Perioral Dermatitis - A Holistic Approach
Perioral Dermatitis can be itchy, painful, and a real drag. Don’t despair; there are ways to help reduce flare-ups and even prevent them altogether.
Prevention & How to Reduce Flare-Ups
What is PD?
Perioral dermatitis (PD) usually appears as a red, bumpy, sometimes scaly, uniform rash. With darker skin, the lesions may appear browner in colour.1 The bumps may also contain a clear fluid discharge, be itchy, or have a burning sensation associated with them. PD sometimes resembles acne vulgaris or rosacea, and is oftentimes misdiagnosed as such; however, a common difference with PD is the rash-like dryness, which can help separate it from the others. This condition is most common in women between 20 and 45 years old but can be seen in all ages and genders.
My clients see the best results when PD is approached holistically, meaning both internally and externally.
What causes PD?
Inflammatory skin conditions like PD are complex, often leaving much room for trial and error in addressing it. Some information indicates a link between PD and topical steroid creams, asthma medications, heavy moisturizers, and sunscreen. PD, however, is not contagious; it cannot spread from person to person.1
From current research, and my experience with clients, it would appear that the main triggers for PD include stress, fluoride, topical steroid use, harsh skincare, compromised skin barrier, sluggish liver and detox pathways, gut dysbiosis, and hormonal imbalances. The common thread is that these triggers create a perfect storm for inflammation. Skin conditions like PD feed off inflammation, creating a vicious circle that can be difficult to break. I see the best results when we use external rituals to calm the inflammation, while leaning on internal rituals to identify the root cause(s) to stop the inflammatory cycle for good.
Preventing or Reducing Flare-ups:
Less is more
Keep skincare simple
Eliminate any abrasive scrubs, exfoliating products, and anything that is aggressive on the skin
Get rid of all fragrance, including essential oils; fragrance-free is key
Focus on gentle hydrating products
Avoid steroid creams, even non-prescription hydrocortisone
Avoid Sodium Lauryl Sulphate (SLS)
Repair the Skin Barrier
Follow a gentle skincare routine for at least 4 weeks
Get a hydrating facial mist with aloe and hyaluronic acid
Use SPF daily
Wash your face with warm water (not hot)
Eat gelatinous foods like grass-fed gut gummies
Add collagen to your foods and drinks
Try a humidifier (especially if in a colder, dry climate with central heating and harsh wind)
Remove Fluoride
Those who are sensitive to fluoride may experience a weakened skin barrier around their mouth
Chronic fluoride exposure has been linked with perioral dermatitis and simply switching to fluoride-free toothpaste can help the skin repair itself and alleviate redness
Avoid Inflammatory foods
Heavily processed and packaged foods
Inflammatory oils (sunflower, canola, palm, etc.)
Excessive amounts of gluten
Reduce stress
Write in a daily gratitude journal
Try breathwork, yoga, or swimming
Consider a ritual like the tapping solution, (i.e., Emotional Freedom Technique (EFT))
What is EFT? A form of acupressure that uses the fingertips to stimulate parts of the body.
Repair the Skin Barrier
The skin is the body’s largest gatekeeper from the outside world. The skin craves homeostasis and, when supported correctly, a healthy skin barrier can heal and balance itself, making you less prone to irritation and breakouts.
Why is barrier function so important? The answer comes down to hydration. When the barrier is intact, water is retained in the skin and this in turn keeps the skin healthy, which is necessary for all enzymatic reactions. A strong barrier prevents bacteria, viruses, and other potential contaminants from permeatingthe skin and triggering an inflammatory response. When the skin is not concerned with fighting invaders, it can focus on healing and regeneration. It’s this overactive immune response that contributes to chronic skin conditions like PD. The goal is to break the inflammatory cycle.
Bring it All Together: Holistic Habits
Looking at skin from a holistic perspective is foundational to life-long healthy skin. Supporting your skin barrier with good lifestyle practices will go a long way. Some include:
Prioritize Sleep
Prioritizing quality sleep serves the skin in so many ways. Think of sleep as the skin’s time to heal and repair itself. Sleep promotes cellular turnover and regeneration.
Support the Liver
Clearing sluggish detox pathways dramatically impacts the skin and is a great foundational step in calming and clearing inflammatory skin conditions, like PD. An overburdened liver from daily stressors and modern life is common; I see the best results when including liver supportive rituals in a client’s treatment. Start by opening the drainage pathways through the colon, kidneys, and lymphatic system.
Repair the Gut
The gut and skin are your primary interfaces with the external environment. If your gut is unhappy chances are your skin is breaking out, and your skin barrier has been compromised. A healthy gut contributes to skin homeostasis and a healthy skin barrier, which helps the restoration of healthy skin post irritation or flare-up. It also decreases Transepidermal Water Loss (TEWL).
Balance Hormones
A compromised barrier, irritating skincare, and estrogen dominance can be the perfect environment for PD to thrive. To calm PD in this case, we see the best results when we address estrogen dominance to calm the immune response, while repairing the skin barrier. Generally, estrogen boosts the immune system,2 which is why estrogen dominance can aggravate PD. This is sometimes why we see a connection between hormonal birth control use and PD, due to the flood of artificial estrogen.
Your Key Takeaway
Inflammatory skin conditions are multifaceted and may have a lot of contributors and aggravators. Take a minute to think about what was happening around the time you first noticed PD flaring up. I find that this is often a great place to start, to help pinpoint what might have triggered it. Combine your favourite rituals of nutrition, lifestyle, mindset, and skincare for long-term success. With a holistic approach, clearing PD for good is possible!
References:
2. https://drbrighten.com/immune-system-hormone-guide/
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