without identifying the root cause. It’s exacerbated by things like stress, anxiety, and poor diet or gut health. In cases of chronic perioral dermatitis, we can see flare-ups more often in periods of high stress. The best course of action is to treat perioral dermatitis under the guidance of a dermatologist, who can prescribe topical creams and prescription-only medications to control symptoms. Often, you will need a topical cream, such as pimecrolimus or tacrolimus, and a course of antiinflammatory antibiotics (doxycycline, tetracycline or minocycline) to settle things down. Generally speaking, oral antibiotics should take care of the problem in two to four weeks.
WHAT TO AVOID
You want to avoid anything that will further inflame your skin. This includes side-stepping products containing active ingredients (including chemical exfoliants) and physical scrubs. It’s all about supporting your skin with the prescriptions mentioned above and daily skincare essentials that feature select ingredients your skin can benefit from. I made Doctor Rogers RESTORE®️ for this reason, and to ensure people’s foundational skincare is free of cheap filler ingredients, fragrance and other common irritants that can trigger outbreaks like perioral dermatitis. Despite popular opinion, steroid creams are also a big no-no when it comes to trying to address symptoms. Steroid creams can make things worse. Anti-inflammatory creams or oral anti-inflammatory antibiotics will help settle the skin without the risk of a rebound flare that can happen with topical steroids.
When it comes to perioral dermatitis, less is more. I recommend following a stripped-back skincare routine that restores skin health and balances the skin microbiome.
Basic products work best on red or angry skin — look for lipid-rich cream formulas which help strengthen the epidermal barrier and cell membrane (minus aggravating fragrance and dyes!). In the morning, splash your face with water then apply a non-irritating moisturizer such as Doctor Rogers Restore Face Cream, and finish with a zinc-based sunscreen like iS Clinical Eclipse SPF50+ before applying any makeup on top. In the evening, wash your face with a non-irritating cleanser like the Doctor Rogers Restore Face Wash. Follow with your prescription topical creams, and finish with a heavier moisturizer on top like Bioderma Sensibio Rich Cream.
Some people may benefit from incorporating a skin-supporting probiotic like The Beauty Chef Gut Primer to alleviate symptoms. This seems to only work on a subset of patients, but it can be tried at home while you wait to get into your dermatologist. I typically take one pill a day for a week. If it is going to help, you will see an improvement by then. Practicing proper sleep hygiene by getting 8-9 hours of rest per night may also help promote a clearer complexion, along with following a healthy diet and drinking plenty of water.
Meet the author: Board-certified and practicing dermatologist, Dr. Heather D. Rogers, MD, is the founder of Doctor Rogers Skin Care and Modern Dermatology in Seattle, Washington. She studied at Stanford, University of Washington School of Medicine and Columbia University Medical Center. She lectures nationally, is well published, and an active member of the American Academy of Dermatology. Highly respected among the skin care community, Dr. Rogers has been annually named “Top 1% of Most Honored Doctors in the US” by Castle Connolly.
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