Perioral Dermatitis: A Physician’s Natural Treatment Approach

I didn’t just read about perioral dermatitis in a dermatology textbook—I learned about it by living with the condition on my own face. For years, a red, bumpy, itchy rash around my nose and mouth made me feel frustrated, self-conscious, and totally lost. As a physician, I had quick access to prescription treatments, and tried several of them without success. As a natural skincare formulator, I was determined to solve the puzzle in a more sustainable way. My own experience with this condition played a huge role in the birth of Osmia Skincare—because I realized just how many people were struggling like I was, and how few gentle, effective options were out there.

This post is here to help you understand what perioral dermatitis is, what causes it, and most importantly, how to manage it—because there is hope, and healing is absolutely possible.

What Is Perioral Dermatitis?

The name translates to “inflammation around the mouth,” but it can also show up around the nose and even the eyes, where it’s referred to as periocular dermatitis. It looks like a cross between eczema and acne, and feels like a hot, red, irritated mystery. The rash often includes the following:

• Small, red bumps (sometimes with whiteheads)

• Burning, itching, or tightness

• Flaky or dry skin

• Clear borders around the lips (the area immediately outside the lips is usually spared, as are the lips themselves)

It’s often misdiagnosed as acne or a stubborn patch of eczema, which leads to treatments that can actually make it worse.

What Causes Perioral Dermatitis?

One of the trickiest aspects of perioral dermatitis is that the causes are unique to each person who has it, and it’s rarely caused by one single thing. For example, one person might have it from stress and using too much beef tallow, where another person’s dermatitis comes from pregnancy, fluoride, and stress. Here are some of the most common triggers:

• Overuse of topical steroids (even over-the-counter hydrocortisone) and topical steroid withdrawal (TSW)

• Fluoride in toothpaste

• Sodium lauryl/laureth sulfate in shampoo, toothpaste, and laundry detergent

• Heavy facial creams or ointments (tallow)

• Synthetic fragrance or harsh skincare ingredients

• Hormonal fluctuations

• Birth control pills

• Overexfoliation or over-cleansing

• Certain bacteria or yeast on the skin (though not always the main culprit)

• Stress (almost always a factor, either initially or once the condition is present)

In short, it’s usually the result of disrupting the skin barrier and confusing the skin into a state of chronic inflammation.

My Experience with Perioral Dermatitis

My rash first popped up during a very stressful period of my life and made me feel completely disconnected from my skin. I tried to cover it with makeup (bad idea), and I kept layering on more products (worse idea). I thought I was helping—but I was feeding the fire. When I formulated and started using our Black Clay Facial Soap, I finally started to see some improvement. Encouraged, I developed our Purely Simple Face Cream, and that simple, two-step routine helped me find my way back to healthy skin.

At this point, we’ve helped thousands of people calm this condition down, and I’m actually grateful to my own face for being my greatest teacher. But the healing process requires patience, consistency, and a serious commitment to simplifying your skincare routine, as well as making some lifestyle changes to support your skin.

To this day, if I start using the wrong products on my skin (too many oils) or stop paying attention to my stress levels (time to go meditate, girl), I see early signs of a flare-up within a few days.  Luckily, I know that if I go back to my simple routine and bring some awareness to stress management, I’ll be back on track quickly.

Can Perioral Dermatitis Go Away On Its Own?

Some cases of perioral dermatitis may improve without treatment, especially if you stop using irritating facial and household products. But in most cases, it requires a targeted skincare routine and lifestyle changes to resolve completely. Doing nothing might help temporarily, but healing fully often takes active steps toward barrier repair and inflammation reduction.

Natural Treatment for Perioral Dermatitis: A Simple Protocol

Dermatologists often prescribe topical steroids or oral antibiotics to treat perioral dermatitis. And while that can help in some cases, it doesn’t always address the root causes, which means the dermatitis will usually return. In my experience, a natural, barrier-supportive approach can often be just as effective—without the long-term side effects of antibiotics or steroids, and with longer-lasting results. 

Here’s how to start.

1. Simplify Your Skincare

This is your new mantra: less is more. Cut your skincare down to the bare minimum, ideally using only the two products in our Irritated Face Kit—Black Clay Facial Soap and Purely Simple Face Cream—for 2-4 weeks. 

Skincare products and practices to avoid:

• Harsh exfoliants

• Clay masks

• Retinoids or acids

• Occlusive balms or facial oils (yes, even natural ones, even beef tallow)

• Foaming cleansers

• Anything with synthetic fragrance 

2. Eliminate SLS and Synthetic Fragrance 

Not just from your skincare routine, but from your entire life. I can’t stress enough how important it is to get rid of sodium lauryl/laureth sulfate and synthetic fragrance in your hair care, laundry products, and household cleaners. Here’s a link to some specific brands we recommend in all of those categories.

