Over the last 18 months, I’ve been dealing with self-diagnosed perioral dermatitis. It appeared seemingly out of nowhere – the only thing I could attribute to its onset was moving house and the associated stress. Now it comes and goes, characterised by a small bumpy rash on the right side of my mouth that sometimes extends to my chin and upper lip. Usually it’s not too noticeable, but a recent bad outbreak has caused me to look right into it. I’ve asked friends, experts, Reddit (obviously) and my Traditional Chinese Doctor – I’ve gleaned a lot of information that I’m almost certain have solved my problems.
All of this information, including perioral dermatitis treatment options and recommendations, below.
What is perioral dermatitis?
“Perioral dermatitis, or POD, is a red, bumpy rash that usually appears around the mouth,” skin expert and aesthetician Diandra Politano tells me. “It often starts at the folds beside the nose and can extend down to the chin and under the bottom lip. The bumps are tiny, sometimes looking like little pimples, but if you were to pop them, they only release a clear fluid. Often, the skin gives a little warning first with a slight itch or tingling sensation when using actives. If you catch it early, you can sometimes stop it in its tracks. If it progresses, it turns into a dry, bumpy rash, which can be harder to treat.”
What’s actually causing it?
Perioral dermatitis is often caused by a combination of factors that build up until the skin flares. Active products always get the blame first, but often they just loosen the lid.
Common triggers are:
Stress from work, grief, or emotional pressure. I find stress to be a huge trigger. Skincare or treatments, even products you’ve used for years, like retinol or peels, can suddenly irritate the skin if it’s under stress. Sun exposure is another big cause, with flares often appearing after a holiday. Dental health is sometimes overlooked but gum inflammation, or untreated tooth infections can create local inflammation that shows up as POD. Certain toothpaste, chewing gum or dental products can irritate the area as well. Internal factors like gut health, diet, and overall inflammation can also play a part.
Most of the time, it’s the combination of triggers rather than a single cause that leads to a flare
How to tell the difference between dermatitis, acne, rosacea and cold sores:
“It’s easy to confuse POD with other skin issues,” Diandra adds. “Acne tends to show up as larger, deeper, scattered bumps that contain pus or oil. Cold sores usually appear as one or two weepy blisters that crust over, typically right on the lip or just under the nose. Rosacea, on the other hand, usually affects the cheeks, nose and central face, feeling hot or flushed. It rarely shows up around the mouth.”
How to treat it and prevent future flare-ups:
This is where it gets complicated. Personally, I stripped my skincare right back to a cleanser, simple moisturiser and zinc-based SPF, plus a nightly leave-on mask made up of De La Cruz Sulfur Ointment (recommended by a friend) and Sudocream. I exclusively used the Lovebyt Botanical Toothpaste, as well. This seemed to help a little, but I also went and spoke to my Traditional Chinese Doctor who had a theory the dermatitis was being caused by an infected/inflamed wisdom tooth. She gave me some herbs to help and within two days, the rash was all but gone. I’m now a fortnight in and it’s still clear. I’ve reintroduced some of my skincare, too. Worth noting the tooth appeared at the same time as the first bout of dermatitis, too. The dental link was something I hadn’t considered before, but it turns out that oral health can be a trigger. I’ll probably book in to see my dentist, as well.
Diandra also elaborated on perioral dermatitis treatment options a little below:
“The first step is to calm the skin and remove all the triggers. That usually means simplifying your routine: gentle cleansing (Medik8 Calm Wise Cleanser is amazing), a soothing cream like TR Pro (it’s a beta glucan concentrate) and daily mineral SPF. Strip back the actives until the skin settles. In the clinic, LED therapy works beautifully to reduce inflammation and help the skin heal faster. If POD persists, a doctor may recommend short courses of topical or oral antibiotics, but long-term topical steroids should be avoided, as they tend to make it worse.”
“I also believe that lifestyle also plays a big role, she adds. Supporting gut health, following an anti-inflammatory diet, and managing stress can all help keep POD under control. If someone is constantly getting dermatitis they really should see a naturopath and get some blood work.”
Here are some other recommendations from friends:
Medik8 Calm Wise Cleanser
TR Pro Cream
Avene Cicalfate
Lovebyt Botanical Toothpaste
De La Cruz Sulfur Ointment
