It’s not just an elimination diet that clears perioral dermatitis, but the right elimination diet. I wasted too much time trying topical solutions that showed little lasting improvement.
Few things have ever occupied my time and every thought as fully as perioral dermatitis. I prayed for a solution and spent countless hours researching the cure. This frustrating rash has a way of taking over not just your face but the way you live. I promised if I ever found the cure, I would share it.
Countless blog posts, Reddit, and Quora answers point to topical triggers for perioral dermatitis. No doubt harsh chemical-laden skin products strip your skin of its protective layer and can trigger perioral dermatitis. But if that’s what caused your rash, then removing those irritants will solve the problem quickly.
If you think your perioral dermatitis was caused by chemicals, please read: Stop Irritating Your Skin with Sodium Lauryl Sulfate and How to Save Your Skin: Sunscreen for Perioral Dermatitis.
In reality, sometimes you need to reset your skin from within.
Below is the story of how I healed my perioral dermatitis. It helps answer many common PD questions. If you’d like to jump straight to the steps to create your own personal elimination diet: Click Here
Before we start, I’m not a doctor. This content isn’t intended to substitute for professional medical advice. Always seek the advice of your physician with any questions you may have regarding your health or a medical condition.
Perioral Dermatitis and a Personal Elimination Diet Cure
Let’s start with a summary, but don’t miss all the important details below.
Here’s how to use an elimination diet to cure perioral dermatitis. First, create a list of common allergenic foods then add foods you eat on a daily basis to the list. For instance, if you eat tomatoes every day, that goes on the list. Use this list to create a custom-made elimination diet.
Next, you’ll create a list of foods you can eat. With this list, you’ll plan healing meals for the week and be on your way to recovery.
After months of experimenting with natural remedies, I had finally decided the rash was a fungal infection.
Is Perioral Dermatitis Fungal?
By watching videos on Youtube, I gathered information to treat my perioral dermatitis fungal infection. Without delay, I bought dandruff shampoo and Lotrimin to apply to the angry rash. But this only made things worse. When I finally broke down and went to the dermatologist, the first thing I asked her was, “Is perioral dermatitis a fungus?”
Here’s how the doctor explained it: Perioral dermatitis is not bacterial, viral, or fungal but it is an inflammation response. The theory that candida albicans (a type of fungus) causes perioral dermatitis is false. When looked at microscopically, there is no yeast or fungus present.
Finally, some real information and the first piece of the puzzle.
Except, if it wasn’t bacterial, why did she want to treat it with antibiotics? I had done enough research to know how effective killing all my good bacteria was going to be for my health and skin. But more on gut health later.
Perioral Dermatitis and the Candida Diet
Even though I understood the rash wasn’t fungal, I thought a candida diet might be the best way to cure it. It made sense that the inflammation was caused by an internal yeast overgrowth. Why?
Because everyone I read about who had taken antibiotics to clear perioral dermatitis had success until they stopped taking the antibiotics. Once they stopped it would not only flare up again but would often come back with a vengeance.
I also knew from having Lyme disease that heavy antibiotic use is a quick road to candida overgrowth and damaged gut health. So it made sense that my skin inflammation was coming from a fungal overgrowth inside my gut.
In fact, at candida diet (dot) com they have this to say:
The Candida diet is designed to improve gut health, reduce inflammation, and boost immunity. The principles of the diet include removing added sugars, consuming fermented foods, and avoiding pro-inflammatory triggers like gluten and processed foods.
The Candida diet is a low-sugar, anti-inflammatory diet that promotes good gut health and eliminates the sugars that feed a Candida overgrowth. The diet includes non-starchy vegetables, some low sugar fruits, non-glutenous grains, some dairy products, and fermented foods.
This sounded like it would cure the inflammation caused by my self-diagnosed yeast overgrowth.
Except before I had a chance to look further into the uber strict candida diet, I spoke to a local nutritionist. Which lead me to the next piece of the puzzle.
She convinced me that the candida diet was not only difficult to maintain but not the best diet choice for perioral dermatitis. Instead, her suggestion was to try an elimination diet. Elimination diets are the gold standard for identifying food allergies and sensitivities. Both of which can cause an auto-immune response like perioral dermatitis.
Next, let’s look at immune system responses.
Perioral Dermatitis and Your Auto-Immune System
An auto-immune response can trigger perioral dermatitis. This response causes your immune system to mistakenly attack your body’s own tissues. When you rebalance gut bacteria and strengthen your immune system, your body is able to heal perioral dermatitis.
