My Perioral Dermatitis Experience

If a global pandemic, online school, natural disasters galore, and polarization of our country weren’t enough, 2020 bestowed something upon me that I had never experienced in my 45 years. Yes, my friends, I became very acquainted with a condition known as perioral dermatitis. #UGH

However, with the help of an expert, the right products, and some dietary and stress management, my perioral dermatitis is almost completely controlled. Here’s how I did it!

What is Perioral Dermatitis?

For those of you who struggle with perioral dermatitis, you know 100% what a true pain in the ass it can be. Perioral dermatitis can range anywhere from mildly annoying to completely agony-inducing and can be very hard to pinpoint the cause, thus effective treatment can take a while to figure out.

In mild cases, PD presents itself as patches of slightly bumpy, red, or irritated looking skin around the mouth, chin, and nose. It can also show up around the outer corners of the eye. For some though, the skin can become incredibly angry, painful, and even infected. It’s like if eczema and acne had a child. A very agitative and obstinate child.

Here’s the rub…there are a myriad of things that can cause PD and those can be different for everyone. Ingredient sensitivities, stress, pregnancy, diet, and steroid withdrawal, to name a few. The key is finding what’s causing it FOR YOU. Looking back, I think mine was caused by the perfect storm of the addition of some very active acid-based products to my skincare routine, my overall stress levels (hello, pandemic), and some unhealthy changes in my diet. (Once again, hello pandemic and processed sugar. #bananabread #somuchbananabread)

My Perioral Dermatitis Experience

It started in the Spring – what seemed to be a few red, slightly itchy bumps around my nose area. Honestly, I didn’t think too much about it…I just assumed it was from a new product that my skin wasn’t agreeing with. But the bumps seemed to spread over time – running from around my nose to my laugh lines and especially my upper lip. I couldn’t really wear any foundations or concealers over because it would aggravate it, as well as most lip products being bothersome as well.

I think most would consider my case relatively mild, but given the fact that my job revolves around reviewing multiple products at a time, consulting with several brands on product development behind the scenes (i.e. experimenting with products that haven’t hit the market yet), and being in front of a camera weekly, this was not good for me. My case might have been “mild,” but it was stubborn as hell and didn’t budge for months.

Suddenly, everything I normally used on my face made my face so angry and irritated. I was baffled by this since I had never experienced anything like this ever. Looking back, I think my first mistake was constantly slathering products on my face in an attempt to quell the flare-up. I just wanted it to go away quickly. Well, with PD, patience is a virtue. Not my strong suit.

Believe it or not, over the course of a couple of months, I couldn’t find ONE product on my shelf that was helping this condition. (Ahem, have you seen my product shelves? I could run a damn skincare boutique out of my home.)

And that’s when I knew it was time to consult an expert on the matter. Luckily, working in clean beauty, I’ve become friends with many, many folks way smarter than me in this department, so I reached out to my bud Dr. Sarah Villafranco. (Full disclosure – I think my actual words were, “What the F*^K is up with my skin? HAAAAAALP MEEEEEE.” #alwayskeepingitclassy)

Sarah put me on the right track and I’m happy to report it worked!

Look, I’m not here to re-invent the wheel.

Sarah is a wealth of information on perioral dermatitis not only because she is a physician, formulator, and owner of Osmia Organics, she’s dealt with the PD beast herself. So I’m not here to pretend I’m a PD expert…I’m still figuring all of this stuff out myself. However, I can say that the most informative article you could read on perioral dermatitis is right here. So much great info.

My Perioral Dermatitis Routine

The first thing I did was completely stop using all of my usual skincare products. *brushes a tear away*

Yes, that meant no more retinol, AHAs, Vitamin C serums, masks, oils, you name it. (PD does not like facial oils, by the way. This was difficult for me because I LOVE MAH FACE OILS.)

I followed this simple routine morning and night.

