Help me with my **possible** perioral dermatitis

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Hi Everyone.

I am at my wits end with my skin and wondered if anyone could suggest anything.

About eight months ago I went on a course of antibiotics for a wound that wouldn't heal. It did the trick, but a couple of days after I finished the course I began to get huge flakes of skin coming off each side of my nose and just under it. There was no real redness at first, just extremely flaky skin, which Ive never had before.

This then turned red on one side and was quite sore. This cleared up, but switched to the OTHER side of my nose and this is what I have had ever since.

It has come and gone in various degrees of severity, but generally, it is red and mildly flaky/dry with lots of little bumps which look like acne but never come to a head. Having said that, I have been getting cystic type acne right in the fold of the nose recently.

TREATMENT: I initially googled the problem and concluded it was perorial dermatitis. I didn't want steroids as I know that makes it worse, so I went to the doctor (who didn't know what it was and had to GOOGLE perioral derm!?)who gave me DUAC cream. That helped a bit but it just came back.

I have since been to numerous doctors who have given me everything which I have eventually tried.

I was advised to use an anti fungal cream,so used canesten (without steroid in it). This gave me some kind of allergic reaction and i got eczema all around the area where I used it. To treat this separate condition -ergh) i was prescribed a steroid cream, daktacort, which made the eczema go away but then the PD came back worse and now I'm back to square one.

I'm almost positive its a classic case of PD, and since I tried everything the only option is antibiotics. However, I am EXTREMELY reluctant to take any seeing as it would seem that anti biotics gave me it in the first place! It all started as soon as I finished a course of them, having never had it in my life before.

I have no idea what to do, and would appreciate ANY advice. Apologies for the huge post!

Note: I should also add that I have tried lots of home remedies like coconut oil, lemon juice, apple cider vinegar which have helped mildly but not gotten rid of it. In the past three months I've also cut out wheat, sugar, dairy and yeast (considering it may be candida overgrowth). I even switched to fluoride free toothpaste. Nothing has gotten rid of it! (except the steroid/anti-fungal, and only temporarily!)

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441 Replies

  • Posted

    Hi! I totally understand how you are feeling about your perioral dermatitis. I have been suffering with it for

    about five months now. Like you, I did everything to try to avoid taking oral antibiotics, as I know from experience that they do not do good things to my body. I also tried all types of home remedies... apple cider vinegar, yogurt masks, clay masks, and all types of all natural face washes. Some things would help but not cure the problem. However, about five days ago, out of sheer desperation and curiosity, I found some Bacitracin ointment in my drawer and decided it couldn't possibly hurt to try it. Since my face looked so horrible anyway, I just slathered some of the ointment on and went to bed. When I woke up, I thought I was hallucinating.... the rash had drastically decreased in severity. The red bumps were less red and raised, not the mention the oiliness of the ointment had kept the rash from getting so dry overnight. Needless to say, I tried it again the next night. It has been five days, and my rash is almost completely gone. I don't know if it's just a fluke or if these results will even last, but I'm hoping they do. I got online specifically to find somewhere to post this so that others could see it. I have spent so many hours researching remedies for perioral dermatitis, and i just knew I needed to give back. I don't know if the bacitracin will work for you, but if you're desperate like me, I would say give it a shot. Good luck!!!

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    • Posted

      I am so very happy for you. Reading others getting results from things they try elated me. Would you be kind enough to post again in a couple months to tell us if you had lasting results or the condition came back. I pray it doesn't.
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    • Posted

      Hi pleased you have found something that helps I use sudocrem or viscopaste which also contain Zinc so this seems to be the key to getting rid of the redness.good luck everybody


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  • Posted

    Thank you Ladire!

    So happy that you have found something that works for you. I really think that it is a case of trying everything, just in case it works. Its so unbelievably frustrating to have something which effects you so much, yet no one really knows what causes it or how to treat it. Its really a case of trial and error. My main problem has been that my GP had never even heard of perioral dermatitis, and just prescribed me whatever he found on google. Very frustrating. It seems that most people get by through their own research!

    Unfortunately Bacitracin isn't available here in the UK. I will have to try and find something similar! However, the good news is that my PD has decreased dramatically. I'm not even sure if it was anything I'd used, as I continued moisturing and applying apple cider vinegar and it just kind of decreased over a few days. Its still quite red and dry, but I think it may just be the healing stages (there were times when it was so dry that it cracked aand bled!). There are certainly no bumps or itchiness anymore. So thats great news. I just sort of waited it out, and it seemed to go.

    Whatever the case, I know from having this on and off for a year that it may almost be gone, and sort of lay dormant for a couple of months, and then flare up badly again. So I'll bare your advice in mind for a future outbreak! I'm just incredibly happy for it to have gone down at all. Fingers crossed it stays like this in time for Christmas!

