OK, I know what you're thinking already: What the F is perioral dermatitis?!
Before I answer that, I just want to preface today's long post to say, I will not be posting photos of my face currently for a handful of reasons but mainly, I just couldn't bring myself to photograph the current state of things just yet. Perhaps I will eventually if I can muster the courage, but for now, here are some flashback photos to 2016, when I was on the upside of my struggle with adult acne (you can read that full post here).
Back to the original question though: what the F is perioral dermatitis?
Well, I wish I knew more, really. To be completely honest, I had no idea it was a thing until a few weeks ago when a random string of Googling the following:
"Weird, red, bumpy rash around mouth"
led me to a WedMD page about ... drumroll please...perioral dermatitis. And in short, it's more or less what I described above: a weird, red, bumpy rash around your mouth. Let's back up a bit though for context.
A few weeks ago, around the end of January, beginning of February, I noticed a small cluster of itchy bumps on my upper lip, toward the corner of my mouth. Appearance wise, they kinda looked like a cluster of zits. But also, kinda not. Considering, this isn't my first round at the acne rodeo, I immediately sensed it was something else, based on the location and the itching sensation. These didn't seem like my typical pimple (sigh, yes, I do indeed have a typical pimple) but that left me wondering, what the HECK are they?
Knowing me, I tried to avoid stressing about it as much as possible (because it only gets me into trouble when I do), and decided to let the darn thing just breathe for a few days sans makeup. But then, over the course of a few weeks, it slowly started to spread. Around my mouth and across my chin. That's when I started the midnight Googling, which landed me down the rabbit hole of Google Image horror. A few (hundred) links later and I was certain it was perioral dermatitis (which in plain English just means a rash around your mouth).
Granted, my rash isn't bright red like a lot of the images online might lead you to believe but apparently this is to be expected on people with more color to their skin. It is quite bumpy, flaky, dry and slightly itchy though. And in comparison to a lot of those photos, mine doesn't look as severe...yet anyway. Hence why I immediately booked an appointment with my dermatologist the very next day, who promptly confirmed my fears: yes, it is perioral dermatitis and no, it's not here to take over your life.
After making a general game plan with her and A LOT of late night Googling, I've put together everything I know about this less than appealing (but very common) rash in hopes it helps someone else out there!
Some starter facts...
Thus far, here's what I know:
- Perioral dermatitis is actually quite common, particularly among women between the ages of 16 - 45. (Considering the large amount of you guys who sent in DMs on Instagram, it also seems to be something not all of us talk about openly!)
- It is NOT contagious.
- It can spread past your mouth, up around the nose and for some folks, around the eyes.
- It usually resolves itself, but pretty slowly. For some folks it lasts a few weeks, others months. (UGH.) If you come into contact with whatever triggered it initially, you can relapse.
What causes it?
I think perhaps the most frustrating thing about perioral dermatitis is how difficult it is to pinpoint the cause and also the most effective treatment for it. Generally speaking though, most common causes include:
- Excessive use of steroid creams on your face
- Certain nasal sprays
- Fluoride toothpaste
- Heavy skin creams or heavy moisturizers
- Home and personal hygiene products that contain SLS (sodium laureth sulfate)
- Hormonal changes
- Birth control pills
- Extreme cold and/or high winds
- Excessive UV light
- Bacterial or fungal infections
- Having a pulse
The last one is a joke, but the point is this: there are a lot of possible triggers for PD (yep, we're nicknaming it because I'm lazy and I don't want to type it out each time), a lot of which are in your control and some of which aren't. So we can't beat ourselves up over it, right?
So here's my theory...
While I can't necessarily pinpoint what caused mine with great certainty, I have a hunch. And here it is: Given that I receive a lot of beauty products for my blog, I test out new lines that seem interesting and worthwhile to me pretty often. Toward the end of last year and beginning of this year, I started using the Tata Harper Velvet Moisturizing Cream, which is an amazing product, just on the thicker side. Of course, now that we're in winter, I figured my skin would love the extra TLC with a heavier step in my routine.
Add in the fact I had a string of editorial shoots (for my Funny Face series, this Carolina Herrera shoot and this Brooklyn Bridge shoot), all of which had me outside in high winds and freezing temperatures with a lot more makeup on than what I usually wear and well, I like to think it was a perfect storm of a lot of different triggers.
I've always known my skin is pretty sensitive (and acne prone) so this latest development just reaffirms it. As much as I'd love to be that girl who can test out new beauty products all the time, I just don't think it makes sense for my skin and my body. More on that later though.
How to treat it?
