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Perioral dermatitis: causes, symptoms and treatment

Posted by Lara Schimweg on
Ein Zeichen einer Perioralen Dermatitis ist ein helles sichtbares Dreieck, dass zwischen Nase und Mund entsteht.

Wondering what perioral dermatitis is? Do you suspect that you are affected by the skin disease? Or confirmation from a dermatologist? Then you can find out more here about how to recognize the so-called stewardess disease, what the causes are and how it can be treated.

Perioral dermatitis usually shows itself in the form of redness, blisters or dry patches as well as pimples and inflammation. A bright triangle can often be seen around the mouth .

The main cause is over-care of the skin due to too many and, above all, unsuitable cosmetic products.

The treatment of perioral dermatitis usually consists of a so-called zero therapy , in which no cosmetics are used at all.

What is perioral dermatitis?

Perioral dermatitis is a skin condition involving inflammation on the face. It usually shows up around the mouth and on the chin. Hence the name: "Perioral" means around the mouth, "dermatitis" means inflammation of the skin. It is also called mouth rose or stewardess disease. Although it is not dangerous or contagious, it is very unpleasant for the person affected.

Where does the mouth rose come from? Too many and, above all, unsuitable or irritating cosmetic products can be the cause. An overreaction of the skin leads to irritation around the mouth and nose in the early stages of perioral dermatitis. Later, perioral dermatitis can also affect the area around the eyes.

For the treatment of stewardesses' illness it is necessary to forego skin care and make-up for a certain period of time, the so-called " zero therapy " . Medical treatment under the supervision of a dermatologist is also possible.

Perioral dermatitis symptoms

Perioral dermatitis usually begins insidiously. At first the skin feels a bit irritated. Redness is also more common. The skin may also burn and become hot. In many cases, the skin can hardly tolerate any products and reacts to just a little skin care or make-up. This often even applies to products that were otherwise very well tolerated.

How do I recognize Perioral Dermatitis?

Redness, blisters or dry patches as well as pimples and sores form around the mouth . Hence the name "Mundrose". A distinctive feature of this skin condition is a bright visible triangle that forms between the nose and mouth. This area is not red, pimples or blisters appear, although the skin around it is very irritated and inflamed. If you notice that your skin is becoming more and more sensitive, you should definitely listen to your skin and use less (irritating) skin care products.
If you're noticing these symptoms of perioral dermatitis, you're probably asking yourself, "Do I have perioral dermatitis?" However, there are similar symptoms as well rosacea , acne or seborrheic eczema. It is best to clarify with a dermatologist whether you have perioral dermatitis or acne, rosacea, eczema or another skin disease.

Perioral Dermatitis Causes

Where does mouth rose come from? The causes of perioral dermatitis have not yet been finally clarified. Various causes could play a role; a perioral dermatitis can be triggered by stress , fungus , bacteria or other causes. In addition to stress, however, too much and above all unsuitable cosmetics and incorrect use are responsible. If you often have to wear mouth and nose protection, such as during the corona pandemic or in general in medical professions, this can also promote mouth rhinitis if there are other causes. This is then also called maskne .

Perioral dermatitis from over-grooming

How does perioral dermatitis develop? It usually occurs when you have used too many products on your skin. A simple skin care routine or a light everyday make-up are usually not a problem. Rather, it is the trends in skin care that encourage more and more layers of skin care. Constantly switching between different products can also overwhelm the skin. The skin gradually becomes more and more sensitive due to too much and unsuitable skin care.

Too much moisture can also be a problem for healthy skin. The dose is also important when it comes to moisture. The result is that the horny layer swells. This weakens the skin barrier and loses its ability to protect itself.

But there are even stronger means: more and more chemical peelings (acid peelings) with dizzying concentrations of active ingredients are coming onto the market. It would be much healthier to exfoliate at most 1-2 times a week.

Tip: An enzyme peel is milder than other peels

Incidentally, a very mild enzyme peeling is best, especially for sensitive skin, because it only helps your skin gently with flaking.

Stay Kind contains no mechanical abrasives, no acids and no fruit enzymes, but body-like enzymes.


Conventional natural cosmetics often contain essential oils , rose water , drying alcohol and many other irritating substances that attack the skin barrier and can trigger allergies. Such natural cosmetic products can also irritate the skin to such an extent that perioral dermatitis develops. Soaps are another problem . They are too basic and attack the skin's protective acid mantle.

rose petals

Jack of all trades or myth: is rose water good for the skin?

Don't be fooled: seductively scented cosmetics with essential oils damage your skin

Soaps are sustainable: are these old-fashioned cleansers good for your skin too?

Pure vegetable oils applied to dry skin act like a cleansing agent and remove fats from the skin. According to the principle, like solves like. Therefore, dry eczema can develop over time.

