Perioral dermatitis zero therapy: simply do nothing for healthy skin

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Perioral dermatitis is also called mouth rose or stewardess disease. It is an inflammation of the face, usually around the mouth. Hence the name perioral dermatitis ( perioral = around the mouth; derma = skin, itis = inflammation). Later on, perioral dermatitis can also affect the area around the eyes. Here you can learn more about perioral dermatitis and its symptoms and causes .
The main causes are too many or wrong cosmetic products and stress. Therefore, for the treatment of perioral dermatitis, it is necessary to completely abstain from skin care and make-up for a certain period of time. The term for this is also “zero therapy” . In this article you will find out how to get through the zero therapy and what else you can do.

A consistent zero therapy is the only way to get rid of an acute stewardess illness. This means: do not use any cosmetic products.

How long you should go without using it depends on how your skin reacts. You should really go through a very strict zero therapy for at least one skin cycle. A skin cycle lasts about 28 days. So one month is the minimum. However, 6 weeks or a few months are recommended. The longer you hold out, the better your skin can regenerate.

If you have perioral dermatitis, it is especially important to leave your skin alone immediately. Unfortunately, there are often recommendations on the Internet for all sorts of treatments, creams or oils that are supposed to work against perioral dermatitis.
It is extremely understandable that you are now looking for a good solution that will quickly resolve the problem. Unfortunately, this is not the right way, because anti-pimple creams, active ingredient treatments or balancing oils would only exacerbate your perioral dermatitis. Niacinamide , serums with soothing substances or peelings of any kind are also taboo for your skin for the time being.
Moisturizing serums with hyaluron or other moisturizers would further irritate your skin in the acute phase. Even if hyaluronic acid is very skin-friendly and otherwise provides wonderful moisture: In the case of acute perioral dermatitis, hyaluronic acid causes the horny layer to swell and your skin would become even more sensitive. Give yourself a little time until more is possible again.
Even the good old zinc ointment is not right now. Although zinc can otherwise work really well for pimples and inflammation. What you have now, even if you see pimples and sores on your skin, are not normal pimples. Your skin has seen too many active ingredients, serums, creams or oils lately that even a simple zinc ointment could be too much. Zinc (zinc oxide) must always be dissolved in a fat and too much fat or rich butters would now irritate.
So please refrain from using all skin care products from now on - including treatments and emergency aid! If your skin is as restless as it is now, you probably want to do something about it. The right thing to do in this case, however, is to remain patient and calm and do nothing.

For your skin, zero therapy means that you should only wash with water, because the "over-treated" skin must not be overwhelmed any more. That's right... just water. That sounds really tough. And you should also avoid using a cleaner during zero therapy if you can. The issue of cleaning is of course very individual. If you have very oily skin that quickly develops new deposits, you can occasionally cleanse it with a very mild cleanser that does not contain strong surfactants, active ingredients or moisturizers. Pay close attention to your skin's feedback, it's really crucial here.

In fact, you should always wear sunscreen during the day.
In the zero therapy you now face a dilemma. Your skin is so irritated that it will also react to the sunscreen. We cannot generally recommend doing without sun protection. However, if you can avoid most of the sun for a few weeks, you may want to consider going without sunscreen for a few weeks to allow your skin to regenerate.
If you use sunscreen, or if you start using it again, make sure it doesn't contain excessive moisture, vegetable oils or butters, doesn't contain any active ingredients, and doesn't contain any irritating fragrances of any kind. Unfortunately, this is sometimes quite difficult when it comes to sun protection. Especially if you prefer a natural cosmetic sunscreen. With vitamin C, it is best to see how it works individually. Vitamin C derivatives are usually added to good sunscreens because they boost sun protection and thus also protect against oxidative stress from UV rays. Here it probably makes sense to accept the vitamin C derivative if it is included. Often the vitamin C in sun creams is not so high dosed. In any case, it cannot be compared to a vitamin C treatment. Do not worry. If you are very unsure, it is best to speak to your dermatologist about the topic. She or he can probably help you with your current skin condition on how to deal with the topic of sun protection.

You should also not wear any make-up during zero therapy.

If you feel very uncomfortable some days, you can use simple mineral makeup . It should contain no bismuth oxychloride, no mica , no silicia , no active ingredients and no vegetable oils. The loose minerals can be applied to redness and inflammation with a kabuki brush. Plus point: You can wash this makeup off your face with water. If a few minerals remain on the skin, it is not a problem because minerals cannot react with the skin. It is very important that your skin does not come into contact with too much moisture, fatty butters or waxes. These are often found in natural make-ups. Conventional make-up is also not an option during this time because moisturizers and active ingredients could delay healing. In the period of zero therapy, really only use water for the time being. It is often claimed that stopping skin care abruptly puts even more stress on the skin. That's not true, because any further contact with cosmetic products will exacerbate your perioral dermatitis.

Your skin may become very dry during zero therapy. It may also start to flake over time. That's okay and that's what we want. After all, the skin was over-cared for and often over-moisturized. This is the only way your skin can recover now. She's kind of starting over.

You really shouldn't use cosmetics all over your face during zero therapy - not just on the areas that are visibly affected.

Experience shows that for many people with perioral dermatitis it is very difficult to keep up the zero therapy. It can be a really stressful time. So make it clear to yourself: It's about your skin being able to get healthy again in the long term.
It helps if you can do something else instead of your usual skincare routine, and luckily there's also:
A black tea mask can improve your condition. Below you will find instructions for the black tea mask.
It can also help if you find a ritual different from your skincare routine. You can use this right away to reduce your stress. After all, stress is also an important cause of perioral dermatitis. For example, you could meditate, do breathing exercises, go for a walk or brew a special tea and consciously enjoy it every morning.

Just like treatments, most skin remedies that can be found on the web are not a good idea for mouth rhinitis. Tea tree oil is definitely not suitable for perioral dermatitis. It contains irritating essential oils that can damage even healthy and intact skin.

If you still need a little something to soothe you and your skin, you can make a homemade black tea poultice. This soothes the skin a bit.
Maybe your skin won't feel as stressed afterwards. However, ready-made masks that contain black tea are not for your skin. Because these contain other ingredients that would currently be too much for the skin.

With anti-inflammatory foods you can support your skin to heal from the inside. Of course, this makes sense at all times. There are four key steps to an anti-inflammatory diet: Reduce sugar. Fermented and high-fiber foods support your gut and microbiome. Good oils and fats have an anti-inflammatory effect.

We wrote a separate article about diet for perioral dermatitis . There you can find out more about which foods are particularly anti-inflammatory.

After zero therapy, you can gradually sneak skin care products back into your routine. You should proceed as cautiously as possible and keep reflecting on whether you might be doing too much. Another article is already in the works.
And before that: even if you find first-aid ideas all over the internet - don't touch them. Because that would ruin the whole healing process and you would have to start all over again.

Have you ever done zero therapy? what are your experiences

This article originally appeared in February 2022. To celebrate Skinfasting Month we launched in May 2022, we are republishing this article. Last edit: 07.12.2022