    Do you have any suspicions about why you may have gotten PD? I know some people say it may be contraceptive pills, or steroid withdrawal. Im interested to know, as it seems it can be caused by many things. I'm almost certain mine was antibiotics. I guess some people are just unlucky!

    Really appreciate your advice. Good luck with everything!

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  • Posted

    I first started having symptoms of pd about 5-6 years ago but wasn't diagnosed for awhile. Mine started very subtly - just a few bumps here and there around my nose. It wasn't until just before my wedding that I got serious about trying to figure out what it was because it was getting worse and I didn't want to look horrid in the pictures.

    In my case I have been on oral steroids for 10.5 years because I have Lupus. I notice whenever I try to decrease my dosage I have a PD flare up. I'm pretty consistently at 10 mg/day but even 7.5 mg will cause the condition to worsen. My dermatologist prescribed a steroid cream and antibiotic combo which worked wonders as long as I was using it. The second I stopped it just EXPLODED all over my face. That outbreak lasted almost 3 weeks and I was miserable and humiliated. It's been over a year and it hasn't been that bad again. Now I'm pregnant - not sure if that's a factor - but I'm having trouble again and this time it's not clearing up.

    As far as topical treatments I haven't found one thing that has made a difference long term. It seems like everything works at first and then within 2 days I'm back to square one. Or if the older bumps have smoothed out there are new ones taking their place.

    One thing I know without a doubt is fluoride toothpaste and ANYTHING that foams (contains the ingredient SLS) will cause me an immediate outbreak. I have been using Xyliwhite toothpaste for almost a year - honestly I don't recommend it because I don't have that fresh, clean feeling after I brush. Before that I was only using baking soda and water, which also lacked the minty fresh feel, but each time I went to the dentist she would say, "I don't know what you're doing but keep it up! Your teeth look amazing." But if I go to my parents and use their toothpaste I will have new bumps pop up within an hour.

    This is my current line of thought: Antibiotics and steroids both cause an increase of yeast in the system. I also have a serious issue with sweets and carbs - which is also a symptom of yeast issues as well as contributes to the problem. I have started attacking the PD with anti-yeast treatments. I've been dousing it with a solution of grapefruit seed extract and water at least 2x daily - 2 drops in about a teaspoon or so of water. (You can also ingest this when diluted, but it tastes like dish soap!!) I do try to swish the extra around my mouth and spit it out, though. I have also been using an over the counter anti-fungal cream. It helps with the dryness/flakiness but I'm not seeing a whole lot of difference as far as new bumps are concerned. I would LOVE to break my carb addiction to see if decreasing the amount of sugar in my system can help the problem. But that's a lifetime issue I'm dealing with slowly. I have been overeating with my pregnancy, so, again, the carbs/yeast may be a factor.

    Best of luck to you! I know how frustrating this is. I've never had issues with my skin and have always been told what a wonderful complexion I have. So I am just devastated over this. I don't wear a lot of make up or fuss with my face much, so this is all very aggravating.

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    • Posted

      I am currently using sea salt and not doing moisturizer because I thought the idea was to dry it out. I was told not to use coconut or any oil because itt feeds it. Any advice? I hate looking flaky. 

      Thanks for any feedback. 

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    • Posted

      Welcome to the forum Olive.  I must start out by saying that the forum has been redesigned recently and not very well because recent posts will sometimes show up out of order.  This results sometimes in your posts not being seen therefor not being answered.

      Lisa who is a long time contributor of this forum has remedied this problem by starting a Facebook page devoted solely to providing advice and sharing from fellow sufferers.  I suggest you look to Lisa's latest posts to see about joining.  It's a wonderful place to share experiences and recommendations.

      As to the sea salt....I have tried that and everything under the kitchen sink to cure my PD.  The only thing that got rid of it for me is zinc sunblock or diaper etc. or making mixing up your own with zinc oxide powder that you can purchase at a pharmacy and add to a cream of your choice.  It goes on thick; like clown-face but it worked for me.  As to the coconut oil, I have heard of others using it too.  Everyone has tried and had success with different things.  I really think it would be most helpful to you if you got on the facebook page that Lisa started up.

      Look forward to seeing you there!


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  • Posted

    Hi Dawn8319!

    Thank you so much for such an extensive reply. I'm so glad there are other people to talk to who are going through the same things as I have.

    After extensive research and hours at my computer screen, talking to people who have also had perioral dermatitis, I honestly believe that it is caused by different things for different people. There are definitely certain things which seem to trigger it in many people, as well as certain remedies which work for some people. But the treatment is just as ambiguous as the cause-they vary wildly from person to person. I would say though, that it does happen from the inside. I think topical remedies can keep it at bay, or alleviate the symptoms, but not completely get rid of it and often it will just flare up once you stop these topicals (as you have unfortunately experienced!).

