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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  • Posted

    To Fiona: I have tried violet extract. It's another one of those things (for me, anyway) that worked at first but then just lost it's effect. But everything seems to do this to me. As far as the antibiotics go, I wonder if it has to do with the type of antibiotic you use. I'm one of those people who've basically lived on antibiotics for one reason or another my entire life. But when I think back my PD started after being diagnosed with MRSA back in 2007. I thought the PD was a recurrence of the MRSA at first. Now I'm wondering if the specific antibiotics they gave me to treat it were to blame, or if years of antibiotics lead up to the PD.

    Lisa - I wish you luck. I feel like I have tried everything. I totally understand the psychological effects you're talking about. It also seems that everyone who develops this had excellent skin beforehand. I'm wondering if people who've struggled with acne just don't realize this is something different. Regardless it really is horrible. I feel lucky that I'm currently a stay at home mom, but the PD causes me to "stay home" much more often than I should. I have friends who are constantly asking why they haven't seen me, asking me to lunch, etc., but I always seem to have outbreaks and don't want to be seen. Best of luck!

  • Posted

    Thanks Dawn,Well I am up at stupid o clock with burning itching face,which is stopping me from sleeping.

    I just found UK Holland & Barrett - Mega Potency Acidophilus Capsules with very good reviews.I think I might try these to restore good bacteria.

    Dawn these can be used whilst pregnant as long as you check with doctor first- just a thought.

    The Elidel cream has helped I put some on this afternoon and before bed and I can tell there has been an improvement in appearance.However: face is very uncomfortable so we will see

  • Posted

    Dear Lisa and Dawn,

    Just came away from the mirror after finding MORE outbreak....yesterday it looked like it was getting better. Really let down about the violet took me two days to find out where to order it from and I don't even have it yet. Post later with more info after I have a conniption fit.

  • Posted

    Dear Dawn,I so feel for you-It's a bugger isn't it.

    I am in midst of 4th horrid flare up. 4 months on,4 flare ups later It all over my lower face,under chin and on forehead,it makes you want to scream!

    I keep asking my husband if it looks better and he says yes a bit....but I see the pity in his eyes! eek

    I too have used antibiotics before and never had problem but I did use steroid cream in ignorance before and I have terrible sweet tooth- both things fungal infections love!

    The main reason I think it is fungal in my case is that a swab test revealed no bacteria and no infection.To my mind that only leaves allergy or fungal!

    I forgot to mention that I have also started antihistamine tablets just to add to the mix.

    In my case the Elidel cream is definitely helping, I am 100% sure of it now.

    Elidel has only been around since 2002,invented to help itchy skin disorders and to help inflamation.

    The new wonder steroid type cream (without being a steroid )

    Please post how you get on with the Violet extract- it sounds good.It also claims to help with hysteria,I may order some just for that,as this PD does agitate ones mood some what mad

    I will keep posting...We must find a solution if we keep on..knowledge is power or so they say!

    • Posted

      I've been reading over this thread. Hoping to find the magical cure. Ha! 

      Going on a year now since I had pd. I see the mention of a facebook group. What is the link? Its much easier to keep updated through that. 

    • Posted

      Hi Shari, 

      If you go to Facebook and search Perioral Dermatitis, you will get several results.  Our group is a closed group, so you need to send an email request to join.  We have about 200 members now and it is a very active group with lots of discussion.  

  • Posted

    Lisa, Dawn and Fiona- great to see so many people here sharing their experiences! Keep me updated on what is working for you.

    Dawn- I never thought about it that way; that it might be the type of antibiotic. It does sound reasonable and would explain the mystery of it. That also gives me hope; I would always be reluctant to remedy PD with more anti biotics, but if we consider it might be the type of anti biotics that matter, then a different type of anti biotic might work in curing something caused by another anti biotic. (Hope that makes sense?!? ha!)

    I am so thankful that my PD hasn't come back in a month. This is the longest I have had without it. (Although, there is very very slight flaking which is barely visible in the very folds of my nose. That would suggest it isn't quite gone i suppose...I just hope it eventually disappears!)

    Since it has died down, a product that has helped alot which is available in both the US and UK is a cream called Avene Cicalfate. It contains zinc and no irritating alcohol. I have been moisturising the previously affected areas with that and it seems to have worked wonders! I didn't buy it with the knowledge that it helped PD, but in my research since, alot of people say it has helped or even cured theirs. It is a sort of matte finish treatment cream...not too greasy, which I like. Seems to moisturise the area whilst leaving it relatively 'dry' and non greasy. Lisa- it is available at Boots here in the UK for about £7. I think it might be a little more expensive in the US.

