Perioral Dermatitis & What You Can Do About It
Lately, I’ve been seeing more and more cases of perioral dermatitis. So, I did a deep dive into the research to see what we can do from a nutritional and holistic perspective to help manage it.
Perioral dermatitis is an inflammatory skin condition that appears as small red papules, pustules, or scaly patches around the mouth, nose, and eyes. It is most common in young adult women and can be chronic and recurrent. Symptoms may include burning, itching, and sensitivity, and it is frequently mistaken for acne or rosacea. There isn’t a single cause of perioral dermatitis, but research suggests that a combination of factors can contribute to its development.
Common triggers:
Steroid Creams – these creams can weaken the skin barrier and disrupt the skin microbiome making the condition worse long-term.
Environmental Exposures – Air pollution, allergens, and harsh/sudden weather conditions/changes can irritate the skin barrier, making it more susceptible.
Microbial Factors – The presence of Candida albicans, Fusiform bacteria, and Demodex mites have been linked to perioral dermatitis.
Fluorinated Toothpaste – fluoride may irritate sensitive skin, disrupt the skin barrier, and contribute to inflammation.
Chewing Gum – Certain artificial sweeteners and additives may act as irritants.
Dental Fillings (Amalgam) – There are reports suggesting a possible link between mercury-based fillings and perioral dermatitis.
Cosmetic Products – Skincare products with occlusives, sulfates, artificial fragrances, essential oils and actives like glycolic acid, and retinol, can trigger perioral dermatitis. Also some SPFs can also trigger a flare. Choose gentle, fragrance-free options to avoid irritation during a flare.
Hormonal Factors – Fluctuations in hormones, such as those during the menstrual cycle, pregnancy, or with birth control use, may contribute.
Genetics – Some individuals may have a genetic predisposition to skin barrier dysfunction, making them more susceptible.
Nutritional Deficiencies- such as zinc, vitamin A and omega-3s are common deficiencies when it comes to skin conditions.
Poor Gut Health- gut dysbiosis or leaky gut can trigger perioral dermatitis, this is where the gut-skin axis comes into play. When the gut lining is compromised, it can trigger an immune response, creating inflammation in the body, leading to the development of skin conditions.
Conventional treatment options
Traditional treatments focus on symptom management with topical antibiotics (Metronidazole, Clindamycin, Erythromycin), anti-inflammatory agents (Azelaic Acid, Sulfur, Calcineurin Inhibitors), and oral antibiotics (Tetracyclines for severe cases). While steroids are sometimes prescribed, they often worsen perioral dermatitis by disrupting the skin’s microbiome and causing rebound flare-ups.
HOW IS PERIORAL DERMATITIS DIAGNOSED
Diagnosis is typically clinical, meaning a doctor or dermatologist will assess the appearance and location of the rash. There are no specific laboratory tests, but in some cases, additional evaluations such as skin swabs, bacterial cultures, or biopsies may be done to rule out other conditions like rosacea, seborrheic dermatitis, or allergic reactions.
HOLISTIC TREATMENT STRATEGIES
When addressing perioral dermatitis holistically, the goal is to reduce inflammation, support the skins microbiome, and correct underlying imbalances to help prevent flare-ups and reduce the severity. Here’s what to focus on:
Anti-Inflammatory Foods – Prioritise foods rich in omega-3 fatty acids (salmon, flaxseeds, walnuts) and antioxidants (berries, leafy greens, turmeric) to calm inflammation and support skin repair.
Nutrient Optimisation – Address nutrient deficiencies such as zinc (pumpkin seeds, oysters), vitamin A (liver, sweet potatoes), and B vitamins to promote healthy skin barrier function.
Support Gut Health – Identify and correct gut imbalances with gut microbiome testing. Support gut health with a large variety of fruits and vegetables, fibre and targeted probiotics.
Stress reduction – Chronic stress can interfere with our stress responses. The adrenal glands will produce cortisol when stressed which can suppress the immune system ,leading to greater inflammation in the body, resulting in inflammatory skin conditions. We can’t avoid stress but we can implement stress-management techniques such as breath-work, meditation, gentle movement, and quality sleep. Also please note that use of Topical Steroid Creams can also interfer with the adrenal glands.
Support Your Hormones – If you have tried everything, it might be worthwhile to looking into your hormones with some proper testing. Progesterone or oestrogen imbalances could be whats causing your symptoms. Tracking your symptoms alongside your menstrual cycle could provide valuable insight into whether hormones are the root cause.
Oral Health – Swap your toothpaste to a fluoride-free option. Recommendations: Red Seal, Moo Goo, Grin, Dr Bronners, Grants.
Find A Qualified Nutritionist and Skin Therapist– Working with a qualified nutritionist to address internal imbalances will help you reduce the reoccurrence of perioral dermatitis. It's important to consult with a skin therapist who can guide you on the right topicals, skincare, and makeup regimes.
If you have tried everything and still struggle with perioral dermatitis, it’s time to take a holistic approach and speak to a nutritionist. You can book a FREE 15-minute consultation today. My approach focuses on understanding your unique skin type, diet, lifestyle, and underlying health conditions to create a tailored plan that addresses the root causes of your acne.
Reference:
Tolaymat L, Hall MR. Perioral Dermatitis. [Updated 2023 Sep 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK525968/
Gürtler, A., & Laurenz, S. (2022). The impact of clinical nutrition on inflammatory skin diseases. Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, 20(2), 185–202. https://doi.org/10.1111/ddg.14683