Help me with my **possible** perioral dermatitis

Hi Tash! I can tell we've been reading the same sites.. that type-A quote is from Sarah @ Osmia. I actually tried her kit for several months and while it made the rest of my skin GREAT, the fluid-filed bumps were just as frequent for me. However, I think I have a much more persistent case (it's been four years), and I feel that for people who complain of the dryness and flaking (which I've never had), Osmia would work well, as it's really soothing. Plus, Sarah is a huge help if you have questions.

Avene looks good too... it appears one of its main ingredients in zinc. I've never used jojoba, so I can't speak to that, but I have found almond and hemp seed oil don't seem to cause any problems.

I typed up a big, long thing about Elidel, but I included a link to a study so it's still awaiting moderation. In a nutshell, Elidel worked perfectly for me, but in my case it was like cortisone in that when I stopped, I had a rebound flare. I talked to my derm and she said skin does get addicted to it, so it's not for long-term use. HOWEVER, it does not thin skin like cortisone, and operates in a slightly different way, but still suppresses the immune system. I honestly think it's great for people who are able to use it temporarily while they remove their trigger or their skin just decides to cooperate. In my case, I would have had to to use it for.... well, forever..... unless I wanted to deal with a rebound flare or the potential harm of suppressing my immune system. I actually decided I'd be OK with using it for life the other day, but when I went to apply it, my chin turned bright red. Can't win.

Anyway, please keep us posted, and hang in there. Thoughts on returning to the Lucas Paw Paw, since it was working? Maybe petroleum is not a problem in your case... they all seem so different!

Hi Kimberly,

Thanks for such a quick response! Am really feeling for you, four years is a long time to feel in the dark on this.

Hah yes I'm certain we PD sufferers must have very similar internet history. You know you're desperate when you get past page 10 of the Google results!

That information was really helpful. I have a GP appointment today, so I'm going to ask for Elidel, and monitor how my PD reacts.

If you suspect yours if fungal (saw in earlier post), have you tried combatting the yeast internally with drugs? My mother is actually a GP (who, sidenote, has been appalled by other GPs treatment of this) and suggested I could try an oral anti-funal at some stage.

To me there does seem to be a crossover with fungal rashes, if you google "Candida affecting the lips, mouth and face | 1.5" and click the first result (don't want to link in case it mods this post), that's incredibly close to what my rash looks. Although I am fairly certain mine is PD, because I also have it into my nostril and also on my eyelid (which are typical PD symptoms), it does make me wonder if there are many variations of PD triggered by yeast vs. bacteria issues etc. Might explain why there are so many different cures for everyone?

Yes definitely considering going back to the pawpaw, it's funny to find myself wistfully dreaming of how mild my PD was then. Maybe the more complicated or intense treatments, like the topical rosex of jojoba oil, actually just irritated it further?

Melchior: If you think it may be flouride, you could try the Avene thermal spring water spray. It's ridiculously expensive for essentially just water in a can, but you can get small one. Basically I just spray it around my mouth, then use a cotton pad to wipe away any dirt etc. Seems to be better tolerated by my skin than splashing around in the sink.

To add to the above: I saw the GP, have got Elidel which I will be applying twice daily (Ps. To any forum reads from NZ, it's $50 a tube here, not govt funded sadly!). My question, in between applications I'm still incredibly dry and tight, I obviously don't want to upset the rash or reduce the efficacy of the Elidel, but does anyone have any suggestions for keeping the skin from flaking between applications? Otherwise I find it a bit hard to go out, I look like I have facial dandruff! Hah.

Finally, I also got skin scraping test, which will hopefully determine once and for all if it's fungal or bacterial. Am wondering if anyone else has done this, and would be interested to know their results if so?

Hi Tash and everyone. I had skin scrape test and the results were negative for bacteria and infection.....to further complicate matters Antibiotics did help me in the end, which does not make sense considering result does it, but this seems to be the way with PD.

Tash you can use Elidel cream with other cream just wait a few minutes between application.

Hormones are linked with fungal infections and most people (not all but most) seem to have hormone changing incident which they link to PD. These vary from puberty,having a baby,birth control pills,coils being fitted or in my case the start of peri menoapuse.

The things which stopped my PD dead were:

Stopping black cohosh (herbal supplement for menopause symptoms.

Stopping steroid creams (I have also read that steroid inhalers can be a culprit)

Doxycycline 500mg 1 a day for month.

Using probiotics the minute I had stopped Antibiotics to restore balance within.

I also hanged to gentle soap and stopped using general beauty creams I bought expensive La Roche Posay - Effaclar Duo.