    That being said, I am so dissapointed with the way that my condition has been treated by doctors. I know that it is hard to determine how to treat it, but my experience, in the UK, was that many doctors hadnt even heard of it let alone diagnosed it! It is SO common, so why isn't it more widely recognised? Even doctors who did recognise it tried to consistently prescribe steroids to treat it, even though I explained that they made it worse. Its a case of trying things from your own research I think.

    For me, having tried eliminating many things to try and treat it (toothpastes, wheat, dairy, fermented foods etc) there didn't seem to be any pattern or correlation. Sometimes I would eat badly and the PD would be very mild, and other times I would stick to a strick healthy regime with no 'trigger' foods and it would flare up.

    At the moment it is the best it has ever been. In fact, it is almost gone! No bumps, just very mild flaking in the creases of the nose which are barley visible. It is still very red though, but I think that may just be hyperpigmentation from the flakes and bumps which sometimes bled.

    The only pattern for me, which might have suggested a trigger for PD, was that it would always be worse around my period. I have read in many places that it may be linked to hormones. That would explain why you have gotten it during pregnancy! I suppose we won't know, but I do believe there is a link between the two.

    For us unfortunate ones who suffer with PD, I believe the only options are to either wait for it to eventually disappear, and, if not, to try and curb it with products we have found to work for us, individually. I don't know about you, but I got to a point where I was exhausted with researching miracle 'cures' or triggers for PD and I just sort of accepted that I will never quite know what causes it and will just have to wait it out. And less stress can only be a good thing right? I think stress really shows on your skin, too.

    I wish you the best of luck with everything, and really hope you find something that works for you! Congratulations on your pregnancy also......heres hoping the PD dies down when your hormones settle after your little one is born!

    Good luck.

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  • Posted

    I have written this response three times and it keeps getting deleted! Someone in the world doesn't want me to reply to your post...

    Anyway, I totally agree with the concept that there may be different causes for different people. The fact that different solutions seem to work for different people says a lot. I've tried everything I've read and nothing has worked long term for me. Just when I *think* I've found an answer the PD comes back. (For the record I tried the bacitracin ointment the poster above suggested. It seems to help the redness and flaking but I constantly have new pustules forming each day.)

    One thing I am convinced of, however, is the theory that this is somehow related to candida/yeast overgrowth. Everyone seems to develop the condition after some sort of course of antibiotics. And I've long suspected I had a systemic yeast problem. The thing that concerns me is I've read blogs and personal accounts of people who are VERY strict about their carb/sugar intake and candida treatments and still battle the PD on some level. I'm assuming this is now a lifelong issue we'll have to deal with in some capacity.

    Best of luck to you as well!

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  • Posted

    Oh no! Well, glad it posted in the end!

    And I completely agree about the candida thing. In fact I'm pretty sure of it. It has never ever happened to me before, but happened as soon as I finished a course of antibiotics which would definitely suggest candida. Some people get thrush, but it would seem that some of us unfortunately get something chronic on our face! I have done a lot of research on the link between PD and candida, and the science is very black and white. Anti biotics are anti- life...they kill the natural gut flora, causing an overproduction of yeast. And yeast infections can surface in many places on the body. One way they manifest is through skin conditions, and something like dermatitis is exactly the thing that yeast causes.

    That being said, I'm not sure that anti candida diets really work at starving the yeast and healing the gut from candida. I tried the diet, strictly, for about three months and saw no difference. I've also read on many forums that many have not had success with it in relation to their PD. But I do think it is helpful to avoid the main yeast feeding foods, in the hope that eventually, over years, your flora will be replaced. I was thinking about taking probiotics. Have you had any experience with that?

    Through all my research, one thing that I am fascinated with is how different people's bodies react in hugely different ways to anti biotics. I have only had three or four short courses (two weeks) of anti biotics in my entire life, and have unfortunately ended up with PD for almost a year. Yet my boyfriend, who had a condition in his early teenage years which required extensive courses of anti biotics has never had any skin problems or yeast related problems (it would seem). Sometimes it seems very unfair!

    I am pleased that I didn't take more anti biotics, as suggested many times by my GP, to cure PD which was caused by them in the first place. If I had, I would dread to think what my PD would be like now! I think my body seems very sensitive to them. If you have to take them, it might be worth trying probiotics alongside the medication you are taking in a bid to help the 'healing' process? What do you think?

    Again, thank you so much for your extensive response. It has been comforting to hear other people's experiences and I am positive that PD dissapears over time. Its just a case of being persistent and trying to make it as comfortable as possible.

    Oh! And I forgot to mention. Two things which I think helped me a lot was a) using anti fungal soap everyday. In the UK, I got a sulphur soap from Amazon which was only about £4. I know you can get zinc soaps worldwide and they seem to help a lot of people. Might be worth a try! It can be very drying, but I think that drying seems to help PD anyway, as long as you moisturise with something natural afterwards. and b) Putting manuka honey on the affected areas for half an hour or so everyday, sometimes longer. It is antibacterial and keeps the area moisturised without being greasy. It also seemed to dramatically reduce the PD in general.

