The ESK blog
Perioral Dermatitis: What it is, what helps and why it might be time for a skincare reset
10 September 2025
Dr Anne Thomson
Let’s talk about the skin drama that’s equal parts annoying and confusing: perioral dermatitis. If you've ever noticed a red, bumpy, sometimes itchy or burning rash setting up shop around your mouth (or nose and eyes), only to find your regular skincare routine makes it worse—congrats, you’ve just met one of dermatology’s more stubborn gate-crashers!
But don’t worry—we’re going to break down what this rash is, what causes it and how you can send it packing by getting back to basics.
What is Perioral Dermatitis?
Perioral dermatitis is a rash that typically pops up around the mouth, but it can also show up around the nose and eyes. It looks like clusters of red or flesh-coloured bumps—sometimes itchy and flaky, sometimes burny, always unwelcome.
90% of cases of perioral dermatitis are in women, usually aged between 20-45. Kids can get it too and, much less commonly, men.
It’s not quite acne, not quite eczema, but something in between. Some dermatologists even think it’s a variant type of rosacea. At its heart is a skin barrier problem – and like all sensitive skin issues, perioral dermatitis loves to spread and flare up if you treat it the wrong way.
What Causes Perioral Dermatitis?
Whilst we don’t fully understand the cause of perioral dermatitis, there are some common triggers we know of, including:
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Topical steroid creams: These can bring temporary relief—only to make things much worse when you stop. It’s a cruel cycle.
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Heavy, occlusive moisturisers or makeup: These trap heat and bacteria, creating a breeding ground for irritation. Jumped onto the slugging trend for glass skin lately? That could be why you’re here…
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Fluoridated toothpaste: Some people are super sensitive to it. If you suspect it’s a trigger, try a fluoride-free version for a few weeks and see what happens.
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Hormonal changes: The menstrual cycle, oral contraceptives, and even pregnancy can influence flare-ups.
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Over-cleansing or over-exfoliating: That squeaky-clean feeling might be your skin barrier crying for help.
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Environmental exposure to heat, cold, wind or UV rays from the sun.
Understanding what triggers perioral dermatitis is the key to calming it down—and keeping it gone.
Perioral Dermatitis Treatment 101
Step one in perioral dermatitis treatment? See your doctor for a diagnosis. It’s easy to confuse perioral dermatitis with other similar looking conditions – such as rosacea, acne and allergic or contact dermatitis.
Step two? Put. Down. The. Steroid! It might feel like it’s helping in the short term, but long term, it only fuels the fire. Your doctor can advise whether to go cold turkey (expect a flare up for a week or so) or gradually decrease it to nothing.
Step three: simplify your skincare routine like you’re decluttering your wardrobe, focussing on your skin barrier. The goal is to be gentle, boring (in a good way!), and barrier-loving.
Here’s a basic routine to support healing and prevent flare-ups:
Cleanse Gently
Use a soap-free, fragrance-free cleanser. Nothing shreds a skin barrier faster than soap – look for a barrier-friendly pH of around 4.5-5.5.
Our Calming Cleanser is a non-foaming, coconut sugar-based formula with a gentle pH of 4.5-5, making it ideal for sensitive skin types, including those with eczema and rosacea. This creamy cleanser effectively removes impurities while preserving the skin’s natural hydration and pH balance. Its non-soap formula minimises irritation and dryness, providing a soothing cleanse without disrupting the skin barrier. Designed for sensitive skin, Calming Cleanser avoids harsh ingredients like astringents, camphor, and menthol, which can trigger irritation. Gentle yet thorough, it supports a healthy microbiome and barrier, leaving skin calm, soft, and ready for the next step in your routine. Featuring; A creamy soap-free cleanser for skin that needs a gentle, silky wash.
Calming Cleanse
Moisturise Strategically
Yes, you should moisturise. Drying out your skin makes it worse. Choose a lightweight moisturiser that hydrates without clogging. Look for one that contains barrier-repairing, evidence-based ingredients like:
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Niacinamide – to calm redness and inflammation.
Repair + is a moisturiser formulated to support skin hydration and barrier function. Its combination of niacinamide, panthenol, hyaluronic acid, and ceramides is designed to help maintain skin moisture, strengthen the barrier function of the skin, reduce the appearance of redness, and support overall skin texture. Key Features:
Repair +
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Hyaluronic acid – to hydrate without heaviness.
