Guide to Perioral Dermatitis Part 1 - The Basics :: POD Fiesta

Guide to Perioral Dermatitis Part 1 - The Basics :: POD Fiesta

Welcome to your POD fiesta: An exploration of your weird chin rash.

In 2001-nu-metal-butt-rock circles, POD stands for Payable On Death. In non-2001-nu-metal-butt-rock circles, POD (or PD) stands for perioral dermatitis. I've had it for well over 5 years (I've lost track), so I'm launching a special category on this blog dedicated to it. Why a Fiesta? Because even hell rash deserves a celebration.

Like acne and other acne-adjacent skin conditions (such as roseacea), POD can be chronic. Unlike acne or roseacea, POD is not as well-known, so it's often misdiagnosed or treated ineffectively. It's also stubborn as f*ck. That's why I'm putting together this guide. Arm yourselves with knowledge, my friend, then pelt your doctor with it mercilessly.

This is Part 1 of a 3 part series on perioral dermatitis. To kick this thing off, I'm going to break down the basics: what it is, symptoms, triggers, etc etc.

What is perioral dermatitis?

Perioral Dermatitis (aka "POD" or "PD") means literally "inflammatory disease around the mouth." Women get it more frequently than men. 20-45 year olds get it more frequently than older folks or children/teens. Night-droolers get it more frequently than people who sleep like Disney princesses.

What is dermatits?

Dermatits is a typo I did not catch while writing this. If you see "dermatits" in any of these articles, know that it is not a skincare product that is awesome, nor is it boobs made entirely of skin.

Does POD differ from other forms of dermatitis?

Yes. "Dermatitis" is a catch-all for skin inflammation, and includes a range of conditions such as eczema and contact dermatitis. Dermatitis symptoms can be similar, but causes, triggers, and treatment can be different. This is important because the steroid creams that are often used to treat other forms of dermatitis can make the POD better initially, then make it much worse. If you are using or have used steroid creams, let your doctor know; this information can help with your diagnosis.

What does perioral dermatitis look like?

Sometimes the rash is red or pink, sometimes it is more flesh colored. Sometimes the bumps are just bumps, and sometimes they come with whiteheads. Sometimes it's over a itty-bitty area, and sometimes it's just everywhere. It can also peel. It ranges in severity from mild irritation to full on cracking and bleeding.

This is what mine looks like:

Mild Perioral Dermatitis / Chin Rash Flare-up :: Crappy Candle

Can you have acne and perioral dermatitis?

Oh absolutely. Skin can be vindictive in lots fun ways, simultaneously. You can get a nice dime-sized cyst mixed in with a rough red patch of POD. Then some of that patch can turn into angry papules. It's a real party, my friends.

Does POD only appear around the mouth?

Periorbital (or periocular) dermatitis is the same kind of rash, but around the eyes. I developed a very mild case of it under one eye after a few vacation days involving warm weather, lake water, and a lot of sunscreen:

Mild Periocular Dermatitis / Eyelid Rash Flare-up :: Crappy Candle

I'm also fairly certain I had POD around the sides my nose from the time I was about 9. I had that mysterious nose rash until high school and no one ever told me what it was. I just thought it was part of growing up.

So yes, kids can get it too!

Is perioral dermatitis contagious?

Come closer friend and let me rub my rash on you. We'll find out.

(no it's not contagious)

What are symptoms of perioral dermatitis?

  • rash-like clusters of pink or red bumps around the mouth and chin (or nose and eyes) that just don't ever seem to go away
  • whiteheads may appear on top of that rash
  • and maybe the rash is peeling too
  • it could also be causing discomfort -- itching, burning, or stinging
  • if you've got it real bad, you could get blisters, cracked skin, or bleeding
  • nothing you put on it seems to help
  • it may go away, then come back, then go away and come back. Good God this thing is never going to leave me alone is it, like Dean from the Gilmore Girls.

What causes perioral dermatitis?

A doctor will likely tell you the exact cause is unknown, but is connected to overuse of topical products, specifically topical steroids and/or cosmetics.

There may be hormonal element to it, and certain environmental factors, like wind and heat, can play a role. Some say it's caused by candida overgrowth. Candida is a type of yeast/fungus that is naturally found in the body. I couldn't find any good sources on this connection, but this is a good article of the lack thereof. So, if you're reading this and have an alternate opinion, feel free to duke it out in the comments.

What are common POD triggers?

  • topical steroids (corticosteroids, cortisones, etc)
  • heat (sun, hot showers)
  • fluoride in toothpaste
  • drool or excessive lip licking
  • sulfates (in cleanser, toothpaste, and shampoo)
  • products with petroleum or wax as an ingredient
  • sunscreen
  • foundation, primer
  • moisturizer
  • toner, makeup remover, micellar water
  • basically everything you like to put on your face :(

How is POD diagnosed?

Diagnosis is visual, and based on the symptoms you report to your doctor. In my case, I was not having a flare-up at the time I got in to see a dermatologist, so I showed her a picture I took when it was flaring and she agreed with my self-diagnosis. If a doctor performs some kind of diagnostic test, it's probably to rule out other conditions like an allergic reaction or infection.

What can POD be misdiagnosed as?

