Updated: Jun 11, 2021
Right after giving birth to my son in September 2019, I started to develop small red bumps around my mouth.
It turned into a severe red, dry, and flaky rash that spread up to my nose and the edges of my eyes. In January 2020, I finally got my doctor to look at my face and was shocked to hear I had periorificial aka perioral dermatitis.
Before my diagnosis, I assumed the rash was part of the normal post-partum hormonal experience. I'd never had any skin concerns before, but it was an extremely stressful time, being sleep deprived, learning how to be a mum, and feeling overwhelmed with the changes in my life that I could not have prepared for.
I was also diagnosed with postpartum depression and anxiety when Charlie was four weeks old, so I was navigating new mental health challenges at the same time that my skin felt like an explosion of terrible-ness.
Sure, it's 'just skin', but I didn't recognise myself. I felt like a shell of a human, and I hated the way I looked and how it made me feel.
Now that I'm in a maintenance phase on the other side of my skin journey, I wanted to share some helpful information on perioral dermatitis, as well as the products I ditched in managing my skin condition.
Plus, my recommendations for gentle skincare products that help me to feel good about my skin.
I'm also passionate about sharing my real, raw, unfiltered photos of my skin, because I hope it makes anyone else currently going through the same thing feel that little bit less alone.
So, What Is Perioral Dermatitis?
"It is a condition that arises when the microbiome (our skin’s ecosystem) becomes upset because of applied treatments. Patients most often present with multiple small red bumps around the mouth, eyes, or nose, which itch and burn," he said.
What Causes Perioral Dermatitis?
Dr Freeman said perioral dermatitis is most often caused by prescribed treatments like topical steroid creams that have been used incorrectly for other facial conditions, or cosmeceuticals, makeup and inhaled treatments (such as asthma medications).
"Additionally, culprits of irritation I see everyday include retinoids (vitamin A serums), MI/MCI preservative-containing cosmetics, pawpaw ointment, inappropriate strength or combination of skin care, and makeup or creams that are too thick and do not let the skin breathe."
Perioral Dermatitis Treatment.
First thing's first - go and see your medical professional. Whether it's a GP or a dermatologist, talk to a professional about your skin before buying or using any new skincare products.
Dr Freeman added, "[Treatment involves] stopping using all topical medications, makeup, moisturisers and cleansers. The body will self-regulate back to baseline, but in doing so, the rash will get far worse for two weeks before it settles. Due to this, your dermatologist will often prescribe oral treatment where appropriate to combat this."
"I advise my patients to go back to basics, so no active ingredients, fragrances, or makeup, just a basic light moisturiser with minimal preservatives and warm water to cleanse with."
My Perioral Dermatitis Skincare Routine.
So, after listening to my doctor and doing some of my own trial and error, the following are six types of products I avoided (and which ones worked best for me) in my experience with perioral dermatitis.
1. Exfoliating Products.
Gah, I think back to when I used to use extra strength daily peel pads and cringe.
It was absolutely the worst thing I could have put on my face because it just destroyed my skin’s moisture barrier. You will know if your skin can’t tolerate chemical exfoliants if your face is always red, sore and feels sting-y when you use them.
My recommendation: When my barrier is impaired, I don't exfoliate at all. I went about six months without exfoliating. Once ready, I recommend using something gentle once per week - more on that in a second.
2. Cleansers Containing SLS.
Some cleansers left my skin feeling tight, and I used to think that was normal.
Sulfates like sodium lauryl sulfate (SLS) are surfactants (detergents) that remove residue, dirt, and sebum from your skin, but they can also damage the skin barrier, dry out the skin, irritate your eyes and face, and strip skin of its natural oils. They are commonly found in foaming cleansers, and using one may flare perioral dermatitis.
My recommendation: There are many SLS free cleansers around, but my favourite is the Biologi Bc Refresh Cleanser because it's a light, non-irritating foam cleanser that leaves my skin feeling hydrated. No synthetic fragrances either.
3. Active Ingredients.
I stopped using active skincare products with ingredients like vitamin A and vitamin C so I could pinpoint anything that would flare the dermatitis up. But that doesn't mean you can't use serums at all - I look for ones with hydrating, soothing ingredients that will help repair my skin barrier.
My recommendation: Another excellent serum is La Roche-Posay Toleriane Ultra Dermallergo Serum 20ml - a gooey, fragrance-free serum with a dropper applicator.
It is made for sensitive skin and uses an ingredient called neurosensine, which is a peptide scientifically proven to block the pain sensation and prepare your skin for actives again. I started using this after my perioral dermatitis had subsided, but before I started adding active serums into my routine, and it worked a treat!
4. Too Many Steps in My Skincare Routine.
This one actually involves a few products I ditched because, as I learnt, simple and gentle is best when it comes to a skincare routine for perioral dermatitis. Your barrier needs to heal, and layering too many products and makeup over your struggling skin (even though I know how it feels to want to hide it) unfortunately won't help.
My recommendation: During my flare ups, I stuck to using a cleanser, serum and SPF. My serum of choice was the Biologi Bf Hydration Body Serum and any time my skin feels sensitive, I always come back to this one because it’s a light, watery serum texture and feels beautiful and fresh on the skin.
5. Makeup Wipes.
As a sleep-deprived new mum, I get it. Sometimes, you feel so tired and just want to quickly get your makeup off with a wipe.
But I found using makeup removing wipes or any textured face cloths caused micro-tears in the skin, further aggravating my skin condition. Or if you have face cloths, reusing them one too many times without washing is basically spreading bacteria all over your face. Yum.
My recommendation: I love cleansing my face using a clean, damp microfibre pad like the Face Halo Original because they are so soft and grab all my makeup and SPF. Even using one gently also provides a small amount of manual exfoliation. Just be sure to chuck them in the washing machine after use.
6. Makeup, Especially Foundation.
I understand feeling very self-conscious about dermatitis and wanting to cover your face in thick foundation, but honestly, my skin did not start to heal until I put all these tips into practice - including not wearing any makeup during a dermatitis flare.
My recommendation: If it's necessary for you to wear makeup, look for a base product that is lightweight and doesn’t clog the pores. I recommend the Inika Certified Organic BB Cream and I wear shade PL1 Porcelain.
Finally, the last piece of advice I can give you is this:
Take the time to look after yourself, and please, don't feel guilty about it.
Time, professional advice and consistency will help to manage your skin, but know your skin doesn't define your worth. Even when it feels like it.
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*This article should not be substituted for personal, professional medical advice. If you're concerned about your skin, please seek advice from your medical professional. And if you or someone you know is struggling with their mental health, please contact Lifeline on 13 11 14 for 24/7 support.