I Developed Perioral Dermatitis Practically Overnight—Here's What Helped

Let me be clear: The above picture is not even remotely close to what my skin looked like from December 2021 to February 2022. (Guys, this is definitely an after.) And while I very much wish I could supply you with a before, I was so traumatized by the complete 180 my skin did last fall that I quite literally didn't take even one photograph. To be completely honest, I wanted to crawl into the deepest, darkest black hole planet earth could offer me, never to return.

As much as I hate to say it, and as much as I wish I was above feeling self-conscious about less-than-perfect skin, I was in a complete state of panic, anxiety, and depression. Practically overnight, my skin had gone from clear, even, and glowy, to red, inflamed, and bumpy—mostly around my chin, mouth, and nostrils. Sure, that might seem dramatic, and there are certainly far worse things happening in the world than my all-of-a-sudden inflamed skin, but I think anyone who has dealt with any type of skin condition will understand the toll it can take on your psyche and self-confidence. Especially when you have no clue what it is, what caused it, or how to treat it. 

I talk more about what happened here, but after a few weeks of research and product experimentation and little to no improvement (in fact, the redness and bumps only seemed to get worse, spreading like wildfire), I booked an appointment with a dermatologist in Arizona where I was living at the time. After talking to a friend who had something similar happen and was diagnosed with perioral dermatitis, I had a hunch that was what I was dealing with. But I wanted to consult a professional A) to confirm and B) for a treatment plan. 

Sure enough, my derm only needed to look at my skin for two seconds before proclaiming that the rash-like spread of bumps and pustules around my nose and mouth was perioral dermatitis—likely triggered by stress and/or a recent overuse of active skincare products. To help clear the situation, he prescribed me a specialized antibiotic, and while he said the PD could come back eventually, the treatment would clear it up. (Spoiler: It worked like a charm!) Even after my skin had cleared, however, I was curious about PD. According to my research, it's very much on the rise, and way more likely to affect women—Hailey Bieber has even said it's something she struggles with. 

Since it's still a bit of a murky topic, and since, apparently, lots of other people are probably also dealing with PD, I decided to reach out to more experts in the industry to get their take—what perioral dermatitis is, what products to use and avoid, and what the "ultimate" if I may, skincare protocol would look like for people struggling to get their inflammation under control. Of course, you'll most definitely want to book an appointment with a professional—I definitely don't recommend self-diagnosing—but consider this a helpful, supplementation resource. Keep scrolling! Everything you ever wanted to know about PD is just ahead. 

First of all, what the heck is perioral dermatitis?

According to Joshua Zeichner MD, FAAD, Perioral Dermatitis is thought to be a cousin to rosacea, is often mistaken for acne, and is a rash characterized by red bumps and pus pimples around the mouth and nose. (If you want a reference to what my face looked like in a matter of just weeks, click on that hyperlink above.) Oh, and one more fun fact: about 90% of cases are found in women. 

"The cause is unclear, but the condition is thought to be associated with the use of cortisone creams, heavy ointments, fluorinated toothpaste, hormonal changes, over-exfoliation, and most recently, wearing face masks," notes Zeichner. "Similar to rosacea, the skin likely develops a sensitivity to the environment and over-reacts with extra inflammation, leading to the characteristic bumps."

Interestingly, I had been wearing face masks less in Arizona (where they weren't mandated), but I had gone a little heavy with a couple of new active/exfoliating skincare products which might have injured my skin barrier and triggered that inflammatory response Zeichner mentioned. I was also going through an especially stressful time emotionally which could have played a part as well. Unfortunately, I'll never really know, and as my dermatologist told me upon the diagnosis, there are still a lot of unknowns surrounding the condition.

Products to prioritize and avoid if you have perioral dermatitis:

Prioritize: Both Zeichner and Sofie Pavitt, a New York-based esthetician and acne whisperer, agree that the best products for dealing with perioral dermatitis are benign, protective formulas that will help calm, soothe, and repair an aggravated skin barrier. "Gentle, protective products are key when treating something like Perioral Dermatitis," confirms Pavitt. "An occlusive moisturizer such as Glossier's After Baume ($28) would be perfect; it's a great barrier cream that protects the skin after application and immediately soothes inflammation. It also has the National Eczema Association Seal of Acceptance so it's perfect for the most sensitive skin." Additionally, Zeichner notes you'll want to stick to ultra-gentle cleansers that won't disrupt the outer skin layer. 

Oftentimes, you'll need to combine the right skincare regimen with an antibiotic prescribed by your dermatologists, such as tetracycline or erythromycin to fully clear the skin—I took the former for about two weeks which worked wonders. (Just be sure to incorporate a high-quality probiotic to keep your gut health in check—I'm obsessed with the below from Cymbiotika.)

Avoid: If you're taking any type of hydrocortisone cream (without a doctor's okay) stop using it, and if you're taking a prescription corticosteroid, consult with your doctor to see if you can stop applying it. While these types of treatments might seem helpful, they can easily trigger or worsen perioral dermatitis. Pavitt also recommends avoiding any "active" products that include harsh ingredients like acids and retinol. (Fear not—you'll be able to resume your regimen once the condition completely clears.)

The expert-approved skincare protocol for perioral dermatitis:

"You'll want to think simple, simple, simple, when creating a skincare routine if you have PD," says Pavitt. "Don't overthink it—the most basic of routines is the right direction for treating the condition, and if it reoccurs, look at lifestyle triggers that might be causing it. And while it's difficult, remember to be patient; it might take a little time to clear!"

The morning routine:

Cleanse with something über-gentle:

Apply a skin-protecting moisturizer:

Finish with a lightweight SPF:

The evening routine:

Both Pavitt and Zeichner agree that you can totally use the same basic protocol for both morning and evening (aside from the sunscreen, of course), but if your budget bandwidth allows, there are a couple of tweaks you could make pre-bedtime.

Try a *slightly* stronger cleanser:

Cool inflammation with an ice roller:

Use a night cream with lanolin:

Shop more products that helped with my PD:

Next: This New $16 Serum Replace My $245 One, and My Skin Looked Better in One Week