As discussed in our previous article (What Causes Perioral Dermatitis?) it can be really hard to work out what’s caused a bout of perioral dermatitis, which means it can be very hard to treat!

But with any outbreak of perioral dermatitis, there are few things you can try even if you can’t pinpoint exactly why it’s happening. First of all, go to the GP and get a diagnosis, so you can rule out any other skin conditions, and decide on appropriate treatment. 

With a mild case of perioral dermatitis, a good strategy is to tackle the problem from two sides (avoid irritating triggers; boost the resilience of your skin) and see if it improves on its own.

If your perioral dermatitis doesn’t get better after a few weeks of doing that, there are some medical treatments available.

1. AVOIDING IRRITANTS

• Avoid topical corticosteroids*
• Switch to a unfluorinated toothpaste and/or mouthwash
• Talk to your doctor about switching to a different contraceptive 
• Avoid using make-up, or try hypoallergenic brands.
• Use a mild, natural soap-free cleanser instead of soap.
• Avoid fragranced skincare, or toiletries that contain irritant ingredients (which, don’t forget, can include essential oils!).
• Switch to a hypoallergenic sunscreen and stay out of the glare as far as possible.
• Keep a food diary and avoid spicy or acidic foods if they’re causing the rash to get worse. Some foods do seem to aggravate perioral dermatitis, but these can vary from person to person.
• Ask your GP to refer you for allergy-testing if you suspect something you’re eating or coming into contact with is causing a flare-up.
• Switch your laundry detergent to a natural one and check out the tips on our Detergent page.
• Switch to SLS-free shampoo.

2. LOOKING AFTER YOUR SKIN

• Feed it with nutrients so it can repair itself and normalise the cycle of regeneration; use skincare rich in EFAs, vitamins, antioxidants to support the robust functioning of the skin barrier function.
• Keep it well moisturised; use an unscented moisturiser every morning and night.
• Wash your face very gently in warm, not hot, water.
• Use a gentle antimicrobial rescue oil on your face to keep possible infections at bay; our Balmonds Scalp Oil is perfect, but patch test first.
• Always patch test, even if it's a natural product. See our Patch Test page for more information.
• Establish some anti-stress strategies as a matter of urgency. Stress plays havoc with the skin, and in order to manage your health it’s vital to reduce daily anxiety and pressure. You may need a change of environment, to take some time off or find ways of de-stressing every day. Talk to your doctor, union, HR or employer about how you need to look after your health. More information here.
• Get a full night’s sleep. Sleep is an underrated medicine, but going short on it will affect how resilient your skin is and how your body reacts to irritants.

If avoiding triggers, switching to non-irritant alternatives and changing your skincare routine doesn’t improve your perioral dermatitis, you can ask your doctor about other treatments. Of course, these should not include steroids, but there are still some options for you.

3. MEDICAL OPTIONS

• Immunosuppressants such as tacrolimus or pimecrolimus creams
• Topical or oral antibiotics
• Topical acne medications

*If you stop using steroids, you’ll need to work out how to manage the condition you were originally using them for, so consult your GP or a dermatologist. It’s possible that if you stop using steroids suddenly, you’ll experience a rebound of inflammation which the steroids were suppressing. This should pass, but it’s worth checking strategies for managing inflammatory responses.

Check out the next article in our series on perioral dermatitis for a three-part natural skincare routine designed to manage flares: What’s The Best Moisturiser For Perioral Dermatitis?

Try Balmonds Scalp Oil as a moisturising rescue oil.