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Perioral Dermatitis Lifestyle Changes


Since writing my first article about perioral dermatitis, and having to manage the condition on my own face, I have become quite the expert on the subject! We get a huge number of emails each week from people who are interested in a natural, more long-term method for healing perioral dermatitis after steroids and antibiotics from the dermatologist have left them feeling frustrated and hopeless. I’ve had the amazing privilege of seeing some before and after photos, in which someone's dermatitis is hardly noticeable after four to six weeks of strictly following our plan. Of course, results are not universal, and things vary from person to person. But, I’ve been incredibly touched by reports of people going out on dates for the first time in months, women wearing way less makeup because their skin looks so much better, and people just remembering how to smile again! (Both of these images are of an Osmia customer, who gave her permission for us to use them. She had a great recovery, and is still a wonderful customer.) 

woman with perioral dermatitis
In addition to using the Osmia products that are safe for perioral dermatitis (they're all here), we recommend switching out these other products in your daily routine, as well as a few other lifestyle recommendations. And, if you haven’t read the original article about PD on our site, you should start there and then pop back here for next steps. 

WHAT KIND OF TOOTHPASTE SHOULD I USE IF I HAVE PERIORAL DERMATITIS?

You need to look for a toothpaste that is free of BOTH fluoride and sodium lauryl/laureth sulfate. For many years, I've used Jason Seafresh Deep Sea Spearmint—the paste, not the gel. I get a lot of calls from people who are using fluoride-free toothpaste, but are surprised to find that SLS is still hiding in the ingredient list—be sure to check your labels, even if you're using a natural brand! When I travel, I love using Bite fluoride-free toothpaste bits, which are also safe to use with perioral dermatitis. 

WHAT KIND OF SUNSCREEN SHOULD I USE IF I HAVE PERIORAL DERMATITIS?

This is the toughest question I get about PD, and one that may have a different answer for different people. The only two natural options when it comes to sunscreen are zinc oxide and titanium dioxide, referred to as barrier sunscreens. I tend to use zinc oxide as my main sunscreen ingredient, because it protects your skin from both UVA and UVB rays, which titanium dioxide does not.

Here’s the problem: many of the natural sunscreens I have tried make my perioral dermatitis symptoms worse. Lots of them are oil-based, and the heavy oils make my red bumps appear. Non-nano zinc and titanium are very white, and can make flaky skin look more pronounced. It may take some trial and error for you to find the perfect products, but the two that work best for me are Mychelle Unscented SPF 28 and the Sliptint by Saie. I usually blend them together in my hands and apply them as a single layer. 

Other brands I've tried and liked include Coola, Babo, and Suntegrity, in case the Mychelle and Saie aren't right for you.

WHAT KIND OF HAIR PRODUCTS SHOULD I USE IF I HAVE PERIORAL DERMATITIS?

Most importantly, choose a brand that does not use sodium lauryl/laureth sulfate or synthetic fragrance. Here are the brands I come back to again and again for my coarse, wavy, increasingly gray hair:

  • Desert Essence (unscented) is inexpensive, and great for people with chemical and scent sensitivities. Also nice to use on your kids, as you don't cringe when they spill 1/4 of the bottle from squeezing too hard. 
  • Josh Rosebrook products are amazing, and leave my hair super soft. I love the Balance shampoo and conditioner, which smell phenomenal, and make my hair air-dry in nice chunky curls. His serum spray is great for days when you're blow drying your hair.
  • Innersense Organic Beauty has several options, and all of them are lovely. Recently I've been using their unscented Clarity line, which I take to the salon with me when I get a haircut. The rich conditioner that works especially well for my thick, wavy hair.
  • Evolvh's Ultrashine shampoo and conditioner are both lovely, with a tangy grapefruit scent. 

WHAT MAKEUP SHOULD I USE IF I HAVE PERIORAL DERMATITIS?

Ideally, you should not use any makeup while your skin is angry and red—any day you can go without makeup will help your skin heal. Once things are on the mend, or if you have an event that requires some makeup, these brands are my favorites for perioral dermatitis. 

  • Alima Pure is wonderful for powder foundation and eyeshadows, with a huge array of colors.
  • Saie is one of my favorite brands, and makes up most of what's in my makeup bag!
  • Ilia is super popular. I have not used their foundations, but love their lip oils!

Ingredients to avoid in makeup over the affected skin are bismuth (in many mineral foundations and powders), talc, parabens, petroleum, and possibly beeswax (it forms a heavy layer on the skin and can be too occlusive).

