Ever felt like your skin is staging a revolt? That's how I felt when I first stumbled upon perioral dermatitis. It's a skin condition that can leave you feeling frustrated, and it's more common than you might think. Let's dive in!
Before I knew anything about it, I was just like you, scrolling through social media, when I first heard about perioral dermatitis. I didn't even realize there was more than one type of dermatitis! So, I reached out to Dr. Shammi Theesan, a founding dermatologist at Ode Dermatology, to get the lowdown.
So, what exactly is perioral dermatitis?
Dr. Theesan explains that it's a condition where the delicate balance of your skin's microbiome is disrupted. This can lead to an impaired skin barrier, resulting in bumps, redness, itchiness, and a tight, sometimes even sore or pus-filled feeling. It typically shows up around the mouth and nose, but it can also extend to the sides of the eyes. Ouch!
What causes this skin condition?
It often boils down to the skincare we use. Are you using too many products, especially those with active ingredients like vitamin A or C? Are you 'slugging' (applying a thick layer of occlusive product) when it's not suitable for your skin type? Is your foundation too heavy? These are all questions to consider if you're dealing with perioral dermatitis, Dr. Theesan says.
And this is the part most people miss... The most common culprit? Incorrect use of topical steroids. This includes both prescription steroids, often prescribed thinking the rash is eczema, and steroid-based nasal inhalers. Hormonal changes, like those during postpartum or perimenopause, can also play a role.
Who's most likely to be affected?
It's most common in young women aged 20 to 45, particularly those with lighter skin tones. While less common in men, children can also experience it, typically between seven months and 13 years old. The symptoms include skin tightness, scaling, redness, and difficulty with makeup or moisturizer application.
"Sometimes you can get pimple-like bumps, but you don’t have any whiteheads or blackheads," Dr Sammi says. "You can have little fissures or cuts in the corner of your nostrils or the sides of your mouth called the oral commissure, and your skin just feels bumpy [and] dry and you’ve got these satellite lesions of red bumps and spots.”
Is it a life sentence?
Thankfully, no! Dr. Theesan assures us that it doesn't have to be permanent. It's a team effort between the patient and their dermatologist to rebuild that skin microbiome.
How can you treat it?
It's not an overnight fix. It requires lifestyle changes and treatments. Removing the offending agents, like topical or inhaled steroids and heavy makeup, is crucial. Improving gut health and reducing stress are also key.
Dr. Theesan recommends a gentle, vitamin B or niacinamide-based moisturizer, a ceramide-rich cleanser used once a day, and prioritizing sleep. She also suggests reducing dairy, gluten, and processed foods. And of course, consulting a dermatologist for oral and topical treatment options.
But here's where it gets controversial... What if the root cause is something other than skincare or steroids? Could diet play a larger role than we realize? Are there alternative treatments that aren't being discussed?
I'd love to hear your thoughts! Have you dealt with perioral dermatitis? What worked for you? Share your experiences in the comments below!
