It’s Not Acne, Eczema or Rosacea — You May Have Perioral Dermatitis

perioral dermatitis
Dr. Lindsey Mcilvena, MD

In her day job, treating patients living with chronic disease, nutrition and lifestyle are not after-thoughts, they’re central to helping her patients get well. She’s also our go-to expert on plant-based diets.

Have you noticed a strange rash around your mouth and perhaps your eyes? Is it crusty, flaky, bumpy, and red? Is it getting worse despite everything you’ve tried — from prescription medications to apple cider vinegar, nothing seems to work, does it?

You may have perioral dermatitis (PD), and not a lot of people know about it. This bothersome skin condition is more common in females, particularly women in their child-bearing years who have a history of asthma, eczema, or other allergic-like conditions, but the condition may also be present in men, younger or older women, and children.

Perioral dermatitis can alternately appear to be acne, eczema, or rosacea. Studies have shown that the use of topical steroid creams (like over-the-counter hydrocortisone) can precipitate PD.  Other studies suggest that toothpaste containing fluoride, cosmetics containing sodium laurel sulfate (SLS), emotional stress, and hormonal imbalance may play a role; definitive evidence is still lacking, though.

In many cases, despite the use of special prescription soaps, moisturizers, topical antibiotics, and rosacea medicines, the PD rages on.

So, what can you do to make it better? Here are 5 tips.

  1. Wash your face less.
    This may seem counter intuitive, however, each time you scrub your face you further irritate the already inflamed area. Avoid sloughing the dry skin off the rashy area as well— it only angers the PD. Try washing your face only once a day, or every other day.
  2. Avoid potential trigger products.
    Stay away from fluoridated toothpaste, products containing SLS, topical cortisone, and heavy makeup. All of these may aggravate the problem.
  3. Eat a whole foods, heavily plant based diet.
    You don’t have to skip the meat, dairy, and eggs if you’d prefer not to, but try making the bulk of your meals consist of fruits, vegetables, nuts/seeds, and legumes. These foods are full of the micronutrients (vitamins, minerals, antioxidants, phytochemicals, and polyphenols,) that will help your skin repair itself.
  4. Drink plenty of water.
    Shoot for 100 ounces per day unless you have a heart or kidney condition that precludes this level of hydration. Just like the plant-heavy diet, staying well hydrated will help your skin heal faster.
  5. Relax and be patient.
    Try not to stress out too much about what your face looks like; stress will potentially worsen the inflammation. Try being as patient as you can; it sometimes takes months for improvements to become apparent.

What about cleansers and moisturizers? Check out Osmia Organics, a product line created by an MD; she has a special starter pack for PD. Many people have seen their PD resolve completely with Osmia’s products.

Sources: NCBI, Hindawi

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