This response is triggered by anything from stress, poor food choices, antibiotics, to a variety of different toxins. In fact, many immune-disrupting toxins are found in your environment, food, personal care, and/or household products.
Most likely, it was a combination of events that stressed your immune system and caused this inflammatory reaction on your chin and around your mouth. Perioral dermatitis is an outward sign of inflammation in the body.
Perioral Dermatitis Food Sensitivities on the Elimination Diet
Once an autoimmune response is triggered, your body needs to be brought back into balance by eliminating disruptive toxins so it can heal. An important change to make is eliminating foods your body is allergic or sensitive to.
Although food allergens and sensitivities are both harmful, they respond differently in the body.
With a food allergy, your immune system creates a response like hives, swelling, itchiness, or dizziness. Your body’s response is often immediate and dramatic.
On the other hand, food sensitivities or intolerances cause reactions in the gut like “gas, bloating, diarrhea, constipation, cramping or nausea.” In some cases, if you eat these foods in small amounts, you won’t notice any adverse reaction. Likewise, food sensitivities sometimes show up a day or two after eating offending foods.
Although both food allergies and sensitivities trigger perioral dermatitis, food sensitivities are less obvious. And this is precisely why allergy testing doesn’t work for curing perioral dermatitis.
Delayed reaction times and vague symptoms often cause food sensitivities to go undiagnosed. Because of this, a food journal is important when starting an elimination diet. It allows you to pinpoint the relationship between the foods you eat and the new perioral dermatitis bumps that pop up because of them.
How to Create a Personal Perioral Dermatitis Elimination Diet
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Your special elimination diet for perioral dermatitis starts with eliminating common allergens AND everything you normally eat a lot of. So if you eat a banana every day, that’s got to go. If you drink tap water, STOP. Rice and potato fan? No more. Or at least until the body rebalances. Keep reading, you’ll learn when to re-introduce foods too.
You’re going to eat uncommon for 1 month. Maybe 2 if you need further restoring. I’m telling you, your body is powerful and has an amazing ability to heal itself once supported.
That being said, this can turn into a very long process if you’re not willing to go cold turkey on a lot of familiar, healthy, and good-tasting foods for a short period of time. In fact, it takes very little of a trigger food for a flare-up to occur.
Create Your Personal Elimination Diet “NO” List
These are the two categories of food you’ll need to add to your “no” list.
Category One: Allergenic Foods that Can Trigger Perioral Dermatitis
Because these foods are more likely to cause inflammation than others, it’s important for everyone with perioral dermatitis to eliminate them. Basically,
- Processed foods – complicated, multi-ingredient foods make it difficult to find problem ingredients
- Dairy products
- Grains – including wheat/gluten
- Corn – syrup, meal, chips, etc.
- Any dried fruit preserved with sulfur dioxide
- Peanut butter
- Natural flavors and “spices” – because the FDA hasn’t officially defined these terms, they can describe any food. If the specific spice is listed like cumin or garlic, that’s a “yes” food.
- Tap water
Tap water was the second thing I re-introduced and it caused a flare-up within 24 hrs. When sink water has high levels of chlorine, it kills good bacteria and can cause inflammation.
Remember, it’s only for a couple of months. Next, let’s add the last layer to your “no” list.
Category Two: Foods You Normally Eat
This is where you customize your elimination diet. Otherwise, your healing diet may only limit some of the foods that bother you.
You want to avoid foods you commonly eat every week.
As difficult as it is to believe, a non-allergenic food like a banana can cause an inflammation response in one person while others are able to eat it without negative responses. These are often the foods you not only eat daily but crave as well.
But life’s no fun when you focus on what you can’t do. So now, it’s time to make your “yes” list. Trust me, this will come in handy when making a meal plan.
Create Your Personal Elimination Diet “YES” List:
These are all foods you can eat abundantly as long as you don’t normally eat them numerous times a week.
For example, I ate beef every week, so instead, I started eating organic grass-fed beef or bison. Looking back, I don’t think you need to split hairs over whole-food proteins. They’re some of the least likely foods to cause a reaction.
Chicken, wild-caught salmon, buffalo, Beef, cornish game hen, shrimp, scallops, sardines, anchovies, oysters, lobsters, ground turkey, wild game, etc.
All except corn. Even organic corn is a very allergenic food. Corn is found in many processed foods.
Fresh or frozen. Avocados and tomatoes fall under this category.
