Can diet and lifestyle changes help you avoid perioral dermatitis?

Maintaining healthy skin is a lifelong journey, and one of the most important steps is identifying the cause of your skincare struggles. Not all pimples are created equal, and different triggers often require different treatments. If you’re suffering from inflamed, bumpy, or irritated skin around your mouth, it might be perioral dermatitis.

Here we’ll explain more about perioral dermatitis, how it affects the skin and the different triggers that can lead to flare-ups. We’ll also cover some perioral dermatitis diet changes that may help prevent it.

What is perioral dermatitis?

Perioral dermatitis is an inflammatory skin condition characterized by inflammatory papules and pustules that appear around the mouth. It can also affect the skin around the eyes (periocular) and around the nose (perinasal). Sometimes, the condition is referred to generally as periorificial dermatitis, meaning dermatitis that occurs around an opening.¹

Symptoms often manifest as a bumpy rash with small, inflammatory, pimple-like lesions or pink, scaly patches. In some cases, a burning or itching sensation can also occur.²

Perioral dermatitis flare-ups can be triggered by everyday things such as toothpaste or sun exposure. The good news? It can disappear quickly once the trigger is removed. The bad news? It may reappear when exposed to the stimulus again.

Who gets perioral dermatitis?

Perioral dermatitis most often affects women between the ages 20 and 45.³ But that’s not to say others won’t experience this skin condition. It has been reported in people of all ages, races, ethnicities, and genders. Thankfully, steps can be taken to help prevent it, and it is responsive to treatment—more on that below.

What can trigger it?

The exact cause of perioral dermatitis remains somewhat of a mystery, but several topical corticosteroids and environmental factors have been linked to this skin condition. 

Here are some potential perioral dermatitis triggers:⁴ 

• Steroid creams. Steroid creams pose a conundrum. Short-term use may clear the condition but can lead to dependency. At that point, discontinued use can lead to flare-ups or aggravate the condition. Sustained topical steroid use may increase the risk of developing chronic perioral dermatitis. 

• Fungal, bacterial, or parasitic infections. It is suggested some infections may be associated with perioral dermatitis, including Candida, fusiform bacteria, and Demodex mites (skin mites).  

• Toothpaste and chewing gum. Fluoridated toothpaste, dental fillings, and chewing gum have been linked to perioral dermatitis. 

• Cosmetics. Physical sunscreens and the combined use of moisturizers and foundations may also trigger perioral dermatitis. 

• Hormones. Because women are predominantly affected, certain hormones may play a role. However, birth control pills seem to improve the condition, so more research is needed to determine what effect hormones may have on perioral dermatitis.⁵

These are just a few of the more common triggers. If symptoms persist or worsen after eliminating potential triggers, seek medical advice. Skin issues should be diagnosed by a professional healthcare provider to get appropriate treatment.

Lifestyle changes may help 

There isn’t strong evidence to suggest that certain foods are triggers, so there really aren't specific foods to avoid with perioral dermatitis. That said, a few simple lifestyle changes can impact occurrence and severity. It’s easier to prevent skin conditions than it is to treat them, and perioral dermatitis is no different. Potential ways to treat or help prevent perioral dermatitis include:

• Using non-fluoridated toothpaste. Fluoride is a naturally occurring mineral. According to the Centers for Disease Control, fluoride is added to toothpaste to prevent or decrease the severity of cavities and tooth decay.⁶    

• Avoiding using over-the-counter topical steroids. Topical steroids (e.g. hydrocortisone) are used to treat skin conditions such as psoriasis, vitiligo, and eczema. Of course, always follow the instructions of your medical provider, but we recommend avoiding the unnecessary use of topical steroids (especially if you have perioral dermatitis). 

• Not using most topical products on the affected area. Stick to water and vaseline until the rash clears up. If you’re using a topical prescription product, talk to the prescribing provider before stopping.

• Take oral medications and apply topical treatments. Your dermatology provider may prescribe oral medications, such as tetracyclines (minocycline and doxycycline) or isotretinoin. Topical treatments such as metronidazole, azelaic acid, and adapalene may also work. Azelaic acid is available OTC, but you may need prescription strength.⁷  

• Change your skincare products. It might help to switch to fragrance-free products.⁸ Consult a licensed dermatology provider to design a custom skincare routine with personalized products. 

• Adopt an anti-inflammatory diet. Research is needed to support dietary changes specific to perioral dermatitis, but eating a well-balanced diet can support general skin health. Vitamin A, vitamin C, and vitamin E have proven skin benefits. Essential fatty acids (omega-3s) and fruits and veggies rich in polyphenols help improve elasticity, firmness, hydration, and pigmentation (color). Polyphenols are compounds in food that act as anti-inflammatory agents.⁹  

Be mindful of UV rays

Sorry, sun lovers: UV rays, excessive heat, and other environmental factors can trigger perioral dermatitis flare-ups. In addition, some of the medications used to treat perioral dermatitis may make your skin more photosensitive. That doesn’t mean you have to avoid going outside—just follow these simple guidelines. (Bonus: These may also protect your skin from premature aging, photodamage, and skin cancer.) 

• Apply a broad-spectrum sunscreen with SPF 30 or greater during the day. 

• Reapply sunscreen every two hours and after swimming, sweating, or toweling off. 

• Wear sun-protective clothing, a broad-brimmed hat, and sunglasses when you know you’ll be in the sun. 

• Avoid the sun during peak hours—between 10 am and 2 pm—or seek shade if you’re outdoors.

Can Curology treat perioral dermatitis? 

Here at Curology, we focus on the diagnosis and treatment of acne, rosacea, and anti-aging concerns at this time. That said, our medical providers are here to help and offer advice for this condition. Topical medications such as metronidazole can help treat perioral dermatitis, and oral antibiotics are also an option—both are offered by Curology. While we focus on the treatment of acne, rosacea, and anti-aging concerns, Curology does offer ingredients that can help treat perioral dermatitis. That said, you may need to seek treatment with your in-person medical provider for this condition. 

Curology was founded in 2014 by board-certified dermatologist Dr. David Lortscher, MD, to offer accessible and effective full-service skincare. Our licensed dermatology providers work with our patients to meet their skincare goals by designing a skincare routine with a personalized prescription formula.

We help take the guesswork out of your skincare routine—licensed providers will examine your skin, assess your skincare goals, and provide custom treatment options. Start your journey to healthier skin by signing up today.

P.S. We did the homework so you don’t have to:

1. Tolaymat, L. and Hall, M.R. Perioral dermatitis. StatPearls. (2022 September 5).

2. Tolaymat, L. and Hall, M.R. Perioral dermatitis. StatPearls. Ibid.

3. Tolaymat, L. and Hall, M.R. Perioral dermatitis. StatPearls. Ibid.

4. Tolaymat, L. and Hall, M.R. Perioral dermatitis. StatPearls. Ibid.

5. Tolaymat, L. and Hall, M.R. Perioral dermatitis. StatPearls. Ibid.

6. Centers for Disease Control. About fluoride. (n.d.).

7. Searle, T, et al. Perioral dermatitis: Diagnosis, proposed etiologies, and management.Journal of Cosmetic Dermatology. (2021 March 9).

8. American Academy of Dermatology. Red rash around your mouth could be perioral dermatitis. (n.d.).

9. Michakak, M. et al. Bioactive compounds for skin health: A review.Nutrients. (January 2021).

* Subject to consultation. Subscription is required. Results may vary. 

Written by

Curology Team

Medically reviewed by

Meredith Hartle, DO