What is perioral dermatitis?

Causes of Perioral Dermatitis

The causes of perioral dermatitis are varied—in most cases, several factors play a role at the same time:

Over-nourishment & Improper Skin Care

Using too many creams, heavily occlusive products, or cortisone creams disrupts the skin’s natural balance. The skin barrier is weakened, pores become clogged, and inflammation sets in—resulting in the typical red pustules around the mouth and nose.

Nutrition and Gut Health

Diet can also play a role. Highly processed foods, sugar, alcohol, and dairy products can promote inflammation in the body and put a strain on the skin. Some people with POD report that a low-inflammatory diet rich in vegetables and healthy fats and low in sugar has significantly improved their POD symptoms.

Stress as a Trigger

Stress is a common trigger for skin problems. The release of stress hormones such as cortisol weakens the skin barrier, causes the skin to produce more sebum, and intensifies inflammatory processes. This can worsen existing skin problems or even trigger POD in the first place.

Hormonal Factors

Hormones also play a role. Fluctuations—such as those caused by the menstrual cycle, pregnancy, or stopping birth control pills—can make the skin more sensitive and promote inflammation. For some people, POD occurs more frequently during periods of hormonal change.

Mechanical Stimuli & Environmental Factors

Frequent mask-wearing, friction from scarves in the winter, or intense UV radiation and heat in the summer can irritate the skin and contribute to POD.

POD Treatment: Zero Therapy

As paradoxical as it may sound, the most important thing to do when dealing with POD is to do nothing. This so-called “zero therapy” means:

• Stop using all creams, ointments, and makeup products
• Clean only with warm water and a soft microfiber cloth
• Do not rub; just gently dab
• Stick with it for six to twelve weeks—even if your symptoms get worse at first
• Avoid direct sunlight

That may sound strict, but it's essential for the skin barrier to regenerate.

Step-by-Step: POD-Friendly Skincare

After the "zero therapy" period, you can slowly resume your skincare routine:

1. Start: Protective Day Cream

A gentle, soothing cream protects against external factors without over-nourishing the skin.
Example: The Four Seasons Day Cream by DOC BERGER EFFECT protects against UV, blue light, and infrared radiation and is formulated with a skin-identical cream base.

2. Add gentle cleansing

• To start, use only a mild foam cleanser in the evening (e.g., Foam Sensitive)
• Can also be used later in the morning

3. Mild Tonic

A toner helps regulate excess sebum, restore the skin's optimal pH balance, and make the skin appear clearer.

4. Light Night Cream

After a few weeks, a night cream that regenerates the skin barrier overnight.

5. Integrate serums over the long term

Once the skin has been stable for at least three months, serums can be added—for example, those containing collagen, hyaluronic acid, aloe vera, or Matrixyl 3000 —to provide moisture and soothe the skin.