Osmia Black Clay Facial Soap

This is THE soap for perioral dermatitis, acne, eczema, and the majority of reactive, sensitive skin conditions. Made with Black Australian clay and Dead Sea mud to balance and tone the skin, as well as Organic almond, avocado, and castor bean oils to condition, the Black Clay Facial Soap is the perfect cleanser. I just lather it between my hands and lightly massage my skin with circular motions before rinsing off.

Oh, and don’t be fooled by the tiny size of this soap. Each one lasts at least 3 months. (I’m still on my first one!) Be sure to store it on a soap saver so it can dry properly, though.

Personally, I find that this soap stings my sensitive eyes, so if I have eye makeup on, I remove it with this before cleansing with the soap.

CV Skinlabs Calming Moisture

My hero product. Words cannot accurately convey how much I love this moisturizer. While I initially started my PD routine with the Osmia Purely Simple Face Cream, which is well-loved by the PD community, my skin didn’t agree with the essential oils in the product.

I knew I had to find a moisturizer without any essential oils for my skin. Enter CV Skinlabs Calming Moisture. This antioxidant-rich moisturizer calms redness while deeply hydrating and repairing skin, thanks to ingredients like Beta Glucan– the soluble fiber found in the cell walls of oat kernels which helps promote collagen production, speed wound healing and diminish signs of fine lines and wrinkles, Aloe Vera–  a super soothing and calming ingredient, and Oat Extract, which helps to reduce redness and itch.

Designed for all sensitive skin types, it’s ideal for soothing skin irritated from the effects of microdermabrasion, laser treatments, retinol use, chemical peels, excess sun exposure, or chemotherapy. Also, if you have chronically dry and/or flushed skin, this one’s for you. Friends, it is LEGIT for perioral dermatitis as well.

Best of all, it immediately calms and nourishes my skin while leaving a really healthy-looking glow. I was afraid that the elimination of all of my glowing go-to products would make my face look dull and drab, but this moisturizer really gives me a slightly dewy finish that I really like.

When I started following this pared-down skincare routine, my skin drastically improved in 2-3 weeks, as you can see in the above photo.

Since then, I’ve been able to add in more skincare products, but I’m in no rush. Some of the ones I’ve been able to use without experiencing a negative reaction are African Botanics Infusion, MUN Anarose Toner, Pai Instant Calm Redness Serum, and Beautycounter Countermatch Adaptive Moisture Lotion.

Other Helpful Tips

Consider your diet.

When we went into quarantine, the baking was out of control in our house and my system was not ready for that kind of increase in refined and processed foods such as sugar and flour. If you are noticing reactive skin, take a look at what you are eating. Has anything recently changed in your diet?

Another thing I did was take this Food Sensitivities Test which pinpointed certain foods that are reactive in my body. The jury’s not out on whether these tests are fully accurate, but my test definitely confirmed some suspicions that I had and I’m SO GLAD I took it. (Although, goodbye egg whites! We had a good run, but my skin is more important.)

Check your toothpaste.

Confession. Although I’ve used natural toothpaste at times in the past, I was still using conventional brands most of the time up until my PD started. And if there’s one takeaway I can leave with you concerning ingredients that trigger PD, please remember that SLS, or Sodium Lauryl/Laureth Sulfate, is PD’s #1 enemy. Stay the hell away from this ingredient, friends. Far far faaarrrrrr away. Most conventional toothpaste brands like Colgate or Crest use SLS and it’s a huge no-no for reactive skin. Now, I exclusively use David’s Toothpaste in the morning, and David’s Charcoal Toothpaste at night.

Keep skincare simple.

This is really not the time to try a whole slew of new products. Cleanser. Moisturizer. Hey! Think of all the time you’ll save!

Drink lots of water.

Water is crucial for healthy skin! Please be drinking at least half of your body weight in ounces. I definitely need a large water bottle to keep me on track and I love my Welly 28oz Traveler. I drink 3/day.

Supplements might be helpful.

Always talk to your doctor or healthcare provider, but I started taking Evening Primrose Oil after hearing about it from Sarah, and I also take this daily Zinc supplement for skin health.

Wash your masks!

