Perioral dermatitis/Seborrheic dermatitis

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I'm 44 yo and started with bumps/pimple like bumps on my chin probably 5+ years ago. I also would get cyst? Looking bumps, almost like mosquito bites on my neck area under my chin. Saw several dermatologist who said it was adult acne put me on some acne creams. DID NOT WORK, MADE IT WORSE. Never went back. Saw primary care doctor who said perhaps going on a birth control pill would help started with that went away, but would come back periodically. Got frustrated went to a different dermatologist who walked in looked at me and said seborrheic dermatitis and put me on Hydrocortisone 1%. That worked for a few years but it would come back at one point I thought I had a staph infection went up side of my face so I saw him I primary care doctor who prescribed antibiotics and that went away. Recently it started acting up again and the hydrocortisone cream was not working went back to the same dermatologist who prescribe me the hydrocortisone and he said it's perioral dermatitis stop using the hydrocortisone cream used as Metro cream and take this tetracycline antibiotic. After day 2 of Metro cream and tetracycline antibiotics my face was 100% worse red rash like small little sand like bumps that itch intensely and swelling around my eyes and cheek area. Went back to the dermatologist and said I'm not taking this antibiotic anymore or this cream this is not what it's supposed to do he put me on oral steroids change the antibiotic and gave me a finacea gel to use. Being that I'm stubborn I did not take the antibiotic I only took the oral steroid and it cleared up I thought everything was good. Started wearing make-up left for vacation and by day too and it flared up again worse. Had to see a doctor on vacation who was not aware of perioral dermatitis but prescribed me another antibiotic erythromycin. Because of my reluctance to take a tetracycline again. This may or may not have helped it took weeks before everything got better. However for the redness I found a diaper cream with 30% zinc oxide did help when wearing it as a mask at night. The dryness was intense the cracking was intense and nothing I put on helped whether it was all natural or otherwise. Call the dermatologist I had seen previously he prescribed me a sulfur wash for my face told me to keep using it. This was supposed to take care and Slough off the dry skin. It did but then we had redness again. Went back again and this time saw the PA, physician assistant at the dermatologist office who looked at me and said don't use any of the other creams I'm going to prescribe you a cream that's going to help with the dryness, Promiseb. Which did work. However this cream is for seborrheic dermatitis. Which is what she said I had. At this point being frustrated not knowing if this flare up which was the worst I've ever had besides thinking I had staph infection again was due to rebound from getting off the steroid cream I decided to go see an ENT to do allergy testing. First thing the ENT asked me was why was my skin never swabbed. My response was you tell me these are your peers. He swapped my face still waiting on results. However he thinks this is seborrheic dermatitis which is caused from fungus and or yeast. And said everyone knows you don't give antibiotics for this it will make the yeast worse. He told me to take probiotics, Jarrow company, more than one strain of probiotics. He said dissolve a pill on your tongue first then take one pill by mouth because by the time it gets to your stomach all of the probiotics may not still be working. He also prescribed me and anti fungal cream of which my insurance would not pick up so I have not started yet and we've scheduled a patch test at some point in the future to see what if anything I'm allergic to and if indeed it is yeast and or fungus so that we may get to the source and get rid of it so this doesn't happen again. Very frustrating to say the least. I have also stopped taking birth control pills in case that also made things worse, however I was told by PA rhat wouldn't make a difference.

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3 Replies

  • Posted

    Have you looked into TSW (topical steroid withdrawal syndrome/red skin syndrome) ?
    • Posted

      I have, but no one can confirm. I will never use a steroid cream again! Just in case.
    • Posted

      Dr Rapaport does indeed have the ability to diagnose, but at a cost.

      For TSW the only treatments, even cure, is zero therapy. Moisturiser withdrawal is necessary at the height of TSW. Do you have any systemic symptoms such as temperature disregulation, headaches, etc? Or is it limited to your skin?

      Lastly, if you suspect TSW, join the Facebook group, let everyone help and support you.

      God bless

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