    I wish all of you ladies the best of luck. It WILL go away. I know exactly how it feels to not want to leave the house because of it. Its such a bloody pain. But it WILL go away.

    good luck!

  • Posted

    I have used 2 bottles - the first time I used it I was convinced it was working. I just used the dropper on my face - or a cotton ball. And then I rinsed the inside of my mouth with it - just inside the upper and lower lip. It's mainly grain alcohol, so I don't know if that has something to do with it. I dropped the bottle in the sink and lost half of it and ended up ordering a 2nd bottle. The problem is this last round of PD doesn't seem to be reacting as positively to it. There seem to be so many factors that it's often hard to tell what's actually working.

    And Lisa - I KNOW a huge part of my issue is fungal/candida. I have all the symptoms. I just don't even know how to begin breaking myself. It's very much an addiction. I get up every morning looking for something sweet, yet I try not to keep anything like that in the house. When I can't find anything I get very angry.

    I did get a travel sized bottle of Aveeno daily moisturizing lotion - just their regular body lotion, I think. I agree with people who've said the best thing to put on it is nothing, just wash with water and leave it. But my problem is I'm biracial and when my skin gets dry it's just so obvious. I had to come up with some kind of moisturizer. The aveeno isn't very "creamy" so to speak, it actually leaves a dry feeling on the skin. And I seem to have cleared up quite a bit. Again, it's hard to say if the lotion is what's actually helping. I was sick over the weekend and didn't eat much so it's also possible I've "starved" the PD for the time being.

    I also emailed all the major lotion brands and told them what I'm up against, how much I've spent trying different things, etc. I was *hoping* they'd be willing to send me free samples but I did get coupons from all of them. Somewhat helpful, I guess. I also ordered a few things from Boots to try a few weeks ago, they were back ordered but should be arriving soon. When I ordered Boots (US) was having a great online sale.

  • Posted

    I wasn't going to post anything until I had more information to give but I wanted to let Lisa know that I can really feel how upsetting this is for you. Try to keep your chin up and know that you are in good company....I'm determined to get to the bottom of this! And to Dawn... I had never heard of MRSA so I looked it up and realized how difficult this is for you to figure out as there are so many factors to consider. I don't know if antibiotics is the common denominator because I stopped them long before this happened. But who knows? Anyway...I'll keep plugging along. Has anyone been prescribed doxycycline? I was taking it for ocular rosacea and read that it is another type of antibiotic that treats skin disorders. I'm still waiting for the violet extract to arrive and if that doesn't work then I'm going back on the doxycycline to see if that works. It would be great if I could find a natural remedy but I give up. It's not worth this aggravation. Lots of luck!
  • Posted

    The only sure thing that I know is that it takes 28 days for new skin cells to rise to the surface therefore it stands to reason that it would take that long to see DEFINITE results from any possible remedy. I choose to keep this in mind to have some sort of base idea to go on because the one thing I have learned from this problem is that it doesn't make any sense....healing one minute and inflamed the next
  • Posted

    It's great to find people going through the same thing!

    Well I am now at the zingy prickly stage without the heat.I have rather attractive skin shedding going on and feel as if I am leaving a skin trail wherever I go! Thank god for my sense of humour.

    I had to answer the door to take delivery of a parcel today and the delivery man stared at my face and I felt toe curlingly embarrassed !

    I have kept on with the antibiotics despite my thoughts on fungal cause.

    I asked my GP again why antibiotics if swab shows no infection and he said 'We don't know why antibiotics work on PD we just know they do'

    As previously mentioned my PD occurs every month almost to the day and follows a pattern of behaviour.

    This pattern of behaviour has changed but is it the antibiotics or another product I have tried? I am not sure.

    Normally the spots keep coming and coming for about 2 weeks and although some will sort of heal there is always more (too man to count) to take its place.

    This current flareup started on 17th Jan and the spots have stopped coming.I still have a good amount and they are dry, red, and flakey.My face also swelled a little and my lips felt weird and I found it was hard not to dribble....Gross!

    The Elidel does make ones face feel worse but.....

    The Elidel cream most definitely has helped.

