Healing Perioral Dermatitis Naturally (Treatment Tips Your Dermatologist Won’t Tell You!)

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After suffering for years, I was able to cure my perioral dermatitis with a variety of natural treatments and diet changes. I’ve put together all my self-care tips in this post, which has been invaluable to thousands of people. Read on for over the counter remedies to try at home if you’re sick of being on an endless rotation of antibiotics from the dermatologist.

Phoebe Lapine the author with cream on her face looking in the mirror and text overlay Perioral dermatitis


Perioral Dermatitis was one of my biggest wellness foes for over a decade.

If you’ve read my book The Wellness Project or SIBO Made Simple, then you also know that getting fed up with the bumpy pixilated rash around my nose and mouth was the biggest catalyzing event that got me to turn my life upside down. And yet, if I’d known how quickly and easily my skin could heal for good with just a few changes to my diet and self-care routine, I would have gone on this makeover journey so many years before.


I am constantly getting questions from people asking for advice on how to heal Perioral Dermititis naturally and what I did to finally move the needle. So I thought I’d take the time to put my biggest natural treatment tips into one post.

Here’s what we will cover:​


Of course, if you want the full story, I’d recommend picking up a copy of my book, since I’d assume that the habits I put into place over the course of my year of health—balancing my hormones, fixing my gut, overhauling my product pantry, etc.—were a big part of the long-term solution.

In other words, some of these perioral dermatitis treatments below were what cleared up my skin immediately and quickly, but likely it was a more diverse toolkit that kept it away for good. Especially if you have an autoimmune disease, hypothyroidism or are prone to IBS symptoms, SIBO can be a big underlying cause of chronic skin issues like perioral dermatitis. You can find out more about SIBO natural treatments here.

SIBO Made Simple book order graphic

After annual relapses that took me from middle school through college and into early adulthood, and the revolving door of the dermatologist’s office that blasted my gut with every antibiotic under the sun, I can proudly say that I’ve now been more or less perioral dermatitis-free for 9 years.

Below is what I looked like at the beginning of January 2014
; what I looked like two weeks later thanks to my lifestyle and diet changes; and finally, what I looked like at the end of my first month of the new protocol. I took a selfie every morning to check my progress, and you can really see the inflammation slowly going down and my skin smoothing. By the end, there’s just a little subtle scarring above the lip and a faint shadow where the rash used to be around the mouth. All the other pictures in this post are of my skin as it stands today, albeit with a little bit of makeup.

perioral dermatitis healing stages - picture of the author before treatment

perioral dermatitis healing stages - picture of the author after 2 weeks of treatment

perioral dermatitis healing stages - picture of the author after 4 weeks of natural treatment at home


Every once in a while when my body is run down or there’s extreme changes in the weather (mostly the East Coast wintery mix) I see faint Perioral bumps creeping back into their old habitat. But for the most part, referring to the list of practices below helps me nip it in the bud before true havoc can fully take hold on my face.

When I look at “before” pics like the ones above, it feels like a distant memory. And I’m so grateful for that, since my reflection in the mirror caused me so much undue frustration and pain and dollars spent on foundation over the years.

If you’re in the weeds dealing with Perioral Dermatitis and all your dermatologist has offered you is a prescription pad of antibiotics, I can offer you a little bit of hope. There is so much you can do on your own at home to uncover your root causes and ease into your own perioral dermatitis healing stages. Sadly most doctors in charge are not going to navigate this journey for you, so let the natural treatment tips below be your guide.

With health and hedonism,

Phoebe


WHAT IS PERIORAL DERMATITIS?​



Perioral dermatitis is a facial rash, most commonly occurring in women. It usually sticks to the areas around the mouth and sides of the nose, and presents as small raised pink bumps.

Both the color and the texture of the rash, in addition to the great amount of real estate it can take up, can make it particularly annoying to cover up with creams and powders. Meaning, it can be a real source of self-consciousness and misery.

It’s also known as a recurring condition, and many dermatologists will offer the same antibiotic treatment over and over again.

Though one common precursor is overuse of steroid creams and nasal sprays, the cause of recurring perioral dermatitis is unknown. As my dermatologist put it: it means there’s something out of balance in the body. She just had no interest in helping me discover what that was.


PERIORAL DERMATITIS HEALING STAGES AND MEDICATIONS



When traditional dermatology is faced with a case of perioral dermatitis, it usually turns to a bevy of oral antibiotics and antibiotic creams. These treatments can be very effective in getting the rash to go away. But as I learned the hard way through countless rounds of them, it is only a temporary relief and the rash will eventually come back.

Meanwhile, the broad spectrum antibiotics prescribed do untold damage to the health of your underlying bacterial ecosystem.