2. Check Your Dental Products

Some people ask whether fluoride causes perioral dermatitis. While there’s no conclusive evidence, many have seen improvement after switching to fluoride-free toothpaste—especially if other triggers are present. Look for toothpaste and dental floss that are fluoride-free and SLS-free (sodium lauryl sulfate), as these ingredients are common triggers. Brands like David’s, Boka, Cocofloss, and Jason make good options.

3. Ditch the Steroids

If you’ve been using a steroid cream, try to taper off slowly. Going cold turkey can cause a rebound flare, so it’s important that you decrease slowly and steadily over the course of one to two weeks, especially if you’ve been on them for a while. You may see a slight increase in symptoms as you wean, but the longer you stay on steroids, the less your skin will learn to heal itself. 

4. Be Gentle with Your Diet

While there’s no specific diet for PD, it can help to avoid inflammatory foods (like sugar, dairy, and gluten) and focus on whole, anti-inflammatory options like leafy greens, berries, healthy fats, olive oil, and plenty of water. Some people find that eliminating cinnamon, excessive coffee, and spicy foods can help, too.

What Are The Healing Stages of Perioral Dermatitis?

The signs that perioral dermatitis is healing can look different for everyone. Sometimes the symptoms slowly start to recede, with less redness and irritation. Sometimes it gets a bit more red or dry as it heals. Sometimes it gets noticeably worse before it gets better, especially if you’ve used steroids recently. There’s no one pattern to the way perioral dermatitis heals, but it’s usually slow progress!

How Long Does It Take to Heal?

Healing perioral dermatitis takes time and consistency. Most people see significant improvement in 4–8 weeks with the right approach, but flares can happen—especially under stress or with travel, climate shifts, or hormonal changes.

Stick with your simplified routine, and try not to jump from product to product. Your skin needs time to reset and adjust. And remember, making changes more slowly (as opposed to whipping out the steroids) gets results more slowly, but the results can last a lifetime!

When to See a Dermatologist

If your rash is painful, spreading, or not responding after a couple of months of consistent care, it’s time to see a professional. Ask your derm if they’re open to integrative or functional approaches—you want someone who will help calm your skin, not just suppress it with steroids. 

Osmia’s Protocol for Perioral Dermatitis

We’ve created a full protocol based on what helped my skin, and now helps thousands of customers like me manage and calm their skin.

1. Cleanse with our Black Clay Facial Soap

2. Moisturize with Purely Simple Face Cream

3. After 2-4 weeks, if you’re seeing some improvement, you can consider adding our Purely Calm Gel Toner or our Nectar Nourishing Drops. 

Avoid all other products, especially makeup, masks, and SPF during the acute phase (use a hat!)

Make lifestyle shifts to reduce triggers—sleep, stress management, gut health, and all the other products you use in your home really do matter.

You can find more details on the Osmia Skincare Perioral Dermatitis Protocol here. 

Perioral dermatitis FAQs:

—Can you get rid of perioral dermatitis overnight? 

Nope. No matter what the internet tells you at 2am, perioral dermatitis takes time to heal. With this protocol, you should expect to see change within 4-6 weeks. If you only take some of the steps in this perioral dermatitis plan, you should expect it to take longer to improve.

—What is the difference between perioral dermatitis vs. eczema?

Perioral dermatitis and eczema (also called atopic dermatitis) are both forms of dermatitis—think of them as first cousins. Perioral dermatitis is limited to the skin around the mouth, chin, and nasolabial folds (smile lines), and near the eyes, while eczema can happen anywhere on the body. This protocol will be helpful for both conditions, as many of the triggers for eczema are the same as perioral dermatitis triggers.

—What are the signs perioral dermatitis is healing (and what to expect)

Signs that your perioral dermatitis is healing include decreased redness and dryness, and fewer bumps. Sometimes there is a period of increased redness or dryness before noticeable healing begins, but ultimately you should see more areas of healthy, hydrated skin as your dermatitis starts to resolve.

—Is perioral dermatitis bacterial or fungal?

It’s unclear if bacteria or fungi play a role in perioral dermatitis. Some people believe that demodex mites can cause perioral dermatitis, but they actually cause a condition called folliculitis that is treated differently than perioral dermatitis. Antibiotics can help treat perioral dermatitis, but it’s unclear if the mechanism is attributed to specific antibacterial activity or to breaking a cycle of chronic inflammation in the skin.

Be Kind to Your Skin—and Yourself

Perioral dermatitis isn’t your fault. Your skin is simply telling you it needs less—less stimulation, fewer ingredients, more peace. Listen to it. Support it. And don’t be afraid to reach out to the Osmia team if you need help—we’ve been there, and we’re always happy to guide you back to healthier, happier skin.