Everything You Need To Know About Treating Perioral Dermatitis
For a skin condition so common, there’s certainly a lot of confusion about the best way to treat it. Ashleigh Cometti speaks to one expert for her tips on ridding skin of this pesky rash
Dr Heather Rogers, dermatologist, founder and CEO of Doctor Rogers Restore, describes perioral dermatitis as: “a common and persistent form of rosacea that people get around their mouth. It is most prevalent in women in their 20s and 30s and presents as tiny red bumps on the chin, around the mouth and nose.”
Like many skin conditions, however, it isn’t limited to this area of the face alone. In some cases, it can present along the outer part of the eyelids and cheeks. These tiny skin eruptions can sometimes burn, but often times it has no sensation at all.
A number of other skin conditions can imitate perioral dermatitis, so it’s always best to see a dermatologist for a proper diagnosis. In the interim, read on to discover its potential causes and what to avoid, along with a simplified skincare routine that may help nix this facial rash in the bud.
Think of perioral dermatitis as a way of your skin telling you your skin’s epidermal barrier has been disrupted.
The cause of this form of skin inflammation varies, Dr Rogers explains, adding that there’s likely a genetic propensity that plays a role, too.
“There are many associations with perioral dermatitis, including using a topical steroid in that area, toothpaste, overgrowth of yeast or mites,” she says.
Other causes may include too-rich skincare products, stress and anxiety, pregnancy, extreme temperatures or environmental changes, pH imbalance, poor diet or gut flora imbalance.
Dermatologists agree that while we don’t fully know why perioral dermatitis occurs, there are ways to treat it and hopefully prevent it from coming back.
“Since perioral dermatitis is a symptom rather than a standalone imbalance, it can be difficult to treat without identifying the root cause," Dr Rogers says.
"It’s exacerbated by things like stress, anxiety, and poor diet or gut health. In cases of chronic PD, we can see flare-ups more often in periods of high stress.”
Dr Rogers advises the best course of action is to treat perioral dermatitis under the guidance of a dermatologist, who can prescribe topical creams and prescription-only medications to get symptoms under control.
“Often, you will need a topical, steroid-like creams such as pimecrolimus or tacrolimus and a course of anti-inflammatory antibiotics (doxycycline, tetracycline or minocycline) to settle things down,” she says.
Generally speaking, oral antibiotics should take care of the problem in two to four weeks.
What to avoid
“You want to avoid anything that will further inflame your skin,” Dr Rogers says.
This includes side-stepping products containing active ingredients (including chemical exfoliants) as well as physical scrubs.
“Instead, it’s all about supporting your skin with the prescriptions mentioned above and daily skincare essentials that feature select ingredients your skin can benefit from. I made Doctor Rogers Restore for this reason and to ensure people’s foundational skincare is free of cheap filler ingredients, fragrance and other common irritants,” she says.
Despite popular opinion, Dr Rogers says steroid creams are also a big no-no when it comes to trying to address symptoms.
“Steroid creams can make things worse,” Dr Rogers warns. “Anti-inflammatory creams or oral anti-inflammatory antibiotics will help settle the skin without the risk of a rebound flare that can happen with topical steroids.”
Your simplified skincare routine
When it comes to PD, less is always more.
Dr Rogers recommends following a simplified skincare routine that restores skin health and balances the skin microbiome.
Basic products work best on red or angry skin — look out for lipid-rich cream formulas which help strengthen the epidermal barrier and cell membrane (minus aggravating fragrance and dyes).
In the morning, splash your face with water then apply a non-irritating moisturiser (Viva loves Doctor Rogers Restore Face Cream, $135) and finish with a zinc-based sunscreen like iS Clinical Eclipse SPF50+, $78, before applying any makeup.
In the evening, wash your face with a non-irritating cleanser like the Dr Rogers Restore Face Wash, $85. Follow with your prescription topical creams, and finish with a heavier moisturiser like Bioderma Sensibio Rich Cream, $42.
Some people may benefit from incorporating a skin-supporting probiotic like The Beauty Chef Gut Primer, $75, to alleviate symptoms.
“This seems to only work on a subset of patients, but it can be tried at home while you wait to get into your dermatologist,” Dr Rogers says.
“I typically take one pill a day for a week. If it is going to help, you will see an improvement by then.”
Practicing proper sleep hygiene by getting 8-9 hours’ rest per night may also help promote a clearer complexion, along with following a healthy diet and drinking plenty of water.
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