Elidel does suppress reactions as Kimberly said but I used it in the midst of PD but not now and I have not had any rebound problems.Antihistamine works the same way orally and I took this too.

However whilst my skin was fighting PD I found I was sensitive to many things that I can use now without a problem.

I do think allergy has a part to play too.I used La Roche Posay - Effaclar Duo which helps blemishes but I think any top notch gentle cream would have probably worked whilst PD was terrible.

I used Calendula cream,too but the type I used it was quite thin in consistency and cheap and you can buy much nicer ones for more money, this cannot hurt and very gentle.

I used Aqueous and Cetaphil lotion-aparently thses are not good but they didn't cure anything but soothed.

For me personally the dry flaky stage was horrible and my skin flaked whatever I did.

I also think not to touch face which is super hard when it is itchy and flaky but important.

I would also say in all honestly that when it did go La Roche Posay - Effaclar Duo was marvellous at fading red areas that had been worse effected by PD.

Welcome Diane and Tash

After I read Diane's post about Elizabeth Arden cream, I looked it up and it contains iron oxide which may support what I have read about minerals being helpful in combating PD.

Tash' comment about PD sufferers being obsessive made my toes curl a little but I know she's right...I was and still am obsessed about this because I am still getting these blisters that do go away after I apply the zinc ointment but I want them to just go permanently. I am going out with a bunch of people next weekend that I haven't seen in ages and I have this "restrained anxiety" that it could explode at any minute. Fingers crossed.

It's probably because I always seem to agree so strongly with Lisa's posts that I think everyone should really pay attention to her regime....it's like Emily said when she advised that the old posts should be read through to see what everyone has already tried to date. I just feel that Lisa hits the nail on the head.

I am still upset that I missed my doctors appointment in February due to another snow storm and now she is on holiday but as soon as I can I am going to get in there and ask for a prescription of doxycycline.

Anyway, good luck to all and wish me luck that my face doesn't explode by next weekend...I just worry that it's going to be a case of "figures this would happen when I finally have a night out!" type of thing...know what I mean?

P.S. I still think of Lisa or maybe it was Emily's comment that they heard PD described as "The Curse of the Vain".....huh

Lisa: Thanks for your helpful feedback! Much appreciated. I hope I'm in a position to be looking at clearing up the leftover redness soon.

I've had a few applications of the Elidel now and it's definitely showing a little improvement already.

Did you experince any burning heat whilst in a flare? Mine has been quite angry and hot recently, which is difficult to manage. I've been using an ice pack on it which numbs it up and reduces the itching too, but then the heat feels even stronger (just by comparison) when it's taken off.

Fiona: I'm sorry sharing that quote made your toes curl! I really didn't mean it in a derogatory way, obviously I fit the bill myself, but it just made me think there really is an emotional and psychological stress component to it. I'm trying to meditate to help reduce my stress hormones, in hopes it will have an effect on both the PD and my overall health.

I also hate that term, apparently it arose because doctors thought the trigger is make up (hence the curse of 'vain' people). It's a pretty cruel way to put it, plus my trigger was steroids anyway, which were prescribed by doctors! Regardless, it's definitely not vain to want to be healthy and free of constant bumps, itching and flaking.

Best of luck for the weekend, I hope it goes well. And in the off chance you do get a flare, just remember the PD doesn't make you any less of the person you are!

Dear Lisa,

Noooo, please don't apologize. There is always something missing when trying to communicate in this way.... like body language or gestures. Anyway, I'm just digging myself in further.

I hope it doesn't seem as selfish as saying "misery loves company" but I feel comforted to know that I am not the only one to take this condition so hard...an acne-like condition is the last thing that I expected at this point in my life, especially one that was so mysterious and hard to rid.

I suppose your observation made me feel shy because it was like putting a mirror up to my insecurities which seem to have compounded in the last year or so. Having this ailment really hit home to me how tightly wound I was and it too made me concentrate on meditating to help me put things into perspective.

Thanks so much for your honesty

That last comment was meant for Tash! I addressed it to Lisa by mistake...duh!

Thanks Tash and Fiona,On my way to dentist in 5mins but just wanted to say to Tash- Yes very much identify with heat on face during PD.I can remember lying in bed and it felt just as if i was under the hot sun .

My face felt burning !

This is the most complete by way of information discussion and idea exchange that I have found to date on PD. Thank you to everyone who's posted so far. Great information.