Nuts and seeds:
Preferably raw or dry roasted as flavored and salted varieties often use unhealthy vegetable oils.
Coconut oil, avocado oil, extra virgin olive oil (preferably a reputable brand like this one – 70% of olive oils at a normal grocery store are fake or mixed with low-quality oils), flaxseed, and walnut oil.
Salt, lemon, limes, herbs, and spices fresh or dried (preferably organic). For now, skip mixed spices and any condiments that contain ingredients from your “no” food list. If something has natural flavors or the word “spices” as an ingredient avoid it.
Honey, maple syrup, raw cane sugar, stevia, monk fruit. Try to limit or avoid sugar alcohols, especially if they cause you digestive issues.
Mineral, spring, distilled, and filtered water, soda water with real fruit flavoring, fresh fruit or vegetable juices, coconut milk (look for brands without guar gum, carrageenan, or metabisulfite)This one is good, homemade, or short ingredient list nut milk. Many nut milk brands are full of fillers and preservatives.
You will probably eat the same things over and over again. That’s okay. For one month you can eat an extremely limited diet. As soon as your rash is clear for 5 days, it’s time to start re-introducing food.
Obviously, choose the things you missed the most. For me, it was powdered cocoa, tap water, dates, and rice. Two of the four brought back my bumps. Not a full flare-up but a few. That’s why it’s SO IMPORTANT to only introduce 1 new test food at a time.
Creating a Personal Elimination Diet Meal Plan
Now, use your “yes” list to brainstorm meal ideas. I know this can take some creativity.
I find searching for GAPS recipes helpful. If you’re interested, leave me a comment below and I’ll put together some of my easy go-to recipes from when I was healing perioral dermatitis.
It’s important to keep your list simple and limited in the beginning. It might seem boring to eat the same 3 meals every day for a week but it’s a lot easier to detect what bothers you when there are fewer foods to choose from.
Generally, this is how I put together meals:
|Protein||Organic shredded crockpot chicken|
|Veggies and/or fruit||Shredded sauteed cabbage, sauteed diced onions, and topped with a diced whole avocado|
|Sauce and seasonings||Homemade tomatillo salsa, cumin, salt to taste|
- Choose foods that agree with you and don’t make you feel sick.
- Because you’re going to eat these foods a lot, make sure they’re foods you enjoy.
- Have a starch on your list besides vegetables and fruit. Mine was sweet potato.
- Use plenty of healthy fats. These combined with protein and fiber keep you full.
Keep a Food Journal
This is going to save you lots of heartaches if your perioral dermatitis flares up. You’ll be able to go back over the last 2-3 days of eating and easier pinpoint a possible trigger or two. Then you can eliminate those foods until your face clears again and introduce them one at a time.
Here’s an example:
You thought raw almonds and dried cranberries were “yes” foods. But that was the only thing you ate recently since your rash flared that was “new”.
First, check the ingredient list on the packaging. Possibly, the last time you ate cranberries they were sweetened with apple juice but the recent cranberries were sweetened with corn syrup. Or you tried roasted, salted almonds this time instead of raw and didn’t realize the salted ones were coated in vegetable oil.
Second, if all the foods are absent of triggering ingredients, avoid both almonds and cranberries until your face clears. Then introduce one at a time.
While keeping a diary, keep track of not only the foods you ate, but how you felt afterwards.
Finally, take pictures! I know the last thing you want to do with this rash is have your picture taken. But this is an important part of keeping track of your progress. I wish I had pictures from beginning to end. Here is one of the few I took and this was after it was starting to heal.
Give Your Body Time to Heal
It may seem like your perioral dermatitis popped up overnight, but it indicates a long-term internal condition that finally came to a head and presented itself visibly. Be patient with the healing process.
Once you eliminate all triggering foods you’ll start to see dramatic improvements. This helps a lot with motivation.
Re-introducing Eliminated Foods
It takes about 5 days to thoroughly test a food. Although, if it’s an extremely irritating food, you’ll know within 24-48 hrs that you’ve found a trigger food.
First, make sure you only introduce 1 new food at a time. My first was rice. I love rice.
Next, eat the one newly introduced food at least three times every day for 3 days in a row. Unless it causes a reaction. If that’s the case, you’re intolerant to that food and it needs to stay on your “no” list.
After 3 days stop eating the food and continue to monitor your skin for 3 more days. If all is clear, you can safely add it back into your diet.