Oh, and don't forget to WASH YOUR BRUSHES!! I use our Oh So Soap and warm water about every two weeks.

WHAT KIND OF LAUNDRY DETERGENT SHOULD I USE IF I HAVE PERIORAL DERMATITIS?

My two favorite brands are Molly's Suds and Branch Basics. They both offer loads of options, for laundry and lots of other tasks around the house, like dishwasher detergent and cleaning sprays. 

WHAT OTHER LIFESTYLE CHANGES WILL HELP HEAL MY PERIORAL DERMATITIS?

Limit Coffee (At Least for a While)

Ouch. I know it’s painful even to discuss. I generally recommend limiting coffee to a cup or two a week, and drinking tea the other days if possible. Eventually, once things settle down, you may be able to go back to a cup a day, or two cups of half-caff like I do!

Limit Gluten, Dairy, and Sugar

Again, this may vary significantly among PD sufferers, but I don't think it's coincidence that in traditional Chinese medicine, the area of skin affected by PD is linked directly to digestive issues.

In general, I have found that the three most inflammatory food groups are wheat (gluten), dairy, and sugar, and I recommend that PD sufferers limit these items significantly. It’s not as hard as you think it’s going to be—I promise. Tons of dark greens, fresh veggies and fruits, less processed food in general, and plenty of high-quality protein.

All this said, do not become a complete stress case over your diet. Stress is a factor in every case of PD, and if you are in a state of permanent anxiety over what to eat, you will not be helping yourself.

Try an Evening Primrose Oil Supplement

If you're not pregnant or trying to become pregnant, you might consider taking evening primrose oil. For over ten years, I have taken this evening primrose supplement for my skin and for hormonal support, and I actually notice a difference when I stop taking it. There's no good, hard science to support it, but anecdotally, I can tell you it's helped me any many others. 

Commit to Active Stress Management

Having perioral dermatitis is not fun. It’s your face, and it affects your confidence and your interaction with the world. But it’s not cancer. It’s not hunger, or lack of fresh water, or poverty. And it doesn’t define you.

The simple fact is that the more you stress about the condition, the worse it gets.

I think there may be a correlation between PD and Type A personalities. This is not meant in a derogatory way—I am Type A Plus, if there is such a thing! It simply means that the same adrenaline that can make Type A people super-productive can also affect the skin. So, maybe be less Type A about your face? Stop spending endless hours hunkered in front of your computer researching miracle cures (there are none). Don't look in the mirror every five minutes. Stop trying olive oil & powdered sugar one day, and yogurt masks the next, and vinegar the next. Your skin won’t calm down if you don’t calm down, and changing your routine every couple of days is super confusing to your skin.

In order to heal your perioral dermatitis, you will have to manage your stress—about this condition and anything else that feels out of control! You can use breathing, yoga, meditation, exercise, or a cup of tea, but you need to do something every day to quiet your nervous system. Approach your skin with the understanding that it is not DOING this to you, but is telling you something important about your whole health. Make small changes and be consistent. Try things for three weeks at a time, rather than three days. Keep a journal, and take a photo in natural light without makeup once a week (and only once a week), so you can see changes over time.

Other Tips for Healing Perioral Dermatitis
  • Hands off! Only touch your face when you are washing it or applying product with clean hands. 
  • Handle your facial skin gently. If you exfoliate, do it gently! And resist exfoliating when your skin is red and angry.
  • Apply your facial products first, then your body products. The body products use heavier oils, and you don’t need them on your face if you have perioral dermatitis or acne.
  • If your face gets red after washing/applying products (most perioral dermatitis will look worse immediately after washing), try doing your routine only at night for a while. Then your face has all night to soak up the products, and should look more calm when you wake.
  • Don’t wear makeup unless you have to, at least while your skin is super upset.
  • Try a mask of raw honey (but not the solid kind that is hard to spread) a couple times a week. Wash first, then apply honey and leave for 5-10 minutes. I do this in the steam of the shower, so the honey is almost getting “steamed” into my skin. Rinse very thoroughly.
  • If you are going to choose the antibiotic route, oral antibiotics are probably the way to go, as the topicals seem to have other ingredients that can irritate your skin.
  • Lastly, if your dermatologist recommends a steroid cream or lotion (most steroids end in “-one” like cortisone), ask if he or she is aware that steroids are the leading cause of perioral dermatitis. It’s okay to be an educated patient!!

Hope this helps, and please email us at info@osmiaskincare.com if you have other questions about perioral dermatitis or about how to use our products to help your skin start to heal.

With love and much patience from us to you,