Perioral dermatitis (POD) is a stubborn and often frustrating skin condition that presents as a red, bumpy rash around the mouth, nose, and sometimes the eyes. For estheticians, understanding how to recognize this condition is essential, not to treat it but to support clients with care, education, and professional referrals.
This esthetician's guide to perioral dermatitis provides clear insight into what POD is, how it develops, and what you can do (and avoid) as a skincare professional to assist clients on their healing journey.
Key Takeaways
Perioral dermatitis can be confusing, uncomfortable, and often mistaken for acne or a rash but as an esthetician, you can play a vital role in helping clients feel supported and cared for. This guide breaks down everything you need to know about POD: what it looks like, what commonly triggers it (like steroid creams, fluoride toothpaste, or harsh skincare routines), and how to create a safe space for healing.
What Is Perioral Dermatitis?
Perioral dermatitis is a chronic inflammatory skin condition marked by:
Clusters of small, red papules, or pustules
Dry, flaky, or scaling patches
Burning, stinging, or tightness
Often affects the perioral area (around the mouth) but may spread to the nasolabial folds, nose, or even the eye area (in which case it's sometimes called periorificial dermatitis)
Unlike acne, POD typically spares the area directly around the lips and does not normally form comedones (blackheads and whiteheads). It may resemble rosacea or eczema but has distinct triggers and presentation. This makes accurate observation critical, especially since incorrect product usage can exacerbate symptoms.
Causes and Triggers to Know
Perioral dermatitis doesn’t have a single cause but instead arises from a combination of triggers. The most common culprits include:
Topical corticosteroids and steroid creams: Frequent or prolonged use is the main contributor. Even low-potency formulas can lead to POD flare-ups.
Fluoride toothpaste: Particularly sodium fluoride, which can irritate sensitive skin around the mouth.
Hormonal changes: POD is more prevalent in women and can be aggravated by oral contraceptives.
Overuse of heavy moisturizers and occlusive products: These can clog pores and trap heat, leading to irritation.
Overexfoliation and harsh skincare routines: Clients who use AHAs, BHAs, or physical scrubs may unknowingly exacerbate the condition.
Stress and environmental aggressors: UV exposure, extreme weather, and high stress levels can all be contributing factors.
As an esthetician, knowing these triggers is crucial when reviewing your client’s skincare habits or product usage.
When to Refer to a Dermatologist
While estheticians play an important role in skin health, perioral dermatitis is a medical condition that should be diagnosed and treated by a dermatologist. Referral is necessary when:
Clients show persistent or worsening rashes near the mouth, nose, or eyes.
There’s evidence of skin barrier breakdown, inflammation, or discomfort.
The condition does not improve or worsens with barrier-supportive skincare.
Clients are unknowingly using topical steroids or attempting to self-treat with over-the-counter acne medications.
Approach this referral with professionalism and compassion. Use language like, “This looks like a condition best evaluated by a dermatologist. I’ll continue to support you with calming skincare once you receive a diagnosis.” Your role is to support, not to diagnose or treat.
What Estheticians Can Do to Help
Skincare specialists cannot provide treatment for perioral dermatitis, but their esthetician tips for perioral dermatitis play a critical supportive role in skin recovery and client confidence. Here’s how:
Focus on barrier repair: Strengthening the skin’s natural defenses is essential. Prioritize non-invasive facials that hydrate and calm.
Skip exfoliation and aggressive treatments: Avoid peels, scrubs, microdermabrasion, or any form of exfoliation during flare-ups.
Choose gentle, non-fragranced products: Use mild cleansers and moisturizers with simple ingredient lists.
Maintain strict hygiene protocols: Use disposable tools whenever possible, and avoid touching affected areas unnecessarily.
Create a relaxing, judgment-free experience: Clients with visible skin conditions often feel self-conscious about their appearance. Provide emotional support through your demeanor and the environment you create.
Your skill in calming both the skin and the client can make a world of difference during their flare-up.
Ingredient Recommendations and Red Flags
Your product choices are one of the most powerful tools you have when supporting a client with POD. Here are ingredients to recommend and those to avoid:
Helpful Ingredients
Niacinamide: Anti-inflammatory and supports skin barrier recovery.
Panthenol, allantoin, and oat extract: Excellent for calming and reducing irritation.
Squalane, light plant oils: Non-comedogenic and soothing (when used sparingly).
Avoid These During Flare-Ups
Fragrance and essential oils: Major irritants for sensitive or compromised skin.
Sodium lauryl sulfate: A harsh surfactant found in many cleansers and toothpastes.
Retinoids, AHAs, BHAs: While beneficial in other contexts, they’re too harsh for POD-prone skin.
Occlusives like petrolatum: These can trap heat and bacteria, worsening symptoms when applied during active flare-ups.
Remember, what works for general skin conditions may not work for perioral dermatitis. Less is more.
Educating and Supporting Your Client
Many clients are unaware of perioral dermatitis and may misdiagnose it as acne or a rash. Here’s how you can support them without overstepping:
Use clear, non-medical language: You might say the client’s rash looks like inflammatory dermatitis, not ordinary acne. Emphasize facts: it often relates to certain products (even toothpaste) or steroid use, and it’s not their fault. For example, you can tell the client, “I’m noticing a rash that’s commonly referred to as perioral dermatitis. It’s best evaluated by a dermatologist.”
Emphasize consistency and simplicity: Encourage a routine with a minimal number of products. No scrubbing. No switching. No spot treatments.
Coach on avoidance: Educate them gently about avoiding fluoride toothpaste, essential oils, and over-the-counter steroids unless prescribed.
Boost confidence: Skin conditions can impact self-esteem. Offer reassurance, normalize skin struggles, and help them focus on progress rather than perfection.
Education empowers your clients to make better decisions and stay hopeful during flare-ups.
Conclusion
Dealing with perioral dermatitis can be incredibly frustrating for anyone experiencing it, and that's why estheticians play a crucial supportive role. While we can't prescribe medication, we absolutely can make a huge difference by calming inflamed skin and providing esthetician tips for perioral dermatitis.
Ultimately, your expertise in providing soothing facials and valuable client education is significant. By focusing on barrier repair and creating stress-free treatment protocols, you can help clients feel significantly better, especially while they're undergoing any necessary medical treatments. Therefore, you must continue to educate yourself on inflammatory skin conditions to better serve your diverse clientele.
Ready to take the next step in personalized skin health? Schedule a barrier-focused skin consultation and help your clients rediscover calm, healthy skin, one gentle touch at a time. Also, visit Beauty Insurance Plus to learn more about liability coverage options tailored to estheticians.