I still have a few foods that I’m sensitive to (rice and corn). While they don’t cause a perioral dermatitis flare-up anymore, they do cause 2-3 red bumps to pop up. Usually along my jawline or on my checks. These are the foods that would cause perioral dermatitis to flare up in the past.
On a happier note, I was able to eventually add all sweeteners, cocoa powder, all nuts, seeds, fruits, vegetables, potatoes, and meats. Plus, many grains and some dairy. It’s been 9 years since I suffered from perioral dermatitis.
FAQs Perioral Dermatitis Elimination Diet
When you have perioral dermatitis there’s lots of uncertainty and questions. Everyone has a different theory and it’s maddening how doctors keep prescribing antibiotics when so many women have no long-term success with them. Here are some of the most important ones asked around perioral dermatitis and an elimination diet with their answers.
How Does Diet Affect Perioral Dermatitis?
Your skin is the outward indication of what’s going on in the gut. In other words, skin issues mean you have gut issues. And most likely your damaged gut issues revolve around an overgrowth of bad bacteria and yeast. This leads to a leaky gut and causes inflammation in the body.
Once you eliminate foods that irritate the gut, your digestive tract heals.
What Is the Fastest Way to Cure Perioral Dermatitis?
I believe the fastest way to cure perioral dermatitis is to stop treating it like an outward manifestation and instead treat your symptoms from the inside. Of course, this might not make sense at first. Since you SEE the rash, common sense would support that you treat it topically.
That’s just not the case. This rash is a symptom of an internal problem. Once you eliminate internal irritants the body has a chance to repair and heal. This immediately causes your skin to stop reacting to offending foods and toxins.
Foods to Avoid With Perioral Dermatitis
Foods to avoid with perioral dermatitis are known allergens, that is to say, foods that cause inflammation in the body. Secondly, it’s important to avoid foods that you personally have a sensitivity to. This is where a personal elimination diet differs from a common elimination diet. Think of it as a personal plan to heal your health and skin.
What Makes Perioral Dermatitis Flare-Up on an Elimination Diet?
Usually, perioral dermatitis flares up on an elimination diet when you accidentally eat triggering foods. For instance, you eat out at a restaurant and they sweeten their smoothies with corn syrup or braise their vegetables in soybean oil. Consequently, eating out can cause perioral dermatitis flare-ups on an elimination diet.
But so can eating at home when you buy processed food. For example, many store-bought salsas are full of ingredients likely to trigger perioral dermatitis.
who would think red salsa has rice or corn in it? Even the healthiest brands can have ingredients that cause your rash to flare.
Ultimately, you must read the ingredient list on everything you eat. Because it’s too frustrating to eliminate so many foods and still end up suffering from new break-outs.
Why Do I Keep Getting Perioral Dermatitis with an Elimination Diet?
My family has successfully reversed severe acne for two of our teenagers using a personalized elimination diet and this supplement. Without a doubt every time their acne flared up on the elimination diet it was because they knowingly or unknowingly went off the diet. There are a lot of food temptations and “maybe this time it won’t bother me” thoughts that come up when following an elimination diet.
So as stated above, if you’ve narrowed down the foods that cause your perioral dermatitis, wait until your skin has been clear for a while before reintroducing a new food. And if it comes back, investigate to see if you’ve unknowingly eaten one of your food triggers.
How Do You Calm Down Perioral Dermatitis?
While slathering on skin creams like zinc-based baby creams or healing green tea toners feels good, they won’t cure perioral dermatitis.
That being said, an all-natural luxurious face cream helps calm the skin around perioral dermatitis especially if you’ve been trying harsh topical products to kill the rash like I was.
Although, a cream, pill, or potion would be easier to apply than a diet change, know that you’re not just clearing your rash but cleansing and strengthening your health too.
As importantly, it’s better to know the truth than to frustratingly keep trying skin products or strange masks that have little effect. Or in the case of antibiotic medications eventually end up having a more disastrous effect on your skin and health.
What Gets Rid of Perioral Dermatitis Besides an Elimination Diet?
There are a lot of temporary cures for perioral dermatitis. They’ll give you hope and a feeling of happiness as you look in the mirror and watch your rash disappear. Unfortunately, they’re always followed with the sinking feeling of desperation as yet another possible remedy fails and you have to start your search all over again.
It’s maddening how many articles you read on the internet that claim, “I cured my Perioral Dermatitis” and by the end of the article the author explains how with time they hope the rash will disappear for good. Or worse, the end of the page is an update showing how “their cure” eventually failed them and the rash is back with a vengeance.