  • rosacea
  • acne
  • seborrheic dermatitis
  • contact dermatitis (allergic reaction)
  • plain-ole skin irritation

Will perioral dermatitis go away on its own?

It might go away after a few months without treatment, but it might also take much longer than that — think years. Even if it does go away, it may come back. Also, if you keep using whatever products were triggering your POD, it could actually get worse.

The mystery nose rash of my youth eventually went away, but considering that I'm now dealing with it over a much larger area, I'm thinking some people are just predisposed to it. It's best to figure out what treatment works for you so you can use it if and when it does return.

What's next?

Perioral Dermatitis treatment of course! Part 2 of this series covers all the "cures" I've tried — and the ones I haven't tried — including holistic, over the counter, and prescription treatments. Part 3 is a review of the 6 month regimen I did with a dermatologist.


This is Part 1 of my 3 part Perioral Dermatitis Series:

Part 1:  Guide to Perioral Dermatitis Part 1 - The Basics
Part 2:  Guide to Perioral Dermatitis Part 2 - Treatments
Part 3:  MetroGel + Doxycycline Review

And for the Acne Peeps: Visit The Acne Experiment MOTHER HUB

Sources: AOCD // WebMD // Wikipedia // Caroline Hirons

Disclaimer:  I am not a health professional. Perioral Dermatitis is a skin condition that a doctor can diagnose and provide treatment for. I cannot do either of these things for you now, mostly because I am not a health professional, but also because I wrote this before you are reading this, sometime in the past. I'm not a time traveler despite what I may tell you when I wake up suddenly from a deep sleep, hallucinating visions of holes in the space-time continuum.

Guide to Perioral Dermatitis Part 1 - The Basics :: POD Fiesta
Guide to Perioral Dermatitis Part 1 - The Basics :: POD Fiesta


  1. I'm with you on this one.....I've had it for at least 15 years and was originally prescribed a cortisone cream to control it. I finally found a Dermatologist who told me what it was and said I had to stop the cortisone cream STAT, that the rash would get worse (it did), then get better (it did), that I would have it forever and it would flare and calm itself willy-nilly regardless of what I do. Definitely can't use fluoride though. Interestingly, not one single Dentist I have ever talked to about this has heard of it. Aren't they supposed to know about fluoride? The Derm said it was likely a result of trying Flonase for allergies, which does contain a steroid. I only used it for 6 months or so but she said that's long enough. I just started using my Instagram to track the products I can use so I am posting a link to your blog, I hope you don't mind, you have lots of great info! :-)

    1. Huh, Flonase? I never would have put the two together. That's awful! Did you ever find a good POD treatment?

      Sidenote: I'm always fine with link posting, I actually love it :)

  2. I'm currently debating whether i have hormonal chin acne or perioral dermatitis? Like I'm really tempted in sending you a picture so you can diagnose me. lol
    I've been dealing with this for close to two years. It does seem hormonal and i get pustule(s) and/or a couple of papules only in my chin area a week or so before my period. It is very insulin resistant and the severity depends on how restrictive my diet is (paleo) and how much sugar i consume. But the underlying skin on my chin, like the background skin is constantly red. The area behind my nostrils is constantly red and a little rough like i've seen in pics of people who have PO. I don't break out in any other areas.
    I don't wear makeup and i use a moisturizer with very few ingredients. I don't even really exfoliate, or use toners or lots of products. I just use sodium sulfacetamide wash daily.
    I'm debating on going on retin a but i don't know if it'll make this worse.

    1. This actually sounds very similar to my skin, which is prone to hormonal acne AND perioral dermatitis (What fun!). For me personally, the skin on my chin did not tolerate anything except for jojoba/tea tree oil. Foaming/lathering face wash would give me nasty zits, and basically everything else (including moisturizer) would trigger a POD flair. I haven't washed my chin area with anything but water and a washcloth for several years now, and I stopped getting chin cysts. I only use micellar water periodically if I have worn makeup.

      Did you get the sodium sulfacetamide from a doctor? If so, ask them if they recommend something else that isn't a wash. Retin-a tends to irritate POD, so if that's what you have, you're probably better off getting the POD under control first. It may be worth it to experiment with different moisturizer (or oils) as well. It can take weeks for a flair to go down, so it's a bit of a time commitment to figure out what works and what doesn't.

  3. Wow. Thanks for replying. I don't know what it is or if effed up my skin barrier somehow? Only my chin looks like this (red, patchy dry irritated spots, pustules & papules popping up in the middle of the chin). Sometimes, I"m not sure if to my detriment or not I'll skip out on moisturizer to avoid clogged pores.
    One dermatologist i've been seeing for the past 6 months just sort of glazed over my suggestion of PO and just surmised that I was really plugged up there and gave me some rosadan metrogel. As an aside I have melasma on my forehead so I have some hormonal stuff going on in general. So i'm mindful about parabens, other chemicals in products.

    I do find when i can go stretches of time without applying any products (spf, the subsequent cleansers to remove) my skin is sorta better but i still break out eventually every month, it's still red in the background and it's not pih. Doing less isn't curing it and doing more isn't curing it ( i was getting monthly glycolic peels 40% for the last 5 months). It's just a clusterfuck that never ends.

    Anyway thanks again for replying, you've got a great website.


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