In 2026 I started dealing with a completely new thing in my health - perioral dermatitis, or PD to those who are unlucky to be familiar with it. I’m breaking it down in this blog series in case it helps anyone else get answers with their skin healing journey.
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In February I started to notice small bumps and a little redness next to my mouth. My sister, who’s had PD before, actually pointed it out to me.
In March, after a weird not-quite-stomach-bug (but about 24 hours of severe stomach cramping), it got much worse. It really found its full form after a spa weekend at Kripalu with my mom and sister, where I was getting massages and oil rubbed into the skin on my face.
I don’t have a picture of my skin up close at it’s worst - imagine it more red and flakey.
How we got here (what I think triggered it)
This was my first time getting perioral dermatitis (PD), so for the first few weeks when it was quite mild, I didn't really know what I was looking at.
That winter, I'd started using a retinal cream — trying to be a skin care girlie! I'd only used it about 4-6 times over the course of as many weeks, but retinal (and retinol, aka Vitamin A) is commonly used to increase skin turnover and boost collagen production, giving your skin a younger, healthier look by promoting new skin cell growth. The risk, though, is that it can damage the skin barrier — the layer your skin uses to protect itself from the environment. Redness, drying, and peeling during vitamin A use is so common it even has a name: "retinization." For people already predisposed to skin barrier issues, I suspect this becomes an even greater risk factor.
It was also around this time that I was pushing detoxification with a mineral balancing protocol. Pushing detox faster than your body can actually eliminate toxins can lead to a backlog in the system, which very often shows up as skin symptoms. [Read more about drainage and detoxification in my blog post here.]
About a month after I first noticed changes in my skin, I got that weird stomach bug — uncomfortable cramping for about 24 hours — and after that my skin got noticeably redder, more inflamed, and overall much worse.
Frustrated and looking for answers, I turned to the internet for topical solutions because doing nothing clearly wasn't helping. I started using azelaic acid twice a day, Avene Cicalfate overnight, a light CeraVe cream during the day, and washing with a gentle Vanicream cleanser twice a day. It got redder and angrier by the day.
We had a family wedding around this time and I was so frustrated to have this flare up right then. It felt like anything I was doing topically was making it worse, so I pulled it back. I wasn't a regular face-washer before all this, so I even stopped using the gentler cleanser, returned most of the products to Ulta (shoutout to their return policy), and kept only the CeraVe cream for when things were looking particularly dry and flaky.
It's about more than topicals (healing skin from the inside out)
The irony is not lost on me that I work with clients every day on skin health, gut protocols, and detoxification — and this was not the first place my mind went in the early phases of this flare.
I eat a nutrient dense, mostly whole foods diet. I've worked on my gut health for years. I was actively supporting detoxification and drainage pathways because of the mineral protocol I was on. So what was I missing?
What I hadn't pieced together was that the mineral protocol had been ramped up from what I was used to, potentially pulling out more metals than my body could keep up with eliminating. The stomach bug in late winter may have shifted things further. And the straw that broke the camel's back was likely damaging my skin barrier with the vitamin A cream.
So I started to treat myself like a client.
I told myself, what I’d tell a client who found themselves in this same scenario.
Slow down or pause detoxification efforts. I stopped high-dosing certain minerals that I knew could contribute to mobilizing heavy metals faster than my body could eliminate them.
Continue with drainage support. I kept up with supplemental liver and gallbladder support (TUDCA and Ox Bile — though worth noting that if you're not already taking these, they can be detoxifying at the start depending on your liver and gallbladder function). I also got back into my "Big 6" massage and dry brushing routine before the shower to keep my lymphatic system moving.
Test the gut. My last microbiome and GI panel was from 2020, so I was overdue. This time I used the Tiny Health test, which uses shotgun sequencing to test the presence and relative abundance of 125,000 different microbes — compared to the GI MAP, which tests around 68. That's a meaningful difference in the amount of information you're actually getting.
Support the gut. I already eat fermented dairy nearly every day, but I added more sauerkraut and kimchi while I waited for my Tiny Health results. I also started using higher doses of MSM (Methylsulfonylmethane) to support the mucosal barrier and address any leakiness in the gut. A compromised gut barrier allows toxins from inside the gut into the bloodstream, which can flow through to the skin, joints, brain, and beyond.
Within a few weeks I did start to see some improvement with these changes alone. But the Tiny Health results came back with something I wasn't expecting, and I think the findings are worth their own post. I'll be sharing those soon.
(PS - a follow-up to those “before” pictures at the top, here’s where my skin is today)
Want help knowing where to start, or where to go next in your skin healing journey? You can book a call with me here.