Each course of one such medication can wipe out 1/3 of your beneficial gut bacteria. These medications can also make you prone to gut conditions like SIBO.

When you consider that perioral dermatitis is being caused by some sort of imbalance in the body (most likely associated with a thyroid or a gut issue), you can see how these short term benefits can only feed the fire of your underlying condition long-term.

My podcast interview with Dr. Amy Bader on the subject of the skin-gut connection does a great job of explaining why antibiotics can show results, and also why they are so damaging to the health of your skin and the body it covers in the long run.

If you’re here reading this post and dealing with these skin issues, I’d recommend giving the episode a listen for more information on the underlying narrative in your body.

Luckily, there are plenty of simple changes you can make to your lifestyle, over the counter products to try at home, and natural remedies that can help you manage your perioral dermatitis and kick it to the curb for good.


PERIORAL DERMATITIS NATURAL TREATMENTS AND SELF-CARE TIPS


Phoebe Lapine the author taking a sip of a glass of water while sittingin a chair

Addressing an Internal Root Cause​

Give your liver a rest: go caffeine, sugar and alcohol-free for a few weeks.


When I began my wellness project in 2015, the first thing I did was give up alcohol, caffeine and sugar for 1 month. This came after advice that the easiest way to clear my skin from PD was to do a natural liver detox.

If you think about the connection between perioral dermatitis and women with hormonal imbalances and autoimmune conditions, it’s only logical that the liver would be the best one stop shop to get things running smoothly again. It’s responsible for clearing excess hormones, antibodies, and other toxins. If it’s not doing an efficient job in this realm, inflammation is inevitable. Though there are also common correlations to bacterial or fungal imbalances in the gut, starting with giving your liver a rest can also have a positive downwind effect for other digestive organs.

I’m not saying that this will be the case for everyone, but when I gave up these three vices I noticed a remarkable difference in my PD within a few weeks. At the end of the month, it was almost healed entirely. And though I did reintegrate these substances back into my diet in moderation, my PD never fully came back. I attribute this to the big boost I gave my liver and microbiome with this month of detox, and also implementing the changes below thereafter.

Your liver is also chiefly responsible for the health of your thyroid. Even if you’re on thyroid medication, your liver might not be able to convert your medication (usually, T4) into the bioavailable form T3. If you’re unsure whether you’ve had adequate thyroid blood testing, it’s important to get a full thyroid panel.

Rule out food intolerances.​


Though I had done an elimination diet prior to getting my perioral dermatitis under control, I can definitely say that being more diligent about fully giving up my problem foods was one thing that contributed to my long-term healing. We all have different sources of inflammation, and the foods we eat three times a day tend to be common culprits. For me, it was gluten (as it is for many Hashimoto’s folks). For you, it could be soy, dairy or corn. So how do you do an elimination diet? For those tackling a basic elimination diet for the first time, start with the big guns: gluten, dairy, soy, corn, and eggs. I have a few meal plans that can help you cook for one and low FODMAP elimination diet meal plans for those who want to take it a step further.

Support your gut.​


An imbalance of bacteria in your gut can cause a host of inflammatory reactions, including skin issues. If you’ve already made changes to your diet to reduce reactivity, the next step is to heal leaky gut and start fostering a better balance of beneficial bacteria in your intestines. This post on SIBO Probiotics has my favorite places to start to support your microbiome. This doctor-formulated brand is among my favorites.

Addressing an External Root Cause​

Switch to natural skincare products.


Harsh chemicals like sulfates and parabens inflame already sensitive skin even more. If the ingredient list alone of many of your products—and the association to cancers, autoimmune conditions, and the like—doesn’t inspire you to switch to naturals, then the potential for clearing your perioral dermatitis should. Though some essential oils can be irritating, generally speaking, green beauty products tend to be much gentler on inflamed skin.

Definitely start by getting rid of anything with microbeads or exfoliants and creams or toners that burn. Here are some of my favorite natural skincare products. You can also simply start at one of the fabulous retailers like Credo Beauty that curate the best of the naturals aisle for you.

Making sure that your laundry detergent is also free of these chemicals, is equally important, especially given the amount of time our face spends in contact with towels and pillowcases (see below). I like these plastic-free fragrance-free pods. Here is a full list of the best non-toxic cleaning products.

natural toothpaste options for perioral dermatitis healing

Change your toothpaste: try fluoride-free.


Even traditional dermatologists admit that toothpaste can be a big trigger for perioral dermatitis. Just think about where on the face PD tends to crop up—right around your mouth where foamy excess toothpaste can often irritate your skin. If you’ve never experimented with switching toothpastes, this is an easy place to start. In addition to fluoride-free options, you also want to make sure that there are no surfactants like sulfates that contribute to the foamy consistency. Some people also might be sensitive to mint varieties. Here is my the best natural toothpaste brands and what to avoid on the ingredient list. It’s a pretty easy change to make, so experiment to see if this moves the needle for you.