Therefore, perioral dermatitis can also occur when switching to natural cosmetics if you do not pay attention to mild products.

Is facial oil good or bad? 15 benefits of facial oils put to the test

Switch to natural cosmetics

Switch to natural cosmetics: In 4 steps to your natural cosmetics for sensitive skin

In summary: Too many and, above all , unsuitable or aggressive cosmetic products can cause perioral dermatitis. We are fortunate to have a beautiful, robust upper layer of skin (horny layer) that protects us from environmental influences. So we don't need a lot of skin care at all. Beauty advertising never tires of telling us how important it is to use a lot of products. The skin naturally likes minimalist routines . She loves repetition and regularity. She'll be happy if you give her a little help. Depending on the problem, she is also happy about a peeling or one or the other active ingredient in your routine. Just too much is just not good.

Stewardess illness due to stress

It is relatively certain that perioral dermatitis can be favored by stress. Stress is partly responsible for countless diseases. Reducing stress is therefore always a good idea, but it is usually easier said than done. See below for tips on how to reduce stress.

Maskne: Perioral dermatitis caused by mask

Mask can also cause perioral dermatitis . This phenomenon became known as "Maskne" during the Covid-19 pandemic.

Maskne: With these 10 tips you can avoid pimples through the mouth-nose mask

Who is at risk of getting stewardesses disease?

Perioral dermatitis appears to be an influencer disease. At least it seems that way when we follow certain channels. In recent years, more and more of them have admitted to having overdone their cosmetics. The danger exists for everyone who wears or tests many different cosmetic products in their job. These include, for example

  • bloggers
  • Influencers
  • models
  • Actors
  • flight attendants

The flight attendants have also given the disease the name “ stewardess disease ”. In addition to a lot of make-up, stewardesses have another problem: there is a completely different air pressure in the air and the skin is exposed to far more stress than on the ground. Flight attendants often fly through the night. Necessary sleep, which the skin needs for regeneration, is neglected because the day-night rhythm is shifted. Added to this is the fact that even today many stewardesses are still expected to have flawless make-up - a requirement that is fundamentally questionable. Especially at this altitude, the skin loses a lot of moisture. It is literally pulled out of the skin by the air pressure. What remains on the skin are make-up residues. These dry out the skin even more. Ideally, people should wear a rich cream and adequate sun protection during a flight. After landing, it makes sense to moisturize the skin again. Make-up should be minimalistic or better applied only after landing.

Since stewardesses' disease is favored by stress, in principle all people with a lot of stress are susceptible to perioral dermatitis. Especially if you add a lot of cosmetics to it.

Especially if you already have sensitive skin , are prone to acne or have rosacea , you can take care of your skin even more quickly and thus develop perioral dermatitis. In this case, the skin is not quite as robust by nature. The irritation threshold is significantly lower than that of non-sensitive skin. An overreaction can occur after just a few irritating contacts with irritating cosmetic products. Conversely, this does not mean that insensitive skin cannot develop perioral dermatitis. Unfortunately, sometimes we don't realize how irritated our own skin already is. The redness and burning sensation have become normal. It feels like it's going to happen suddenly. This is the initial stage of perioral dermatitis. Maybe you just didn't notice it because the typical symptoms haven't shown up yet. If you have perioral dermatitis that keeps coming back, ask yourself if your skin has always been sensitive. Perhaps you have another skin condition, such as incipient rosacea, that promotes perioral dermatitis.

Perioral dermatitis - treatment

In the case of acute oral rhinitis, only zero therapy initially helps. This means that you should stop using cosmetic products for the time being. In addition, dermatologists can also prescribe appropriate medication to help against the symptoms.

Preventing a stewardess illness is much easier than getting rid of it.

Unfortunately, there is a lot of misleading advice on the internet that can make perioral dermatitis worse. It is often claimed that certain products help. You should only start again with completely minimalist skin care after a complete zero therapy. Black tea is advisable at most during zero therapy.

The zero therapy

With zero therapy , you consistently do without skin care and other cosmetic products over a longer period of time. How long you should do without skin care cannot be clearly determined. It should last at least a month , but the longer the better. Your skin needs time to regenerate. It is understandable that you are looking for an "immediate solution", but in particular active ingredient treatments and supposed "SOS help" would only worsen your skin condition.

Less is more when it comes to cleansing too: skip your usual cleanser and only wash your face with lukewarm water . If you feel your skin needs a cleansing product to cleanse, you can try a very mild cleanser . Listen to your skin and see if it tolerates it.

The topic of sun protection in the zero therapy is much more complicated. Basically, it is advisable to use it daily to prevent skin cancer and premature skin aging. But in the case of zero therapy, that might not make so much sense. One option would be to forgo sunscreen on your face, wear a sun hat, and avoid sunlight as much as possible. If this is not possible, for example in midsummer, a compromise would be to only avoid the area with the perioral dermatitis and cream the rest of the face as usual.