Our Hydraboost Hyaluronic Acid Serum is designed to provide deep, lasting hydration with a blend of high, medium, and low molecular weight hyaluronic acids (HA). High molecular weight HA sits on the skin’s surface, creating a protective hydration layer that feels smooth and instantly refreshing. Meanwhile, low and medium molecular weight HA molecules sink deeper, boosting hydration within the skin barrier. Studies suggest that low molecular weight HA can reduce the appearance of wrinkles and fine lines. Lightweight and versatile, Hydraboost is perfect for daily use as the first step in your routine for plump, hydrated skin.
Hydraboost HA Serum
Featuring
- Enhanced daily skin hydration
- Plumper, healthier feeling skin
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Retinal (not retinol) – a gentler Vitamin A that’s perfect for sensitive skin. Proven to have anti-inflammatory and barrier-repairing properties (with a side of anti-aging effects) try a retinal night cream instead of its older, more irritating cousin retinol. It’s far better tolerated and won’t send your skin into panic mode.
The game-changing night cream developed in partnership with Selma Blair - combines our most potent hero ingredients to effectively and gently tackle the most common skin concerns – in one product. Tackling the signs of aging skin including fine lines, skin elasticity, impaired barrier function, hydration, dullness and uneven skin tone. it is our most powerful product yet and yet it’s still ridiculously well tolerated. Wake up to skin that's supple, smoother, and softer. For the most irritable of skin, Ultimate A may be a better option, particularly when starting to use Retinal based products
Ultimate A Gold
Ultimate A Gold: the most effective and gentle ingredients that evidence based cosmeceutical skincare has to offer, in one revolutionary formula.
*Ultimate A Gold (Retinal) may transfer onto white or light-coloured fabrics. For best results, we recommend using darker clothing or surfaces to avoid visible marks.
Skip anything with fragrance, essential oils, or heavy occlusive agents (looking at you petroleum jelly!).
Be sunsmart
Protecting from harmful UV rays is a must, look for a non-comedogenic, broad-spectrum sunscreen like zinc oxide in a lighter formulation (avoid heavy, occlusive sunscreens) that you can use every day. Also slap on a hat and seek shade in the middle of the day.
Zinc Shade is a lightweight matte day cream and primer. Its non-greasy, matte finish allows for smooth application and works well under makeup. We spent countless iterations perfecting this lightweight, non-greasy formula to avoid the typical white cast and thick feel of zinc products. The results? A matte finish that works beautifully under makeup. With well tolerated matte finish, it's also well suited to irritable and blemish and bump prone skin. With SPF 15 it also provides broad-spectrum sun protection against UVA and UVB rays. Key features: Lightweight, matte formula suitable for daily use Smooth application with minimal white cast Broad-spectrum UV protection Tested SPF 15 with enhanced UVA coverage Usage: Apply evenly to all exposed areas of skin before sun exposure. Reapply as needed throughout the day.
Zinc Shade
And if you’re looking for a skincare recommendation which fits that bill, look no further than our Anti-Aging Sensitive Skincare Kit!
This kit combines evidence-based products formulated for sensitive skin. It is designed to support skin hydration, maintain skin barrier function, and promote the appearance of even skin texture and tone. The kit includes Ultimate A Gold, which contains Retinal and supporting actives to help maintain the look of skin texture and pigmentation. Please note Ultimate A is not suitable for use in pregnancy or while trying to conceive. We've swapped Ultimate A with the new Ultimate A Gold. If you prefer Ultimate A, you can build your own kit here.
Anti-Aging Sensitive Skincare Kit
Key features:
Zero therapy?
We should mention that some experts recommend “zero therapy”, or stopping EVERYTHING, including make-up, using only water to wash the face, and then gradually reintroducing the simplified and gentle routine described above once your rash has cleared. Check with your doctor if this approach is worth a try.
What If It Doesn’t Go Away?
If removing triggers and simplifying your routine doesn’t do the trick, there are medication options. Your doctor may prescribe a topical antibiotic cream like metronidazole or clindamycin. Or you may need an oral antibiotic like doxycycline for 6–12 weeks to fully calm the inflammation.
If you’re dealing with perioral dermatitis, don’t panic—and definitely don’t pile on more products. Think of it as a reset button for your skincare routine. With consistency and patience, and maybe a little help from your doctor, you can tackle this pesky condition and hopefully banish it for good!