I have had a recent influx of patients presenting with a troublesome and persistant facial eruption that is being mislabeled and misdiagnosed as acne or eczema when in reality it is a condition known as perioral dermatitis.
The patient presenting with this concern is most often female and is experiencing small blisters or spots around the mouth, chin and nose (most often concentrated within the nasolabial grooves. The skin around the edge of the lips is usually spared and is clear. The skin affected may be dry and flaky and there may be an itchy or burning sensation. What distinguishes this from acne is the lack of clogged pores or comedones.
What causes perioral dermatitis?
The exact cause of perioral dermatitis is unknown but it can be aggravated by skincare containing a high quantity of oils, steroid nasal sprays or topical steroid ointments. There is also some evidence that perioral dermatitis may be triggered by hormonal causes since it is most often seen in women between the ages of 20 and 50 and rarely presents in men or children. Another possible trigger is irritation caused by sodium laurel sulfate and fluoride in conventional toothpastes. Quite often it is caused by a combination of the previously mentioned triggers.
How is perioral dermatitis treated?
The first thing I do when someone comes in to see me presenting with perioral dermatitis is suspend their current skincare routine. I then put together a non-comedogenic routine that is low in oils but still nourishing to the skin. Typically this adjustment in routine is enough to solve the problem. For additional skin health support, I include vitamins and minerals as well as botanical remedies to promote healing, reduce inflammation and encourage cellular renewal. I do warn patients that if topical steroids were the initial cause then quite often the skin gets worse before it gets better but it does get better with time (so long as you discontinue the steroids). More severe cases may require topical azalaic acid (compounded at 15-20%) and oral antibiotics. While I do try to avoid the oral antibiotics and opt to use antimicrobial herbs in their place to start, there are cases where the antibiotics are the best option when all else has failed.
I have found that those patients that take a comprehensive approach to treating perioral dermatitis that includes eliminating possible triggers, alleviation of symptoms and regeneration of healthy skin cells tend to achieve resolution more quickly than those that only integrate one step in their healing process. If you are struggling with persistent perioral dermatitis then it may be time to consult with a Naturopathic Doctor with experience treating it. To book a free 15 minute consultation with at Connected Health & Skin or contact me and I would be happy to discuss your concerns and what we can do to help you restore your skin to health.
Hi there I think I this, started in high school between the ages of 17 and 18 and I am 28 years old now this occurs about 4 to 8 time’s within a year.
I thought it might be seasonal or drastic weather changes or everytime it’s a new season.. I even thought it could be linked to stressed. But I am stressed now.
I seen a doctor before but they treated it like it was a ring worm
I went to the dermatologist and she said that it is ance but I hardly hve pimples in my face right now.. I was browsing the internet until I came across this post. Please help me. Nikita from south africa
I am so sorry that you are experiencing this; unfortunately it is pretty common. I can’t provide medical advice online but I do recommend consulting with a practitioner familiar with perioral dermatitis near you if possible.
Will you please comment on, generally or on average, how many weeks before patients you’ve treated saw improvement after the root cause of their perioral dermatitis was eliminated? I gather your patients may have needed to iterate through potential causes, and I am wondering how long they abstain from each item before saying it’s time to try abstaining from something else.
Thank you in advance. Also, thank you for writing about this condition.
Hi Chris, typically we remove all potential triggers, irritants and contributing factors initially to jump start healing rather than doing one at a time. Unfortunately, most of the time it is a combination of factors that have led to the development of PD rather than just one singular cause. Typically we see an improvement within a few weeks (sometimes quicker than that depending on the person and severity).
Do you do online zoom consults as I am based in Australia. Would love to know what skincare routine I should adjust too.
Hi, due to regulations on Naturopathic Doctors I only permitted to work with patients within Ontario, Canada. However, there are great practitioners in Australia – connect with the team at https://theclearskinexperts.com.au/