Perioral Dermatitis: A Functional Approach to Healing from the Inside Out
Perioral dermatitis may not be a household name, but if you’ve had it, you’ll never forget it. Red, bumpy, sometimes scaly patches crowding around your mouth, chin, or nose—often itchy or burning—can feel frustrating, uncomfortable, and confusing. Some people even see it creep up around their eyes, making it extra hard to ignore.
And while it often gets lumped in with acne, rosacea, or eczema, perioral dermatitis is its own unique skin condition. Treating it successfully requires a different approach—one that goes beyond creams and quick fixes and gets to the root of what’s driving the inflammation.
What Exactly Is Perioral Dermatitis?
Perioral dermatitis is a chronic inflammatory skin condition. It looks like clusters of tiny red bumps (sometimes filled with clear fluid), often accompanied by dryness, burning, or itching. While it can resemble acne or rosacea, it’s technically distinct.
Some even call it perioral dermatitis rosacea because of overlapping redness and flare patterns, but there are differences: rosacea favors the central face (cheeks, nose, forehead), while perioral dermatitis tends to concentrate around the mouth, chin, and nasolabial folds.
Common Perioral Dermatitis Triggers
Perioral dermatitis usually shows up when your skin is irritated or your system is under stress. Common perioral dermatitis triggers include:
Topical steroids (like hydrocortisone creams): They can temporarily calm redness but often worsen things when stopped. If you’re using a prescribed steroid, talk to your provider about alternatives.
Heavy skincare or makeup: Thick moisturizers, occlusive products, or even fluoride-containing toothpaste may aggravate flares.
Hormonal shifts: Many women notice flares linked to menstrual cycles, pregnancy, or postpartum changes.
Gut imbalances: Dysbiosis, SIBO, or yeast overgrowth are commonly connected to inflammatory skin conditions.
Stress: Mental or emotional stress influences the immune system and can easily trigger skin flares.
Environmental factors: Harsh weather, heat, or wind can make symptoms worse.
The Fluoride Connection
One interesting (and often overlooked) trigger for perioral dermatitis is fluoride. Several case reports and small studies have linked fluoride toothpaste to worsening or even causing perioral dermatitis in some individuals. The mechanism isn’t fully understood, but it’s thought fluoride may irritate the skin barrier in susceptible people.
If you’ve been battling recurrent flares, switching to a fluoride-free toothpaste for a trial period is a simple experiment worth trying. Not everyone will notice a difference, but for some, this swap is a game-changer.
Why the Conventional Approach Falls Short
Most conventional treatments rely on antibiotics, antifungals, or steroid creams. While these may help short-term, they don’t always address why the dermatitis is happening in the first place. That’s why relapses are so common.
Skin flare-ups are often your body’s way of saying, “Hey, something deeper needs attention.”
A Functional Medicine Approach: Healing from the Inside Out
Instead of just managing symptoms, a functional approach digs into the root causes. Here are some key areas we look at:
1. Support the Gut
Test, don’t guess: Functional stool or breath testing can uncover imbalances like SIBO or candida.
Nutrition reset: Focus on anti-inflammatory foods—leafy greens, fatty fish, colorful vegetables—and reduce refined sugar and ultra-processed foods.
Probiotics: Certain strains of probiotics have shown promise for supporting skin health.
2. Balance Hormones
Notice if flares line up with cycle phases.
Support blood sugar stability—blood sugar swings can throw hormones off balance.
Consider hormone testing if symptoms are cyclical and persistent.
3. Calm the Nervous System
Stress hormones directly influence inflammation and skin barrier repair. Daily rituals like meditation, yoga, journaling, or walking outside help calm both mind and skin.
4. Simplify Skincare
Stick with the basics: gentle cleanser, lightweight moisturizer, mineral SPF.
Avoid harsh actives (retinoids, exfoliants, benzoyl peroxide) until skin is stable.
Check ingredient lists for fragrance and heavy oils, which can be irritating.
Consider azelaic acid as a part of your skincare routine.
5. Audit Hidden Triggers
Try switching to a fluoride-free toothpaste.
Minimize heavy cosmetics or skincare.
Use a humidifier in dry climates or seasons.
Your Perioral Dermatitis Toolkit
If you’re working on calming perioral dermatitis, here’s a practical starting point:
Talk to your provider about alternatives if you’re using topical steroids.
Simplify your skincare routine—gentle and minimal is best.
Ask your provider about azelaic acid as a tool for supporting perioral dermatitis.
Switch to fluoride-free toothpaste for at least 4–6 weeks to see if it helps.
Focus on whole, anti-inflammatory foods while reducing sugar and processed foods.
Support stress resilience through daily calming practices.
Track flare patterns related to cycle, stress, or lifestyle changes.
Consider functional testing if flares keep coming back despite lifestyle changes.
Final Thoughts
Perioral dermatitis is more than a surface-level rash—it’s a signal from your body. By looking beyond symptom management and addressing triggers like fluoride exposure, gut imbalances, and stress, you can support long-term healing.
If you’ve been stuck in a cycle of flare, treatment, and relapse, a functional medicine approach may help you finally move forward. At Clear Skin Lab, we specialize in uncovering root causes and creating personalized plans that actually work.
✨ Ready for calmer, healthier skin? Book a consultation with our team and let’s create your inside-out healing plan.