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Here’s How I Successfully Got Rid of My Perioral Dermatitis (for Now)

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Main image – Courtesy of writer

It wasn’t long after I’d written a straightforward article of perioral dermatitis (POD) last year that I realised it was exactly what I was experiencing. Small red pimples appeared in clusters in a rash-like formation around my nose and heading towards my cheeks. ‘Surely it couldn’t be’, I thought to myself. Reader: surely yes, it was. 

I’ve always had fussy skin; rosacea-prone and sensitive. Because of this, redness is pretty  much a permanent fixture on my face, as is a collection of small spots (without a head). So at first I didn’t think much about this flare, before realising I knew exactly what this was. 

Now, I don’t say this lightly: POD has by far been the most frustrating difficult skin concern I’ve come across. I interviewed Hailey Bieber a few years ago about her experience with it, but it wasn’t until I’d dealt with it myself, I fully understood. 

Everyone’s skin is different but I found it incredibly valuable hearing others’ stories with POD to help guide my own. So, here is my story about navigating POD as a beauty editor with input from experts I trust the most. 

 


What is perioral dermatitis? 

Perioral dermatitis (POD) is an often misunderstood condition. It presents very similarly to other conditions like acne, however the treatment options for POD and acne are totally different. Let’s  break down the condition’s name itself. Perioral relates to around the mouth and dermatitis related to inflammation of the skin so this equals inflammation around the mouth. 

 

Image- Courtesy of writer

 

The mouth isn’t the only place you can get POD, you can also get it around the nose (which is where it presents for me) or around the eyes. In this case it’s actually called periorificial dermatitis, which means around the face’s orifices. Typically though, POD has become the catch-all term for the condition. 

It presents as a rash around the mouth, nose and eyes and often looks red, inflamed and contains small clusters of red bumps that all look the same. “Usually, they don’t have any pus in them but sometimes they can and they’re also associated with a bit of a scale,” explains Dr Emma Craythorne, consultant dermatologist and co-founder of bespoke skincare brand Klira. It trends to impact women more, particularly in their 20s and 30s. 

Frustratingly, we’re not quite sure what causes POD. There are a few theories but we won’t dive too deep into those (otherwise we’d be here all day).

 


Triggers of perioral dermatitis 

Identifying triggers of POD can be helpful in understanding what products to remove from your routine immediately, but also what might be the cause of a flare-up in the future. Unfortunately, POD is a condition that typically reoccurs (told you, it’s really annoying) so knowledge is power. 

 

Steroids 

Steroids (oral, topical or inhaled) are a trigger for POD so (with the guidance of a doctor if necessary) stop using these for the time being. 

 

Too much skincare

 It seems that our obsession with skincare over the last few years has resulted in some less-than-favourable consequences. Layering skincare or using products that aren’t suited to your skin can be a trigger. “Although people often associate harsh skincare products as causing [POD], it’s usually related to heavy creams or creams that have a lot of preservatives in them,” says Dr Craythorne

 

Fluoride

We’re not sure exactly why but fluoridated toothpaste is reported as being a common one. This is a tricky one because fluoride is a key ingredient to prevent tooth decay so typically isn’t recommended to go without, but when you’re in a flare, try fluoride-free for a while. 

 

Face mask 

If you’re in a job where wearing a face mask is common practice then that might be the culprit of your POD flare-up. 

 

Cosmetics 

Some makeup products can also trigger POD, particularly if you’re wearing heavy, full-coverage makeup. Consider taking complexion products out of your routine completely for a while, or opt for lighter formulas like tinted moisturisers

 


The diagnosis for perioral dermatitis

Getting a diagnosis is really important. Since treatment options differ so much for conditions that look very similar — acne, POD, rosacea and eczema for example — it’s a good idea to know exactly what you’re dealing with before spending any time or money trying to treat it. 

After seeing Catharine Dennings for an unrelated appointment, I showed her a few photos of my eyes from a few years ago, which she noted was likely periorificial dermatitis. So although this felt relatively new to me at the time, looking back at photos now, it’s likely something I’ve been dealing with for a while. 

 

Image – Courtesy of writer

 


Why are more people getting it? 

Before diving into my personal experience and successes, something I was keen to know was whether dermatologists I’d spoken to thought that POD was on the increase. It seems that I’ve gone from rarely hearing about it to constantly hearing about it. 

Because I’m a beauty editor, there has unsurprisingly been an influx in the condition among us in the industry and I’m not surprised. We quite literally try makeup and skincare products for a living so it’s almost a matter of time. But what about everyone else? 

“The most common reason people get [POD] is because of topical steroid creams or inhaled steroids, which is traditional what we always used to see,” Dr Craythorne explains. But now, she’s noticed people are getting it due to “inappropriate skincare products on their face; often these products are heavy facial creams or creams that strip the skin barrier.” 

 


My perioral dermatitis routine

The temptation to throw everything at your skin as soon as you spot a concern is strong, even for someone like me who preaches to treat your skin with kindness. So I knew my plan of attack was more like a “plan to do very little” attack.