Since I love a good plan, I've put it into phases for myself (and perhaps some of you!):
PHASE ONE // ASSESSMENT
First step should always involve your dermatologist, so if you're battling this right now, I highly recommend you consult yours ASAP. I'm by no means a doctor myself so all of this rambling post should be seen as "somewhat informed advice from a friend who loves to Google late at night, all of which needs to be run by a doctor first." Cool? OK, moving on.
Next, we audit the routine.
- Keep your skincare routine STUPID simple. By that I mean, stick to just a gentle SLS-free cleanser (my dermatologist recommended my favorite by CeraVe) and a gentle moisturizer (like this one and this one). The point is to find products that are SLS-free, fragrance-free and are meant for those with very sensitive skin. Don't exfoliate. Don't scrub. Don't do anything too harsh to your skin right now. Don't do all 10 steps in your routine. Let it relax.
- If you can avoid it, skip makeup as much as possible. Your skin really needs to breathe right now and foundation + concealer will just make it angry and possibly feed the infection.
- If you must wear makeup, try to stick to brands that are SLS free and wear as little as possible. I know, I know. Easier said than done.
- Go through the rest of your home and personal hygiene products to ensure they are all SLS-free. This means: laundry detergents, shampoo and conditioners, body wash, hand soap, hair care products etc.
- Swap out your toothpaste for one that is fluoride free.
- Of course, if you are using a steroid cream at this point, STOP IT immediately. It will only make matters worse.
- There's a slew of other creams and natural ingredients you can put on your skin to soothe and alleviate the rash (like diaper rash creams with zinc, organic greek yogurt, coconut oil and apple cider vinegar). I haven't tried any of them out yet, but generally, I'm sticking to the STUPID simple route. LESS is MORE when it comes to PD.
PHASE TWO // NATURAL APPROACH
As far as treatment goes, I'm allowing myself a two month approach here. The first month, I'd like to approach things as naturally as possible using food, vitamins and supplements. The main goal: to fix my gut, which I'm a firm believer is SO connected with our skin health. While I'm a relatively healthy person with somewhat admirable eating habits, I'm definitely not perfect either. For the most part, I avoid dairy and sugar, and try to consume processed foods sparingly. This month, though, I'm going to be very strict with myself.
If I don't see improvements at the end of this month (so by April 5), I'll move to the MEDICINAL APPROACH detailed after this section.
- Considering I've been getting a slew of pretty bad breakouts in tandem with this PD (OH JOY), I'm taking a page out of Bekah Martinez's book: LOTS OF PROBIOTIC FOODS. While I haven't been a Bachelor fan in YEARS, it was so refreshing to see someone like Bekah Martinez find her voice after the show. I really appreciated her candor and her honesty when it came to her own personal struggle with severe adult acne and I bookmarked her probiotic diet a few weeks ago before this whole debacle started. The idea is simple: my gut health isn't where it should be and I need to build it back up again with some probiotic rich foods. Bekah does a great job detailing her routine in this post, but essentially, here's the 5 products I picked up at Whole Foods at her recommendation:
- A daily probiotic and prebiotic supplement
- Evening primose oil supplement
- Of course, supplements are useless if you're not already getting a balanced diet with real, meaningful nutrients. This month, I'm dedicating myself to eating as clean as possible. No dairy. No refined sugars. No processed foods. No red meat -- only fish. No eating out basically, ha.
- Drinking organic, no sugar added aloe juice (inner leaf). I've read in a number of forums and blog posts now how amazing Aloe Juice can be for skin because of the antioxidants and minerals in it. I drink 4oz of aloe juice mixed with 4oz of water at night.
- I'm also waiting for my at home allergy test kit to arrive -- looking forward to learning what foods I might have sensitivities to!
- I'm also considering consulting a homeopathic doctor soon -- if anyone has recommendations, I'd love to hear them!
PHASE THREE // MEDICINAL APPROACH
If by the second month using the natural approach doesn't help alleviate the symptoms (or if my skin gets worse), I'll likely continue a lot of the diet choices above and start:
- A round of oral antibiotics called doxycycline (typical treatment lasts 3-4 weeks)
And that folks, concludes my very long-winded post about PD. If you've made it thus far you either: a.) have PD, in which case, HI, I SEE YOU! or b.) you got bored watching the Bachelor re-run. Either way, I'd like to end on this note: if there's anything that skin issues have taught me thus far in life, it's how easy it is to fall into the trap of self-loathing. And unfortunately, no matter how many times you go through them, it never really gets easier to shake it off. But I'm here to tell you: I know how you feel. I know the embarrassment. I know the shame. I know the pain you might feel when you don't like what you're seeing in the mirror. You're not alone. Allow yourself time to feel sad about it but don't let it control you. Put together an action plan with a trusted doctor/dermatologist and get out there to kick ass. And smile.
Of course, if you want to chat about any of the above, feel free to shoot me an email too or drop a comment below!