    I am putting this on twice a day.I am also using Calendula Cream, as a mouistriser but only on my chin and cheeks as spots get greasier (I feel) as they go up) asopposed to the bottom of my face which is like desert it's so dry!

    This is only cream that has not stung.I used Aqueous and Cetaphil previously and they stung on application.

    It is interesting Dawn what you say about the 28 day cycle of skin.This fits with my monthly bouts of PD,does this have correlation with hormone link I wonder?

  • Posted

    It was me, Fiona that mentioned the 28 day cycle and I really do think that it has something to do with it. Especially considering the menstrual cycle. Anyway, I have been doing the oil cleansing method and have had wonderful results so far. I am tentative about this but there is no mistaking the difference. The crusting and inflamation have gone. It is still a bit red but I can't complain considering how it felt before. There have been horror stories about OCM but I am convinced it has to do with making SURE that you rinse all of the oil off around the chin and hairline. I don't think I did it properly at first and I did start a tiny pimple. I'm having great results since rinsing more carefully. You should do your own research but it makes sense to me that drying out the skin using alcohol based products would cause a surge of oil of production in the skin afterward to compensate, I looked up Calendula Cream and some do have alcohol. I am still waiting for the violet extract to arrive but in the meantime, using the oil cleansing has had dramatic results. Hope it lasts!
  • Posted

    I am the Queen of Afterthoughts... I always do it

    I was hesitant to say how pleased I am about OCM because I have read wonderful ratings about possible remedies only to be disappointed when I had tried them. I honestly have to say that my skin has never felt better in my life. It hasn't cured my PD but it has successfully rid the scaly, flaking skin around my nose and mouth.

    Lisa, I know what you mean when you said that the delivery man was staring at your skin.... I cannot look anyone in the eye lately for fear that I will see them staring at my nose and mouth area. It happens continuously and with just having a 46 birthday and dealing with the aging issue I am at an all time low. Everything is happening at once and it's not pleasant AT ALL. Ugh.

    Anyway, I wish everyone the best of luck finding a cure

  • Posted

    Sorry Fiona,Yes it was you that said about the 28 days for new skin cells to rise to the surface.I am hoping and praying that my PD won't come again if I take these tablets of 'good bacteria'.

    I was talking to a friend who told me two things that interested me:

    1/ She thinks a liver cleanse could help my skin

    2/ She thinks Black Cohosh could damage my liver and cause skin rash.

    I wasn't sure what to think really.However,I did find reviews of Black Cohosh where people feel it has damaged their livers.

    To be honest after trying 3 months of HRT the Black Cohosh was such a blessing.

    However to be safe I am going to try another health supplement to help with peri menopause symptoms.

    I have tried so many different things for my PD now.

    So happy to hear the oil cleansing method has helped you Fiona,I am going to read up about it.

    With me the antibiotics and Elidel cream seem to be working for me despite feeling yeast is the real culprit.

    Until we find the cause/trigger we are just treating the symptoms though.

    This PD is so isolating-I'll keep you all posted.

  • Posted

    Hi, Thanks so much for sharing your experiences.

    I am in the middle of a horrific PD out-break and have only discovered in the last week that this is what it is. I've been battling this rash for 9 months now and naively have been putting a steroid cream on my face, which has made it so much worse. I now know that this outbreak was initially caused by going on a contraceptive pill which set it off (I went off it after several months but the PD never cleared up) - and then I was misdiagnosed several times and prescribed stuff for acne, then eczema which made it all worse. I finally diagnosed myself after hours of researching on the Internet, and my doctor agrees. I’m now on a 3-month course of oral antibiotics but haven’t been given anything topical to help. I’m so miserable as in the past week since stopping the steroid cream my face has completely exploded in small pustules and is also incredibly dry, flaky, itchy and painful. Urggh! I’m hiding inside like a hermit and too embarrassed to go anywhere, which isn’t helping my employment search! This is the second time this has happened to me – the first was 4 years ago when I was pregnant with my daughter. Throughout the entire pregnancy the rash increasingly got worse – at the time I and my doctors had no idea what is was and still thought it was eczema. Once she was born it mysteriously cleared up and I never really thought about it until it happened again.

    I’m relieved to now know what it is and to bin the steroid cream but desperate to get rid of this thing and hopefully keep it away in the future. Thanks again for sharing your experience – reading this has given me some hope.


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