I've been battling PD for only 6 months now and it feels like an eternity. I'm British but live in the US. Fair skin that is often dry. I've always used gentle oil skin care products on my face and don't wear make up which irritates my skin. I'm 48, most likely peri menopausal and have been under significant stress the past year. My mother-in-law passed away last week after a long battle with cancer and the last year suffering with dementia. My husband and I were the primary care givers. My rash started in the corner of my mouth on one side approximately 6 months ago. Small ithcy blisters that began to involve a larger and larger area. Like many I tried over the counter topical steroids which seemed to make it better but the rash worsened as soon as I stopped the cream. I finally saw my GP and was diagnosed with impetigo and prescribed topical antibiotic ointment which made it worse. My GP then switched to doxycline antibiotics which didn't help after a week's course. I then went to a derm who prescribed a topical steroid and more doxycline and rash got even worse. Derm switched me to minocyline antibiotic in same family as doxycline but evidently a little different and stronger, plus a green oily topical cream I've forgotten the name of that seemed to burn my skin and the rash became cracked and sore. A week into the minocycline, the side effects were so bad I ended up in the ER. I had vertigo, buzzing and crackling noises in my ears, my muscles all felt extremely heavy, I felt like I had the flu and had confusion and disorientation. My husband also said I was slurring. I went back to my GP who told me the cycline family of antibiotics can be harmful for long-term use. She told me it can impact the inner ear which is what happened in my case. I was off work a week as my body detoxed and the symptoms gradually left thank goodness, but those first few days of vertigo, ear buzzing etc. I was very scared I'd caused irreparable harm to my body. Went back to the Derm who prescribed Elidel which seems to calm the rash but not prevent it. A couple of times I thought it was almost gone. Two weeks ago my mother-in-law was in a coma for five full days and we were by her side round the clock and so I didn't keep up with the Elidel. The rash came back with a vengeance within a few days. Like many others I'd switched to a natural toothpaste thinking SLS may be a factor (Earthpaste which is clay, salt and natural ingredients) but it hasn't seemed to make any difference. I'm celiac and have been gluten free for over 10 years so I know that's not the issue. I don't eat meat. I eat a ton of fish, veg and fruit. I do love chocolate and I do drink wine and eat GF breads so maybe yeast is an issue. During the days my mum-in-law was in a coma I developed an ear infection. I didn't make it to my Dr. for a week and by that time my ear and side of my face was very painful. I rarely take antibiotics and here I am for the second time in 6 months on another antibiotic course because of the ear infection. I find the ear infection interesting because that seems like another skin problem and I wonder if they are related. The rash and ear infection are on the same side.

Right now the rash looks calmer due to the Elidel I've been using for four days now, skin is tight, hot and feels like it's burning. The Elidel seems to prevent the blisters from forming. I plan to explore a multi-vitaminand topical zinc applications and look forward to following others' experiences and posting my own. Thank you again for this forum and everyone continuing to provide suggestions and support. You're all awesome! Joanna

JoAnna that is exactly how mine started too! I felt that my toothpaste was burning my mouth as well! I have been SLS and fluoride free for over a year. it is not the cause of my issue, because on occasion I still get rashes on my lips. I too feel it is my move into menopause that has caused this, and the shift in hormones. I don't know if I mentioned this before, it has been some time since I have been on (I lost my mother in February, and the rug was pulled out from underneath me for awhile) Try pure lanolin on your lips as a barrier. I saw it on another forum, and ran out and got it, the suggestion was to get nipple cream used for mothers who nurse. I am in the US, so if you go to the baby section, look for the purple tube!

I love it! Works great! I actually am in a severe dry stage with my lips again, not sure what the trigger this time was, however, I know how to treat it better now. There has been a lot of posts since I last visited, I will have to get back in and see what new suggestions are there for the exploring!

Welcome Joanna, I was so sorry to hear of all of your troubles... We are very close in age (I'm 46, fair, dry skin and assume peri menopausal) and not long ago I went through several family illnesses, care-giving and sadly, deaths. It just seemed to happen so quickly and one after another. I learned not to tell myself that It "couldn't possibly get any worse" because it could and it did. I really hope you are coming to the end of it now.

I mention this because just after everything started to finally settle down, I developed PD. I am pretty sure that a course of intravenous drugs was the main cause but I know that the tremendous stress that I was under for so long must have contributed to it. When I think back on it, it was like I was walking around like a zombie. Anyway, I went the topical zinc ointment route plus eating foods high in zinc and it has kept it at bay. As I have mentioned before, I still get blisters popping up that the zinc eventually takes care of but I have noticed that they appear around the same time; every 28 days or so even though I have not had a period in 3 months.