That’s not a cure. A cure is when the rash is gone and doesn’t come back. And if it does come back at all, you know exactly what you did or ate that made it happen.
What Do Doctors Prescribe for Perioral Dermatitis?
First, it’s not usually easy to see a doctor of dermatology quickly. In my area, there was at least a 3-month wait. To be seen sooner, I made an appointment with the doctor’s nurse practitioner.
The nurse practitioner diagnosed my strange rash as perioral dermatitis and prescribed Metronidazole a 1% topical antibiotic gel. I was excited to get home and apply it. But it burned horribly and after 24 hrs my rash was worse; so I discontinued it.
After my rash spread to my eyes, I developed a lesion that would not heal, and a firm request from my husband, I made an appointment to see an actual dermatologist. She gave me a prescription for an antibiotic called Tetracycline which I never filled.
I did find out the sore that wouldn’t heal was impetigo. Sadly, the harsh topical products I was using to treat my perioral dermatitis had caused this bacterial infection. For this, she prescribed Bactroban an extra-strength antibiotic ointment. Thankfully, it cleared up within a week.
In general, dermatologists prescribe topical and internal antibiotics to clear perioral dermatitis.
Here’s a list of the most often recommended topical treatments:
- Metronidazole cream or gel
- Clindamycin lotion or gel
- Erythromycin gel
- Topical sulfur preparations
- Azelaic acid gel
- Tacrolimus ointment
- Pimecrolimus cream
And here are the 3 most commonly prescribed oral antibiotics:
How Do You Stop Perioral Dermatitis from Coming Back?
Although I’ve been able to introduce many of the foods I originally eliminated, there are still some foods I’m sensitive to.
While they don’t bring back the perioral dermatitis rash, they will cause abnormal pimples. Abnormal meaning, a red bump that hangs around for a few days and if left alone, disappears. Not your normal whitehead or blackhead.
I assume that if I ate these foods daily or weakly, they would wreck havoc in my digestive system and cause an inflammation response like perioral dermatitis.
How Long Does It Take to Heal Perioral Dermatitis With an Elimination Diet?
I saw improvements within 1 week. After a month my rash was gone. Not only did it go away, but so did 10 lbs I had struggled to lose since turning 40 yrs.
You should see your perioral dermatitis healing in the first 2 weeks of a personal elimination diet that doesn’t contain triggering foods.
There’s such an overwhelming feeling of relief once you clear up your rash. All the hard work of changing your diet and going without familiar foods is worth it ten times over.
Will Perioral Dermatitis Clear on Its Own Without an Elimination Diet?
Some of the keys for clearing my perioral dermatitis were going to a doctor to diagnosis the issue, getting some real understanding of what the disease was, then talking to a nutritionist who pointed me in the right direction, and finding some information on a specialty diet that I had never heard of before.
There is no way perioral dermatitis is going to clear on its own. You may unknowingly start a new diet that eliminates all of your trigger foods and stay on it long enough to mostly heal perioral dermatitis. But from my experience and from hearing countless other’s experiences with it, that would be a miracle.
Perioral dermatitis left untreated or treated improperly only gets worse. It wasn’t until it had moved up to my eyes that I was desperate enough to make a dermatology appointment. While that appointment didn’t cure my perioral dermatitis, it did start me down the path to finding an elimination diet that finally healed my rash.
Basically, an elimination diet to cure perioral dermatitis is made up of whole foods like vegetables, fruits, high-quality proteins, and fats. Likewise, you eliminate sugar, processed foods, grains, chemicals, highly processed vegetable oils, and dairy.
After your skin heals, you slowly and methodically introduce foods back into your diet to find the foods that cause your rash to flare. These foods create an inflammation response in your body and need to be completely eliminated.
The Importance of Understanding Perioral Dermatitis for Your Health
As difficult as it seems, perioral dermatitis is something to be thankful for. It’s a visible sign that your health is compromised. That is to say, your body is under attack and unable to win the fight without help.
Often, this uncomfortable rash is a danger signal for a number of autoimmune diseases. Some of these include inflammatory bowel disease, multiple sclerosis, celiac disease, diabetes, autoimmune hepatitis, and systematic lupus.
By cleaning up your diet and lifestyle now, you can save yourself more serious health issues in the future.
Please let me know if there’s anything I can help you with in the comments below. I’m not an expert but I’ll try my best to answer any questions you might have regarding an elimination diet and perioral dermatitis.
Beauty is a side effect of healthy living which makes healthy ways – shapely ways.
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