I hope that this post is in some way informative and, if possible, helpful to anyone suffering from the dreaded perioral dermatitis. Perioral dermatitis is a skin irritation in the form of a redish rash and dry acne-like pustules around the mouth, sometimes also around nose and eyes.
Normally you experience such desperation with this skin condition that you almost want to forget about it and hope to never have to deal with it again, but most of the time it reappears.
The main reason for this reocurrence lies in the unknown root of the problem. The medical approach is standard and varies from treating it as a rash or as acne.
Let me tell you my story.
It all started, when I was 17, as a dried patch in the right side corner of my mouth. I have always followed a facial cleansing routing of cleaner and hydrating cream since I was around 14, so it wasn't a dehydration issue. I tried different creams etc but didn't change the problem, it slowly worsened and I had a slight burning sensation on it. I then visited the dermatologist, he prescribed a cream for the rash, many years later I found it was a cortisone cream, and there I was happy as a larry to have fixed the problem.... but only temporarily, 5 weeks later the rash appeared, so I applied the cream and fixed the problem in a day..... until it appeared again, and I applied the cream again to make it dissapear... You can see the loop here. I had come to a point where I couldn't be a day without the 'magical' cream because if the rash returned, and I didn't apply the cream it would worsen and burn and get bigger. I had become a junkie, addicted to a cream I thought worked miracles with my skin!!!
Many years went by, yes, it was years, I kept taking the cream with me wherever I would go, always handy and ready to use. After 10 years (!!!) I had a major crisis.
At the time I was living in Singapore. Working as a model I was going from one casting to the next, and my skin had to be in the best conditions. I never wore make-up, it was useless, the minute I stepped out of the house it would melt down, the weather there is terribly humid, hot and stuffy. And of course, my 'magical' cream was my ally. At that point I wore it every day, because the rash was always there, subtle, except for those days it showed more and looked like a small pimple. I think the weather was a trigger for the rash, it only aggravated the problem. I travelled to Thailand and forgot to take the tube of cream with me... What a DISASTER! I returned from Thailand with a horrible looking rash that ran from the right side of my mouth to the left side and also at the bottom of my nostrils.
I was devastated, I looked up on the internet skin conditions that related as close as possible to mine, and I ran into it, there it was, it had a name: PERIORAL DERMATITIS. I also found out one of the most common triggers for the condition: CORTISONE CREAMS. I looked up the ingredients of my 'magical' cream and there it was, god damn it! Instead of magical it was evil. Cortisone creams solve a puctual rash, but it also thinners your skin, it makes it so fragile that it breaks out because it cannot protect itself from the aggressive agents in environment. In my case it couldn't even protect itself from the air...
The first thing you have to do is stop using any cortisone cream whatsoever. The rash aggravates. In my case, after 10 years of dependency, it was monstrous. The rash was all around my mouth, it had little bumps, clumped together with dry patches. I have no pictures, but the mere image I keep in my mind of that time still saddens me...
I then visited the dermatologist in Singapore, very cautiously I commented the condition I thought I had and the trigger; I wasn't ready for accepting any other medical solution that might make it worse. The doctor agreed with the diagnosis, and tried to cheer me up by saying she had seen worse. The average treatment is very similar to that of acne: long term antibiotics. She then prescribed antibiotic tablets, Doxycycline 100mg, for one month as well as applying an antibiotic lotion to the rash. The doctor also prescribed a cleaner and hydrating lotion to use.
My skin started to improve in the first week of treatment, but at the end of the month it still hadn't cleared entirely, I still had some patches of dryness and a few pimples left. The doctor prescribed another month of treatment. It cleared completely after that. (Huge moment of happiness!!)
However, side effects of taking long term antibiotics, no matter how mild they are they will still affect your intestinal flora. It destroys it, therefore after treatment I recommend taking probiotics to restore the intestinal flora. It also destroys your vaginal flora, allowing Candidas to proliferate, this can also be prevented by specific probiotic suppositories, which are more effective than oral probiotics. Probiotics are all the living bacteria that is helpful for our flora, intestinal and vaginal.
Once the skin is cleared, be sure that from now on you have intolerant skin. The skin becomes so weak it turns intolerant, reactive to almost every cosmetic component. Oils are not recommended (check for mineral oils too) because they obstruct the pores; avoid harsh chemicals like SLS, parabens, sulphites, alcohol. For those with combination skin like me, be careful with the ingredients that matify and/or to treat acne prone skin. You should look for emollient agents like glycerine, and thermal water to calm and hydrate. The deal here is not to upset the skin to prevent it from breaking again. I stayed with the cleaner and hydrating lotion the doctor prescribed: La Roche Posay Toleriane Purifying Foaming Cream and Toleriane Fluide, since it had worked so good during treatment. Look for formulas to be as simple as possible. Another mayor issue: make-up, during treatment avoid using make-up since most of the ingredients are harsh for reactive intolerant skin, or contain oils. This is one of my quests now, finding make-up that my skin can handle. Use sunscreen!!! I can't believe how many people still go around without sunscreen and wearing expensive La Mer creams, the UVA and B rays are our biggest enemies, theY alter cell growth. Therefore use it, but remember the ingredients. In Spain I use HELIOCARE Ultra Gel SPF90, I trully recommend it after trying many out and provoke another dermatitis breakout in the process...
When moving to Spain to live I couldn't buy any of the La Roche Posay cosmetics from above... aparently they don't sell them here!! Hell! I thought, what was I going to do? Well, I visited a dermatologist, I asked for them to recommend other cosmetics to use and so they did.... They mistakenly thought I had rosacea and prescribed a gel for the face, no cortisone, but it dried my skin so badly it broke again!!!
I have slowly turned to all natural remedies to treat later breakouts avoiding antibiotics as much as possible. The antibiotics left me with no defences, my stomach was crushed and I suffered from Candidas on a monthly basis after that, every time I was going to have my period my defences would drop and the Candidas were all having a party. This breakout was nothing, only the expertise of my previously traumatised eye could distinguish a slight dryness again on the right side corner of my mouth...!! I freaked out. The first thing I did was get rid of the gel, and search for natural remedies. I applied cider vinegar diluted in water directly to the dry patch, I had read it could also be a fungus and apple cider vinegar worked very good, it desinfected the area and you end up having a postule that dries out and you are left with fresh new skin. Whilst using cider vinegar, you have to use a cream for calming the area and moisturising, I used calendula cream. But the biggest help of all has been BREWER'S YEAST. It has helped considerably my skin overall. I'll make another post with more details about this miracle of a nutrient.
It took a month to clear, but I was happy, the breakout happened in November last year. And funny enough, at the end of this year's October I started to see a more subtle dry patch, again in the same place. I think it might be related to the weather change from summer to autumn, the skins dries out more until it feels comfortable with the new climate. I don't discard fungus or bacteria, maybe coming from the stomach, that grows more for reasons I still haven't figured out. So I'm following the same treatment.
I know this is a long post, long story it is too. Still there are many uncertainties: for some reason acne treatment works good for many people, it deals with the irritation of the skin during the breakout, but it does not deal with the root of the problem, thus the reocurrence; Theory of bacteria or fungus in the skin also seems plausible, since the remedies work too, but why always in the area surrounding the mouth? Thus the relationship with the stomach.
So what is the cure of perioral dermatitis? For severe cases I recommend antibiotic treatment to clear the skin, but I don't think it is the solution to the problem, it's a walk through trial and error until you find what works for you. Keeping a food and drink diary also helps, in order to try and find out a relationship with what you eat that might trigger it.
Have any of you suffered from this skin condition? What have been your remedies?
