Woman with smooth skin

If you’ve had the experience of feeling like a stranger in your own skin, you share this emotional and physical struggle with many people. Statistics show that skin conditions are becoming increasingly common, and perioral dermatitis (PD) is one of various skin ailments more and more people struggle with.

Perioral means “around the mouth” and this condition refers to symptoms of irritated, bumpy, red, inflamed and sometimes even infected and scabbed-over skin patches around the mouth. It can range from a mild annoyance to downright painful. Unfortunately, PD is often misdiagnosed (as it appears similar to acne and eczema in many cases) and can be quite challenging to treat.

The good news is that if the underlying root cause(s) of PD can be uncovered and addressed, it is much easier to support and resolve symptoms, similar to most any other skin condition. Conventional medicine typically addresses skin problems from the outside-in versus the inside-out, and here is where the problem lies.

Skin Stats

Just so you know you’re far from alone, check out some of these startling statistics from the American Academy of Dermatology on skin conditions. While there aren’t many stats available on perioral dermatitis itself, keep in mind that PD is one of a myriad of conditions that, in many cases, have the same root causes:

  • Acne occurring in adults is increasing, affecting up to 15 percent of women and can continue into one’s 30s and 40s.
  • The lost productivity among patients and caregivers due to acne is nearly $400 million
  • Approximately 25-30 percent of people with psoriasis experience joint inflammation that produces symptoms of arthritis. This condition is called psoriatic arthritis.
  • In 2013, the costs associated with the treatment and lost productivity among those who sought medical care for rosacea was $243 million.
  • Rosacea tends to impact women in menopause above most other groups of people.
  • Skin cancer is the most common cancer in the United States.

This information and other pretty startling statistics is a warning sign that skin conditions (perioral dermatitis and others) is becoming a major epidemic, and more attention and education is overdue. The good news is that we do have the power to support and (in many cases) even make a total recovery from many skin conditions by addressing the problem from the inside out.

Approaching PD From the Inside Out

When taking a much closer look at the issue of skin, it’s important to first consider the roles that skin play in overall health, as this allows you to take the text step of understanding why PD might be an issue for you, and how to go about improving or treating it.

Skin’s Many Jobs

Believe it or not, skin is actually the biggest organ in the human body. Its primary purpose is to provide a natural barrier between the outside world and your inner landscape. Skin in properly working condition is responsible for keeping unwanted viruses and bacterias out while simultaneously allowing for healthy fluid balance, sending external pains and pressures, assisting in the regulation of body temperature and acting as a line of defense against toxins.

In my work with clients, I also find that how we mental and emotionally feel about our skin plays a huge role in our self esteem and self acceptance, which is nothing to be taken for granted. When considering skin health and how problems like PD can emerge, it helps to think of skin as a sort of mirror displaying your inner health.

How Does the Appearance of My Skin Reflect What’s Happening Inside?

Let’s dig a little deeper. When saying that the skin is a “mirror” of inner health, what I mean is that skin conditions like PD, eczema, acne and so many others should be thought of like all other diseases or health conditions: they are often a symptom of an underlying imbalance or system(s) in need of repair and healing. More times than not, this healing can come in the form of lifestyle and dietary changes, as well as pinpointing and eliminating certain toxins found in the home, household and cleaning products, personal hygiene products and foods.

To get more specific, here are the top seven ways you can heal your PD from the inside out, and you might be surprised to find that other areas of your health improve along the way. Some of these tips are fast-acting, while others might simply be the start of a longer process of getting to the root and slowly but surely working to heal PD. Trust me, long-term solutions are well worth the wait, so don’t be discouraged.

  1. Skip Refined Sugars and Processed/Packaged Foods

Sugar and highly processed foods that primarily consist of refined grains are downright rampant in the Standard American Diet (SAD). This type of diet model is solidly linked with many chronic diseases, and it definitely isn’t doing your skin any favors, either. An excess of dietary sugar can stick to amino acids that form elastin and collagen, and this in turn can lead to over-production of Advanced Glycation End products (AKA AGEs). Basically, these compounds play a major role in fine lines, wrinkles and premature aging, along with being a factor in skin conditions like PD.

If refined sugar and processed foods are a staple at your house, just take it one step at a time. Try more and more each time you grocery shop to choose simple, real foods that come from nature. When packaged products have a long ingredient list with hard-to-pronounce words, that is usually a sign you should skip it.

I love the 21 Day Detox by my friend and colleague, Diane Sanfilippo for more detailed information on how to safely, effectively and quickly support your body’s detoxification pathways and support healthy skin.

  1. Find Out If You Have a Food Intolerance or Allergy

Studies solidly link food irritants and allergens with the worsening or triggering of many skin conditions. Pinpointing and eliminating foods that aren’t working for your body can make a world of differences, sometimes immediately. However, this can also be a longer process of 2-3 months, so stick with it and seek help from an experienced RD or Nutritionist if need be.

Common food allergens are (but are not limited to) dairy, gluten, corn, soy, peanuts, sugar and processed foods and for some even whole grains are problematic. To do an effective elimination diet, it’s important to eliminate all foods for 1-2 months, then systematically reintroduce each. If the idea of eliminating all of these foods at once seems overwhelming, I recommend beginning with a dairy elimination, as dairy tends to be the most common offender in most dermatological conditions. You can also work with a local integrative medical doctor or Naturopath for food allergy testing.