Unclean masks unfortunately can cause a myriad of skin issues like PD, acne, or just general irritation. Since I’ve gotten my skin under control, I do notice that I get some patches of inflamed skin around my nose if I’m wearing a mask for long periods of time and/or it hasn’t been washed recently. (Yes, I get lazy and forget to wash it every day.) Although washable masks are better for the environment, if you are truly struggling with your skin due to mask-wearing, try wearing a disposable one like these.

FYI – be sure to check your laundry detergent for SLS, as many conventional detergents contain it!

Most importantly, lessen your stress levels.

Easier said than done, right?

I know.

BUT. Despite all of the craziness going on in our lives right now, you simply have to find a way to quiet your stress response and that can look different for everyone. For me? It’s a mandatory 2-3 mile dog walk with my pup every single day. I listen to great tunes, take deep breaths (despite the pollen invading my nostrils), and I always feel better. So for me, it’s exercise and moving my body. Whatever works for you, make it happen.

The one thing I really want all of you with PD to do is this. PLEASE STOP STRESSING AND OBSESSING ABOUT YOUR SKIN CONDITION. You all, I was really freaked out about my skin and I got really obsessed about researching PD and looking at my skin and thinking about it all the time…and you know what? There was a direct correlation between how many negative thoughts I had about my skin and how many bumps appeared on my face.

More negative thoughts, more irritation and bumps.

Less negative thoughts, less irritation and bumps.

The mind is an incredibly powerful thing. Just know it’s going to get better. And it will, I promise you!

Speaking of the mind, meditation is incredibly helpful in terms of working with obsessive negative thoughts. I really enjoy both the Simple Habit and the Calm app because I can approach my meditation practice in bite-sized sessions and it feels realistic and doable.

I hope these tips help those of you currently struggling with perioral dermatitis or any skin condition for that matter. Be sure to share your own wisdom in the comments…you never know, it might help someone greatly!

  • Bianca Swanepoel

    September 23, 2020 at 4:21 pm

    Thank you for writing this post! The same thing happened to me during the lockdown and I’m convinced it was owing to the combination of stress and using too many actives on my skin. Luckily mine was also mild and has now dissipated. I’d never known it had a name before reading about it in Caroline Hiron’s book, Skin Care.

  • whoorl

    September 23, 2020 at 4:51 pm

    You are so welcome! Stress does crazy things to our skin, right?! SO glad yours has dissipated as well. I’ve heard that once you have PD, if it starts to come back, it’s usually indicative that something is starting to go awry in your life…almost like it’s a warning sign!

  • Katie

    September 23, 2020 at 9:21 pm

    Now there’s a name to it!! Mine breaks out once a month when I get my period…HORMONES! I also have been noticing, as I recently got a desk job, that I touch my face more. Def need to work on that. Will try the black clay soap….have you found a lip moisturizer you prefer?

  • Zeynep

    September 23, 2020 at 9:36 pm

    Thank you for all this! Very informative! Similar situation is going on my cheek. It was much worse beginning of the quarantine when I was playing around with exfoliating and masks and all! Since I dialed down it has gotten better. I was convinced that I had rosacea but maybe it is PD! I am definitely going to try the calming products you mentioned.

  • whoorl

    September 23, 2020 at 10:50 pm

    My go-to for years has been the Agave Lip Mask by Bite Beauty but they recently reformulated it. I’ve found I continually reach for the Kosas lip balm lately. I love it! https://bit.ly/2OrXYZ0

  • Carla

    September 23, 2020 at 10:50 pm

    It’s funny that you just posted about this because I just got diagnosed this afternoon by my Derm. My doctor recommended a two month course of antibiotic, which I am loathe to take for so long, unless it is absolutely necessary. I’m going to hold off on the antibiotic and try your suggestions first. Thank you!

  • whoorl

    September 23, 2020 at 10:51 pm

    Hope you find some relief, Carla!