Do a 24 hour product detox.


If it’s not toothpaste or chemicals in your skincare routine, there’s always a chance that one particular ingredient is irritating your face. Plants and herbs are strong substances and it’s totally possible despite their origin being the earth that you can react to one or another. The easiest way to uncover the culprit is to do a 24 hour detox where you use zero products. Add them back in one by one and take notes on if you notice any changes. If it’s an external trigger, the effects should become apparent fairly quickly. Interior inflammation and dietary triggers can be harder to pinpoint as their effects often occur days or even weeks after an exposure. This is why when doing a vice detox or elimination diet, I recommend giving it a few weeks to gauge your progress.

The fewer ingredients, the better.


For skincare, the fewer ingredients in your routine, the less your face will have to deal with, and the easier it will be for you to get to the bottom of any problem products. I love brands that use 5 ingredients or less, or DIY options you can easily have at home. You can use raw honey as a cleanser and other singular ingredients from your kitchen to replace common items in your skincare routine like apple cider vinegar as a toner.

The author Phoebe Lapine making peace sign with her hands in the bathroom mirror

Avoid face oils.


All that said about natural products, many moisturizers in the green beauty isle are oil-based. Contrary to popular belief, this does not cause more oil build-up in the skin and is completely suitable for those prone to acne or breakouts. However, face oils can tend to be too heavy for some people dealing with perioral dermatitis. Stick with a light cream moisturizer that includes calming ingredients. This blue chamomile moisturizer was the first one I tried, and I definitely owe my skin’s on-going happiness to it.

Avoiding face oils is not a life sentence. Now that my skin is better and my inflammation under control, I use certain face oils daily and love them.

Choose a gentle, milky cleanser—not one that foams.


When my skin was at its worst, I’d revert to the Clean & Clear (and under control!) commercials of my adolescence and fiercely wash my face as often as possible. But by removing all the moisture, I had apparently just been causing more oil to appear as my skin desperately attempted to hydrate and protect itself.

As someone with sensitive skin, I was told that I should use a gentle cleanser without foaming surfactants. I switched to this lavender cleansing milk and have since also tried this wonderful ocean milk cleanser—both are effective at getting off dirt without stripping your skin of its natural defenses or irritating it further. This Osmia black clay cleansing bar was formulated specifically for people with perioral dermatitis. Since it gets sudsy, if you have very dry skin, I would go with one of the milks instead.

Only wash your face once a day.


Per the above advice, it’s really not necessary to cleanse multiple times a day. At night before you get into bed, making sure you get all that dirt and grime off your face is obligatory. But in the morning? All you’ve been doing is laying under the covers. Just a few splashes of water will suffice to freshen up for the day ahead. After I made this small change, my skin ironically seemed a lot less oily and more balanced.

Wash (or change) your pillowcase weekly.


Of course, the only reason your skin might get dirty at night is if you’re sleeping on a pillowcase that’s been collecting dust and dead skin cells for weeks on end. If there’s one item in your bedding that could stand to be washed or rotated every week, it’s your pillowcases, or at least just the one you put your face on. And again, wash them with a fragrance-free all natural detergent like this one.

You may also want to consider switching your face pillowcase to something natural and ultra soft. These eucalyptus sheets are my favorite.

Use a clean face towel.


Especially if you share a bathroom with a roommate or significant other, make sure you have a dedicated face towel that is just yours. Otherwise, you’ll be washing your face and then immediately putting it into contact with remnants of your partner’s hand soap, deodorant, or other harsh products. This is also an item that should be washed as often as possible.

Take your makeup off at night and sanitize your makeup brushes.​


When was the last time you washed your makeup brushes? A month ago? Two? Ever…? That’s what I thought. It is often the last thing on our hygiene list, and yet, we use the same pads and brushes every day to put on our face, and they can get just as nasty as your face towel and pillowcase. Wash them once a week in unscented castile soap and lay them on a towel to air dry.

Though it might seem silly, so many of these daily skincare habits can help heal perioral dermatitis in the longterm.

The author Phoebe Lapine sitting in a chair with a glass of water

Give your skin time to breathe.​


The irony of makeup is that the skin we feel most self-conscious about is often the same skin that benefits most from not being spackled with heavy powders and concealer. If you can allow yourself some make-up free days during perioral dermatitis treatment or flare-ups, it will help expedite things calming down and returning to normal.



Have you had any success with perioral dermatitis natural treatments, self-care or lifestyle changes? Any inflammation-based condition is so individual. Some people might have food triggers, others environmental ones. I would love to hear any of your own experiences or advice in the comments.
 
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