    Good luck!

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  • Posted

    Am equally frustrated and puzzled at

    Wow. Am sitting here a little stunned at the correlation between antibiotics and PD since I've been wracking my brain trying to figure out why I developed this. I was given antibiotics after a dog bite a few months ago but I've been on antibiotics before and never had an issue. Anyway....I've done tons of research on this and it seems to be happening increasingly often in women as of late who have never had an issue with acne before. Try using Violet Extract.... lots of success stories so I ordered some. Fingers crossed and good luck

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  • Posted

    I am 47 and have been battling Perioral Dermatitis for 4 months.

    I have started the peri menapause and had been trying various forms of HRT.

    Middle of August 2013 I decided to treat Menopausal symptoms with Black Cohosh as HRT was not helping.

    September I had my first outbreak -just a little bit on one side of my chin and one side of my mouth spots/inflamed skin and blister type spots. I tried to get rid of it myself putting steroid cream on it continually (Bad idea I now know!)

    It got worse and worse (experience has now shown me that in my case steroid cream inflames it when PD first comes up, yet seemingly soothes and calms it in latter stages)

    I went to GP and he said it was cold sores (which I had never had before) and prescribed me Anti Viral tablets which seemed to work but as said this outbreak was relatively mild.

    A month later it flared up again and this time a little worse and again GP gave me Anti Viral tablets and it calmed down but took much longer and all this while I was using steroid cream still, not knowing any better.

    A month later almost to the day the same time as my period is due, it flared up again and this time the GP said these cold sores were persistent and I had to have a long course of Anti Viral Tablets to break the cycle.

    It sort of helped and I carried on with tablets but it was taking a month or more to get rid of it; and while I was dealing with the last 5 or more spots another flare up would occur regardless of the Anti Viral tablets.

    I went to another GP and by this time I was fairly convinced I had PD and he agreed with me and took facial swabs and sent me on my way with Dalacin topical lotion (Antibiotic). This seemed to help a little but the spots kept coming and I felt like the creature from the black lagoon.

    When the results of the swabs came back it was neg for virus and Infection and I was told by GP to use nothing at all and stop Dalacin as it clearly wasn't P.D.

    Whatever I use seems to help a little but it still has a cycle of behaviour: flare up, increasing in awfulness with new spots everyday (what ever I do) then slowly starts to heal and when I get to the last few spots; which takes about a month, I then get hit by new and worse flare up.

    So 17th January it flares again, each time a larger area of my face is affected. See regular GP who says this time it is definitely P.D.

    I came away with a month of Lymecycline which I am now taking once a day. I have been told it will take 2 weeks to have significant effect.

    My GP does not think hormones play a part but I do as each flare up is a month almost to the day apart. I don't think the black cohosh causes it but the fact my hormones are all over the place is a factor. Some sites I have read seem to think progesterone is a factor- Lord only knows!

    I have stopped all steroid creams now fully as I read this makes P.D worse.

    My GP says PD is a grey area for GP's and from what I read PD has different causes Infection, viral, fungal or allergy.

    This explains perhaps what will work for one does not work for another.

    I have stopped all steroid creams and I wonder if hormones have caused a fungal type PD?

    I have been referred to a Dermatologist but this will take time for an appointment to come through. I had to beg (and I mean beg) my GP for some Eldel cream as I had read online it might help.

    I think GP's are irritated by my online quest for help but where it has gone on for a while and GP has got wrong diagnosis I now lack faith in them.

    Things I have tried which help a little:

    Washing face in ketoconazole shampoo (some dandruff types) to help kill candida. (Available over the counter in UK)

    Clotrimazole cream such as canasten as my face also itches and burns. (Available over the counter in UK)

    Letting face dry out washing but not using any cream or moisturiser at all. The theory being that yeast needs moist to thrive. (Pretty uncomfortable though)

    Lymecycline which I am currently using will post again when 2 months is up.

    Things I intend to try: which others have recommended:

    Elidel cream,

    Calendula Cream, (available over the counter in UK)

    Nixoderm, (I bought mine of Ebay, very cheap)

    Neem soap, (I bought mine of EBay, very cheap)

    Lemon juice from half of Lemon mixed with teaspoon of Bicarbonate of soda. Apply paste to face, rinse off just before bed.

    So I am keeping on with antibiotics. This really does affect one psychologically. I don’t want to leave the house!

    I never had acne as a teenager. I will keep posting!

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    • Posted

      How are things going? My dermatologist has prescribed antibiotics and a washing with water only regime & because I get eczema, I am allowed to use a very small amount of diprobase lotion mixed with water if my face feels right or dry.
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