I was 39 years old when I was diagnosed with perioral dermatitis. And I was only further frustrated by my apparent skin condition when my dermatologist told me that they’re not really sure what causes perioral dermatitis, and they’re not really sure the best way to get rid of it.
Today I’m sharing my exact steps around how I got rid of my pesky perioral dermatitis. It was quite a long process for me with a lot of trial and error, and I also spent a TON of money on different skincare and makeup products throughout the process.
My last perioral dermatitis outbreak lasted for about two and a half years. I tried everything I read on the internet around what worked for other people, and it seemed like some things would work for a short time, but then the perioral dermatitis would come back with a vengeance.
Here’s a short list of what I tried, usually based on the advice of other (well-meaning) people: over the counter topical steroid creams (FYI: this is one of the WORST things you can do!), essential oils, a prescription cream, over the counter “gentle” skincare lines, “clean” beauty lines, expensive skincare lines that can only be purchased through physicians, dandruff shampoo, apple cider vinegar (taken internally and applied topically), supplements and more.
Whew. I wound up exhausted and with a whole lot of products on my hands, some of which were very expensive, and none of which actually worked successfully for me to clear the perioral dermatitis up.
Hopefully all this information will help you and you won’t have to do like me and spend a ton of money on products that don’t work.
FYI: This is my own personal story of how I got rid of my perioral dermatitis. Please do not consider this medical advice as I am not a physician or a medical professional.
What is perioral dermatitis?
Perioral dermatitis (aka PD) is an inflammatory rash that looks somewhat like acne, and occurs around the mouth and nose. My bumps typically appeared in my smile lines and even up into my nose, and usually on one side of my face more than the other.
In my research I learned that PD is very common in women of menstruating age. In fact, I’m willing to bet that more women have it and don’t even know that’s what it is, or mistakenly treat it like acne.
When my PD breakout was at its worst, I was incredibly self-conscious going without makeup which is not how I normally feel.
Medication was an option, but one that I didn’t want to take.
My dermatologist mentioned a few medications that were an option, like rounds of oral or topical antibiotics, neither of which I wanted to do because antibiotics have very much affected my gut health in the past. I’ve worked to get my gut to a healthier place and I have a family history of serious chronic gut conditions, so I like to avoid antibiotics when at all possible.
She also prescribed Elidel cream for me which worked, but the day I stopped using it (she advised I use it no longer than six weeks), the PD came back in full force.
So I continued my research to find what was actually causing this skin condition for me in the first place.
Here’s a pic of what my PD looked like without makeup back in December 2019. The breakout wasn’t as bad as it had been leading up to this point (I couldn’t find any older pics showing the actual bumps when they were at their worst), but you can see a few bumps inside my nose and you can also see where my skin was so discolored and scarred from how bad my breakout had been. This discoloration/scarring took a little while to go away, even after my skin stopped breaking out with the rash.
Through my research I learned a few important things about PD:
- It takes a while to clear up.
- What works well for one person won’t necessarily be the thing that works for another person.
- It likes as few products as possible on the skin.
- Using steroid creams on it might seem to help, but it really makes the problem worse.
Here’s how I finally got rid of my perioral dermatitis…
I stopped using ALL skincare products on my skin, except for just one.
I literally cut out all cleansers, scrubs, oils, moisturizers, treatments, sunscreens, etc, no matter how “clean” or how expensive they were. I just washed my face using only this Osmia Black Clay Cleansing Bar and warm water, and only at night. This bar cleanser got great reviews in the perioral dermatitis community. If I wore makeup that day, I’d do a double cleanse with the bar. In the morning, I only rinsed my face with warm water. That’s it, no moisturizers, serums or oils. My skin was a little more dry than usual, but my PD really started to clear up doing this.
I switched to a flouride-free toothpaste.
Some skincare experts believe that PD can be caused by toothpastes containing flouride. I switched to this JASON Sea Fresh flouride-free toothpaste since many in the PD community suggested it.
I got rid of any products I was using that contained fragrances, parabens or sodium lauryl sulfate.
What I learned is that all of these ingredients are on the list of potential triggers for people with PD. I made sure that none of my makeup, body wash, shampoo and conditioner or body creams contained these ingredients. And I was shocked to learn just how many products contained these. I switched to Desert Essence Fragrance Free shampoo and conditioner while I was getting my PD breakout under control.
I wore as little makeup as I could.
On the days I could get away with it, I wore very little or no makeup. I noticed that when I wore heavier makeup for a few days in a row, my PD always started to act up a bit. Remember that PD likes as little on the skin as possible.
I stopped drinking coffee.
I know, this one is a heartbreaker. But it wasn’t until I stopped drinking coffee that my PD really started to clear up, and quickly. I’m not even sure when it dawned on me that coffee could be a trigger for my PD. I have always kind of known that coffee is inflammatory because it always has made my body feel just kind of hot, inside and outside but especially through my digestive tract.