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You should also not wear any make-up during zero therapy. In particular, butters or waxes, which are often used in make-up, are not good for your skin at all.

In this article you will learn more about the process of zero therapy, how long it lasts and how to go through it :

Perioral dermatitis zero therapy: simply do nothing for healthy skin

Perioral dermatitis home remedies

When it comes to skin care, home remedies are often not a good idea. However, you can soothe perioral dermatitis with a homemade black tea poultice. All you have to do is boil black tea, steep it for 15 minutes and then let it cool down.

Tip to save time

If the daily brewing of black tea is too time-consuming for you, we can help you: For this case we have developed Tea Break. This is an essence of pure organic black tea. You have this practical helper quickly at hand and save yourself from having to constantly make tea. In addition, Tea Break is pH skin neutral and, thanks to a very mild preservative, can be kept for 6 months after opening.


Medical treatment for perioral dermatitis

It is not that easy to endure a zero therapy. In the case of severe symptoms in particular, the longing for quick relief can be great. Therapy by a dermatologist can help you here. They may prescribe you a cream or oral medication. However, what exactly is suitable for you depends on the individual case. But be careful: medications are not necessarily promising either. Your skin is inflamed and sensitive right now. Test the dermatologist's cream for tolerability on a small, healthy area of ​​skin before applying it to your perioral dermatitis.

reduce stress

It is also important to reduce stress. When you are stressed, it often shows in your skin. Stress is also a cause of perioral dermatitis that you should not ignore. Come up with a new ritual. Here are a few ideas: go for a walk, read a book or integrate yoga into your everyday life. Breathing exercises, meditation and mindfulness can also be part of a therapy for stewardess disease - depending on what helps you to reduce stress.

In any case, it also makes sense to eat an anti-inflammatory diet.

Perioral dermatitis diet

Nutrition is often underestimated, but it is an important factor when it comes to skin health. Even with perioral dermatitis, you can support the healing process with a healthy, balanced diet and do something good not only for your skin, but for your whole body.

reduce sugar

Reduce your sugar consumption. That doesn't mean you have to give up all the sweets. But enjoy it more consciously and with care. This tip also applies to sugar alternatives such as agave syrup, honey and coconut blossom sugar.

We recommend inulin as a healthy alternative to sugar. This does not allow the insulin level to rise, contains a lot of fiber and is good for the intestinal microbiome.


Fermented Foods

A healthy gut also has a positive effect on the skin. And to strengthen the intestinal flora, yoghurt and fermented foods such as kombucha and kimchi are ideal. These foods contain good bacteria that feed your gut microbiome.

Diet with anti-inflammatory fats

Unfortunately, fats are often demonized. They are very important for a balanced diet and have a positive effect on your health. However, oil is not just oil. Better than sunflower oil are, for example, coconut fat, safflower oil or cold-pressed olive oil. However, you should not let the latter get too hot and rather use it for steaming or gentle cooking.

Walnut oil, hemp oil and linseed oil can also complement your diet wonderfully and are particularly suitable for cold dishes.

do you eat fish Then you can benefit from the contained omega-3 fats. These reduce inflammation throughout the body. A herbal alternative is the spirulina algae. However, you should know that these are not as well absorbed by the body as fish. It's up to you to decide what's right for you.

In this article you will find more tips for your diet with perioral dermatitis:

Perioral Dermatitis Diet: Eat Anti-Inflammatory

Skin care after perioral dermatitis

If you have successfully survived the zero therapy, it is absolutely important to sneak the skin care products back in gradually and carefully. Your skin is still very sensitive and if you start using a lot again too soon, the POD cannot heal. Make sure to use mild products without active ingredients and irritants such as fragrances, essential oils or alcohol and give your skin time to get used to the new product. Watch how your skin behaves. If she becomes stressed or worsens again, take a step back. If you work slowly and with your skin, things will pick up again quickly. By the way: you don't necessarily need a skin care routine with countless steps. With a low-irritant and minimalist skin care routine, you give your skin exactly what it needs and at the same time prevent renewed perioral dermatitis. If you would like to test a new product - whether it's make-up or skin care - you can of course do so. But again, you should not overdo it and first pay attention to how your skin reacts.

A basic minimalist routine consists of a mild cleanser, cream and sunscreen.

Tip: You can rebuild your skin barrier with our Human Glow oil.




As you can see, perioral dermatitis is a complex and sensitive topic. Once affected, it is a long and arduous process to heal the skin. If you heed our tips, both your skin health and your well-being should gradually develop positively.

In any case, preventing a stewardess illness is much easier than getting rid of it.

Lara Schimweg

about the author

Lara Schimweg is the founder of Xeno . She studied sports science and health research and is a trained health worker. Lara has rosacea and very sensitive skin.

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