Sweettooth,

Sorry to hear about your Mum...I was wondering about you because you were the one that gave me the idea about mixing my own zinc ointment. Thanks again and I know what you mean about having the rug pulled out from underneath you...I lost my Mum not long ago too. Take Care!`

Damn It!...As usual, I signed out and I have a P.S.I'm running out the door but I meant to ask...Joanna, do you happen to have rosacea? (usually occurs in fair-skinned Celts) Or anyone? I read here that someone tried Rosex but it made their PD worse. My rosacea is getting bad and I want to try something for it but I don't want to have a bad reaction. I would appreciate any info!

Off to drink some wine now which will cause my rosacea to worsen which will then make me look like a drunken stop sign.

I'm in the US and came across this discussion by accident while searching for something else, but wanted to share how I finally cured my very painful, embarrassing, and persistent perioral dermatitis outbreaks. I had several episodes over a 10 year period, but the last episode lasted for about 6 months of pure hell until I went the natural route. Three of us have now healed our outbreaks completely this way. It will take about a month to fully clear the rash, but within 7-10 days of following the protocol below I saw about an 80% improvement and the rest tapered off until it was completely healed. It's an important combination of removing chemicals and adding calendula. Unless you do all of it, this won't work.

1. Whatever you do, do NOT put any steroid of any kind on it. This will probably clear the rash, but as soon as you go off of the steroid treatment, it will come back with a vengeance. A very very angry vengeance.

2. Stop using any cleansers, soaps, shampoos, toothpastes, etc., with SLS or ALS (creates lather)

3. Use a natural cleanser. I use a natural handmade goat milk soap I buy off of ebay. Love it!

4. Use a natural shampoo. I have used several different ones, just make sure you find something natural, either homemade or purchased at the store. There are many available.

5. **Find a lotion or cream that contains calendula.** This was key to my success. Calendula is the main ingredient I found to instantly calm and heal the rash. I love California Baby Calendula Cream. They also sell shampoos and washes with calendula. I found another one I love on Amazon that is handmade with calendula, olive oil (and several other natural oils). It is a really heavy moisturizer that I put on at night, but it is just too heavy for daytime use.

6. Coconut oil is very healing and moisturizing. (Only use non-GMO, organic, cold pressed, extra virgin)

7. Do not use fluoride toothpaste. I switched to earthpaste brand toothpaste and my dentist approved it. My teeth have never felt cleaner, which is a nice side effect. I'll never go back to traditional toothpaste.

8. Apple Cider Vinegar (organic with the mother) can be diluted and applied directly. I saw slight improvement while trying this. Just don't overdo it or you will dry your skin out and make it worse.

9. When your face feels tight or it is burning, itching, etc., an almost instant reliever is a chilled green tea bag. I just threw them in the freezer after making green tea and they were ready to go after just a few minutes of thawing on the counter. I held them over the irritated areas and the relief was almost instant.

That's all. I just wanted to share because I know I would have done ANYTHING to heal mine each time I've gone through this mess!! After I stopped using products with chemicals, I haven't had another episode. Good luck!!

Hi all,

Update: I'm 3 days on Elidel, and it's amazing, the redness on my upper and lower lips is almost gone, only the rash on the sides (where the creases are), is still a bit irritated and bumpy. I almost didn't want to post this in case I jinx it, but I know that's the crazy PD superstition talking! Thanks again to those who recommended it, my doctor was unaware of it's use for PD.

My routine has been 'hope's relief' non-soap bar, pat to dry, then apply the elidel. Then in about 20 mins, as it's still very tight, I apply some Lucas pawpaw. I've also been taking 'Allersoothe' at night, it's a mildly sedating anti-histamine, which has keep me asleep without being woken up by the itch/heat, very helpful.

The Avene calcifate cream has also arrived, but frankly I'm too scared to try something new when I'm seeing results for once. I will save it in case progress stops, or for healing the redness after it's gone (hopefully the latter!).

Fiona, completely understand how you felt. When I read that quote originally I was totally put out. I think because it feels like you're being double punished, like both having the rash AND not being able to focus on anything else eg. having fun with friends or relaxing. Not at all 'misery loves company', I too was so happy to find this thread. I think we could all stand to be as kind to ourselves as we are to each other here!

Also, I was the one who mentioned I had rosex. I may have rosecra, but if so it's very mild. The rosex didn't really make things worse, it was just a bit drying and irritating (lots of flakes). Maybe because it's alcohol based? Still, I think my PD tolerated it better than natural oils etc. in the end.