  1. Include Plenty of Nutrients for Skin Health

A diet rich in skin-nourishing foods is foundational when it comes to achieving healthy skin from the inside out, and getting rid of PD for good. In the world of nutrition, we talk a lot about something called the “4 R Protocol,” which entails removing, replacing, reinoculating and repairing. You can think of the elimination diet phase as the “removal” phase, and the nutrients for skin health as the “replacing” stage.

Don’t worry, while it can feel intimidating to read a long list of specific vitamins and minerals for skin health, know that if you are eating a predominantly whole foods diet with lots of veggies and fruits, you’re probably doing just fine. But for those of you who want a little more information, here are the nutrient front-runners for glowing skin:

  • Vitamin A: Wonderful sources of this vitamin come from grass fed butter and cream, egg yolks, cod liver oil, orange and yellow veggies and fruits, and even from organ meats like liver. Vitamin A is one of the fat soluble vitamins, so always enjoy these foods with a serving of fat in your meal. You’ll notice that most come in the form of fat sources already, just another example of nature’s wisdom.
  • Vitamin C: Parsley, rose hips, kale, mustard greens, citrus fruits, strawberries, guavas and bell peppers.
  • Vitamin D: The best food sources of vitamin D are pastured dairy, liver and eggs. However, it’s best to get your dose of the sunshine vitamin through direct sunlight, in a responsible way depending on where you live.
  • Vitamin K2: Fermented foods like natto, raw sauerkraut and kimchi, along with whole-fat pastured dairy, egg yolks and liver. 
  • Vitamin E: Chard, almonds, wheat germ oil, spinach, tomatoes, cabbage, asparagus, avocado and extra virgin olive oil.
  • Selenium: Wild fish like sardines and salmon, organ meats, beef, lamb, turkey and brazil nuts.
  • Sulfur: Grass-fed meats like beef and chicken, garlic, brussels sprouts, kale, asparagus and eggs.
  • Zinc: Oysters are hands-down the best dietary source of zinc, along with lamb, beef and pumpkin seeds.

If you’re after a way to help fill your nutrient gaps, consider taking a comprehensive multivitamin.

  1. Consider Digestive Health

While it may sound strange, gut health is actually top priority when it comes to resolving PD and getting to the root of most skin conditions. Think about it this way: what you eat is certainly important, but if your digestive tract isn’t able to properly break down, absorb and assimilate all of those healthy foods, you won’t be reaping the benefits. The state of your digestion, gut microbiome and every other aspect of a healthy gut is a major player in just about every aspect of your health, skin topping the list.

To begin with a few simple steps to optimize digestion, begin eating the fermented foods mentioned earlier every day. I love raw sauerkraut and kimchi for veggie sources, and other wonderful options include a low-sugar kombucha tea, full fat plain yogurt (if you tolerate dairy) or a dairy or non-dairy kefir. If you’re new to fermented foods, start slowly with just 1/2-1 tablespoon per day or 2-3 ounces of kefir, yogurt or kombucha, and slowly increase.

Heartburn is a common sign that something isn’t functioning properly in the gut, so check out this article of how to get rid of heartburn naturally for more info.

  1. Balance Your Omega 3s

Too few omega 3 fatty acids and too many omega 6 fatty acids can be to blame especially in the cases of dry, itchy or flaky skin. To increase your intake of omega 3s, begin including more wild-caught, fatty fish in your diet like salmon. This isn’t always possible and can get pretty speedy, so an alternative is a trusted fish oil supplement.

This brand by Pharmax is high quality and one that both myself and many clients have had great success with.

  1. Eliminate Toxins

Unfortunately, there are some toxins in the environment that we don’t have much control over. However, others can be far easier to eliminate or reduce in day to day life, and this can have a profound impact on the health of your skin and be a tool for getting rid of PD. Common toxic culprits lurking in many homes include make-up and other hygiene products, detergents, household cleaning products, shampoos, conditions, soups and perfumes. Consider trading some or all of these products for natural brands that are becoming more readily available.

  1. See Where You Can Decrease Stress

The term “stress management” has become kind of a buzzword these days, and unfortunately it comes with practices that many of us don’t prioritize. However, high levels of chronic (ongoing) stress has been linked with many diseases, and have been specifically studied in their relation to skin conditions.

Lowering stress can seem nearly impossible, but begin by simply looking at one practice you can implement or one small stressor you might be able to eliminate. If you can make it to an hour yoga class several days a week and meditate for 30 minutes every day, more power to you! But sometimes, self-care for real life looks a little bit more like 5-10 minutes in the morning or evening of deep breathing, a 15 minute gentle yoga flow before starting your hectic day, a bi-monthly massage or simply carving out a few date nights per week with your special someone or with friends.

Stress management is highly personalized, so whatever works to bring you a little more peace and presence is just perfect.

If these seven steps to healing your perioral dermatitis from within seem a little overwhelming, please know it’s just fine to go one step at a time. Other PD-specific considerations are trying to avoid using heavy make-up, scented or perfumed face cleansers and products and talking to your doctor if you are taking birth control pills and suspect this could be contributing to your symptoms.