Many derms recommend completely stripping everything out of your skincare routine besides a gentle cleanser. Yep, moisturiser, sunscreen — the lot. Although this is the ideal approach, it’s not always the most realistic in day-to-day life. This is what I’ve done to find a middle-ground. It’s also important to note that my POD wasn’t severe, if it was, I’d likely have been a little more strict on the  skincare holiday.

 

Image – Courtesy of writer

 

Dr Ellie Rashid, consultant dermatologist and medical director at Klira. explains that interestingly many people struggle with this side of POD management because it feels out of their control. Given skincare is an aspect we can control, we tend to want to do the most, when in reality, POD needs us to do the least. 

 

Tori after treating her perioral dermatitis. Image – Courtesy of writer

 

Step 1: Remove pretty much all my skincare 

I did what the derms told me and stripped it right back. I’m talking: fancy cleansers, serums, heavy moisturisers and acids. Going no skincare was a step too far for me though so here’s what my routine consisted of: La Roche-Posay Cicaplast B5 Anti-Bacterial Cleansing WashCerave Hydrating Cleanser and if wearing makeup, I’d go for Dr Sam’s Flawless Cleanser

I’d alternate between prescription azelaic acid (finacea) and prescription topical antibiotic (metronidazole) both of which I’ve used previously on my rosacea and knew were OK for POD. If your POD is severe, your doctor might prescribe oral antibiotics. 

For moisturiser, I used La Roche Posay Cicaplast Baume B5, my all-time favourite thick moisturiser. Although I wouldn’t say it ‘helped’ my POD (I think the lack of other skincare was the key here), it certainly didn’t make it worse and kept my skin from feeling dry and rosacea worsening. I also knew this was a tried-and-tested formula for people I knew had POD. Dr Denning put me on Alastin Restorative Skin Complex, which was a brilliant addition to my routine. 

By no means necessary, but I feel like LED light therapy calmed my angry inflammation. I used (which was genius thinking on my part, if i do say so myself) the MZ Skin Lightmax Mininpro Eyeconic LED patches.

 

Step 2: Rethink toothpaste 

It can be a mystery what has triggered your specific but I’m almost sure mine was fluoride toothpaste. Despite being a huge fluoride advocate (should such a thing exist), I had noticed weeks before this flare-up that my mouth was getting quite itchy after brushing my teeth. This could well be a coincidence rather than cause, but after removing fluoride for a few months, things did improve. 

I opted for something that was free from fluoride and sodium lauryl sulphate (SLS). I also went to a hygienist appointment to check I was all OK to skip the fluoride for a while (I have cosmetic dentist work so like to be really on it) and she gave me the all-clear and I’ll go for more regular hygienist appointments. 

I also got in the habit of brushing my teeth before doing my skincare to ensure no residue was left around my mouth. A blessing in disguise because brushing my teeth before my skincare curbed my late night treat temptations too. 

 

Step 3: Stopped wearing makeup 

This isn’t an easy one and I know not everyone is able to do so, but stopping wearing makeup for the few weeks my skin was really angry was the best thing I could have done. Did I feel the most confident going to beauty industry events without makeup? Not particularly but it definitely helped me in the long run. I opted for light makeup or tinted SPF. Colorescience Total Protection Face Shield Flex mixed with the same brand’s regular SPF 50 and if I needed to knock out some of my redness, a little bit of Dr Jart+ Premium Beauty Balm SPF50

I also acknowledge that my perioral dermatitis was by no means severe, if it has been more severe I think I would have struggled with this far more. 

 

Step 4: Not panic 

It’s really difficult when your skin changes to get stressed and panic but I always have to remind myself that the less I worry the better it’ll get. As long as I’m armed with the right knowledge and am doing the right things, I try to stay chilled about it. Plus, I try not to look in the mirror too much and it works wonderfully. 

 

It’s been months since my initial flare up and I’d say it’s really calmed down and (dare I say it) virtually gone in the last month, so this isn’t a quick fix. Perioral dermatitis is a fusspot and wants you to do the least. Kill it with kindness. 

 

Meet the experts

Dr Emma Craythorne is co-founder of prescription skincare brand Klira. She is also a consultant dermatologist, trustee for the Cosmetic Practice Standards Authority and ex-president of the British Cosmetic Dermatology Group. She is well known for her TV series – the Bad Skin Clinic. 

 

Dr Ellie Rashid is a consultant dermatologist at Klira.

 

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Contributing Beauty Editor

Tori Crowther is a beauty and health journalist and qualified nail tech. The former beauty editor of Popsugar UK, Tori regularly write for titles like Allure, Glamour, Marie Claire, and Women's Health and is Contributing Beauty Editor at Live That Glow. When she's not interviewing derms or writing features, you can find her seeking out the best coffee outside of London.

Expertise: Nails, skincare
Education: Nottingham Trent University
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