I’m not saying that coffee is inflammatory for every person, because I don’t believe that it is. But if you’re having trouble getting your PD to clear up, it’s worth a shot to take it out for a few weeks, just to see. I took it out for about three weeks and my PD started to clear up. Once it was clear, I decided to test my theory and see, so I had ONE cup of coffee in the morning for about two or three days, and all of the sudden, my PD was breaking out again. I haven’t had it since.
The good news is that it’s just coffee that breaks out my PD, not all caffeine. So I can drink black tea and green tea which both have caffeine, and I do just fine with no breakouts. I love a little caffeine every day, so I’m grateful that I can still have tea (and chocolate!).
RELATED: What is matcha and how do you drink it?
Also, some people say that wine or alcohol causes their PD to flare, but I don’t find that to be the case for me.
Thankfully since I was able to clear up my PD about six months ago, my skin has stayed clear, even while I’ve added a few more products back into my daily mix. I’m still very, very careful about what I use on my skin, and I still go by the motto of “less is more” when it comes to skincare and products.
Here’s how I now stay breakout free…
- I wash with the Osmia Black Clay Cleansing Bar and warm water.
- I use about four drops of Corson Beauty Night Oil.
- I use Skinceuticals Antioxidant Restorative Lip Treatmeat around my lips to help with fine lines.
- When I need sunscreen, I only use La Roche-Posay Anthelios Light Fluid Sunscreen on my face. (I use other sunscreens for my body.)
- For makeup, I’m really loving the Prime Skin and Dual Action Concealer, both by Gee Beauty, neither of which breaks out my PD.
- I wash with the Osmia Black Clay Cleansing Bar and warm water, doing a double wash with it if I need to remove makeup.
- I use about six to seven drops of Corson Beauty Night Oil.
- I use Skinceuticals Antioxidant Restorative Lip Treatmeat around my lips to help with fine lines.
I still don’t drink coffee but I drink plenty of tea. Maybe one day I’ll try adding coffee back in to see what happens, but for now, I like how clear my skin is enough to be happy with my daily dose of caffeine coming from tea. Besides, I truly believe if a certain food is inflaming your body in one way like your skin, it’s probably inflaming it in other ways, too, like your gut, your joints or somewhere else.
Disclaimer: This post includes affiliate links, and I will earn a commission if you purchase through these links. Please note that I’ve linked to these products purely because I recommend them and they are from companies I trust. There is no additional cost to you.
Hi Elizabeth, I saw your story as I was searching for answers for my PD. It is at a full blown stage right now. I am on antibiotics by mouth and topical cream as well. I just ordered the Osmia soap looking forward to it arriving. My question is what did you use on your face when wiping off the soap? My wash clothes really hurt my face. I will get the products you use and I’m hoping for results.
H2O at home has really nice cloths that are soft and can be hand cleaned after use with a safe and simple netepur bar. Much nicer than the average washcloth. Although right now, I’m so glared up, I’m just washing with my hands and black clay soap.
Hello, thank you for the article. Just looking at some of my products and noticing sodium laureth sulphate. I read this is better than SLS, but just wondering your thoughts in relation to PD?
Stop using the topical cream! Anything steroid based ingested or put on skin will make it worse long term.
I am 1 day in of no Coffee. So over this POD
I know, it really can be so frustrating 🙁 I hope you were able to get yours cleared up! <3
I am a 71 yr old woman with peri oral dermatitis for one year……….less is more. After 3 different doctors……I think I have found the answer for me. Cereva ointment. I found I needed a barrier. Very light washing twice a day. with almost no soap, just a peppermint wash and Cereva ointment on the trouble spots then delikate recovery cream by Kate Sommerville on the rest of my face. Also, when stressed, it seems to flare up. Almost non existent upon waking It all began with the mask wearing. Any other senior ladies have this issue???
I’m not sure about the mask wearing but I will definitely agree with you that it could be stress related! Stress affects our gut, and coffee also affects both stress levels (can increase for some people) as well as the gut (acidic). All are very much related. I’m a HUGE believer in the gut/brain axis!
My PD never “goes” away. Where as I don’t have bump like pimples like some I just have a constant red, textured and dry skin around my mouth constantly. I, like you have spent SO much money, dr apts and meds which some toned it down quite a bit but never took it away completely. Ugh! I’ve about determined I’ll just have it forever and just have to deal with it! But I will definitely be trying the black clay soap. I wash with cetaphil and cerave light moisturizer. I hope the clay works well with oily skin, my forehead and T zone is VERY oily constantly! Thanks for the tips!
I hope these tips helped you with your PD! So sorry for the delayed response <3
Im only 22 and I’ve had it for about 3 years now off and on. The first time i used the steroid cream and it went away then i switched birth controls and my whole face broke out and it finally went away after a month or so and now its flared up again and I’m pretty sure it is from using hydrocortisone because i used it the first few days and stopped cause ive read it makes it worse so now its full blown again and gotten worse. I’m really trying to find my triggers because it is very much a self esteem killer for me. Thank you for sharing your story and I definitely gonna try your soap!
Don’t give up! I know that what triggers peoples’ PD can vary but I very much felt like when I removed coffee it cleared up almost immediately. That and simplifying my skincare routine. Please let me know how you do! <3