  • April Pickell

    September 23, 2020 at 11:18 pm

    I found you through Osmia, I love the black clay soap too, but like you I’m not getting results with the cream, and I’ve been on her protocol for over six months now. I also have a much more severe case than you do. I just ordered the CV Skin Labs Calming skin cream. I’m wondering about “the jury is NOT out” on the allergy test…Do you think it’s accurate, or not?

  • lonek8

    September 24, 2020 at 9:29 am

    I also have been struggling with this condition this year! I had an episode of several months last winter, but it resolved on its own without me doing anything, so i was totally un prepared for the epic 8 month long struggle I’ve been dealing with this year! I finally pared down my regular routine until I identified the culprit – It appears I cannot use the True Botanicals vitamin C powder anymore (sad face). I also cut out chocolate, which has been a challenge during these stress eating Olympics! Everything else in my skin care routine seems to still be working for me (primarily using the Maya Chia face oil for hydration) and the dermatitis seems to be under better control, although removing the vit C has resulted in a little more hormonal acne, but I’m combating that by trying to remember to use the May Lindstrom Problem Solver mask twice a week. Also, for what its worth, the Kosas concealer has proven to be the best for me in covering the redness without irritating the condition, since I’ve had to go back to work and can’t just be makeup free working from home all day.

  • Veronica Pasfield

    September 24, 2020 at 10:18 am

    I think you might have finally identified my son’s skin condition!! Thank-you!

  • Courtney Groeneveld

    September 24, 2020 at 10:28 am

    I have PD too–started on my chin right under my lip, then spread to between my nose and mouth.. My dermatologist recommend I use Protopic, which is a steroid–he seems to throw that stuff around like candy. It did work (temporarily) but also made my face numb where I applied it (!) and those spots would flush red whenever I had alcohol. That was not a sustainable solution for me, so I started doing my research. I had to cut out all SLS/SLES (in face wash, shampoo, soaps, toothpaste) and also flouride. So I now use a natural SLS/SLES and flouride-free toothpaste AND mouthwash, which is really hard to find (but Listerine does make one!).

    Like you said, you really have to rethink all your products. I used the black clay soap too (kind of randomly, but was surprised to see it worked) and cut back on everything–including makeup, which sucked because I just wanted to cover up the ugly rash. But after cutting back on all products for a wile and then slowly adding back in the cleaner stuff, my rash cleared up completely. The only time I have flare ups is if I accidentally use something I shouldn’t. In the long run, I think it’s better because I use much more natural/green products which are better for me anyway.

  • gabrielle

    September 24, 2020 at 11:26 am

    I had this exact same thing in early 2019- and took a similar approach. Big diet changes to figure out triggers, got rid of all SLS (toothpaste!), reduced product usage by a lot, and stopped trying to cover it up so my skin could rest and heal. It took some time, but it did work. So glad you got it sorted out.

  • Kasey

    September 24, 2020 at 1:08 pm

    Thank you Courtney for mentioning the spots flushing red when drinking alcohol. The same thing happens to me and I’ve never heard anyone else mention it.

  • K

    September 24, 2020 at 1:23 pm

    I had PD last year (right at the beginning of fall) and once I stopped treating it like acne and babied my face it went away. It just showed up again this week and I’m wondering if this is some new weird thing my face has decided to do to mourn the end of summer each year.

    I ordered the Osmia soap and the CV skinlabs cream and am excited to try them out. It can’t hurt to have an extra moisturizing, calming cream on hand heading into a Chicago winter. Thanks for the recommendations!

  • Emily

    September 24, 2020 at 6:26 pm

    Thank you so much for tackling this topic. I developed PD in January, but I didn’t know what it was for two months- I thought it was just a new evolution of acne.
    I discovered the Osmia article about a month ago, and similar to you I did not respond well to the moisturizer. I’ve slipped back into my True Botanicals oil because I think it’s best for my face (I did order the moisturizer you recommended to try it), despite PD and oil being a bad combination. I’ve seen some improvements.
    I read that you are using the African Botanics oil again. Do you have any opinion on True Botanicals or African Botanics? It’s time to order, and they’re both pricey, so I wanted to order the right one.

    Thank you for your advice!