Welcome to my super unglamorous skincare journey with perioral dermatitis. What started as a little dry spot around my nose turned into a year-long skin issue that I’m finally OK sharing (because it wasn’t pretty and I didn’t feel comfortable writing about my experience until it cleared up). Since I’ve been clear for months now, I’m ready to share what worked and didn’t work for me in hopes this helps someone else who is dealing with this pesky skin problem.
Let me start by saying, from the beginning I did all of the wrong things. At the time I didn’t know I was only intensifying the rash, I just figured “it’d go away.” Background for reference, I was going through some major life changes: I turned 30, I was looking for a new apartment to live on my own for the first time since moving to LA (and had to have the uncomfortable conversation with my then-roommate that I was ready to live alone, don’t worry we’re fine and still BFFs), I hadn’t seen my family in over six months, and I was just generally stressed. Not to mention all of this went down during the peak of the pandemic so add in some more anxiety (and maskne).
I explain all of this because, in my head, I thought OK, my skin is freaking out, I’m going through a lot, of course, it’s going to trigger a breakout or dry patch. Again, I really thought it was just a dry patch, or at least I was trying to convince myself that. So it’s November 2020, I go home to Kansas for the holiday and see my family for only the second time that year. I get there and the spot is only irritating me more and becoming way more visible (the mask blessing and curse—a blessing because I could hide it and a curse because the face-covering only made the rash worse). At this point, I thought OK, once I get back to LA, I’ll book an appointment with my derm and figure out what the eff is going on. Until then I’ll just keep it super hydrated with a heavy cream. Now I know that last part was a big no-no.
I get back to LA and my derm was only taking virtual appointments, so we had our FaceTime consultation and she told me it definitely looks like perioral dermatitis. While I was home I came to terms with the fact it probably wasn’t just a dry patch. Of course, I had already Googled what it could potentially be, and perioral dermatitis was at the top of my list so I wasn’t surprised when she told me. I was relieved, thinking now I have an answer—give me the strongest prescription, and let’s get this cleared up.
Again, gotta love my optimistic thinking.
That so wasn’t the case. Not only did the medication not work for me, it sadly made it worse. I’ll break down what I was on below.
Here are a handful of raw photos to show how it would flare up in waves (be nice, these are very sensitive for me to share).
The photo below was taken on the same night … just with a filter on IG …
Friendly reminder: things aren’t always as they appear on social media. (I didn’t post this, I just took it with a filter to show how I could ‘mask it’ when needed on the gram.)
At this point, I was desperate to find a new plan to hopefully help clear up this gnarly rash on my face. I started talking to my friends about it and realized it’s way more common than I thought. This helped me not be as embarrassed about it, and my PD pals gave me some great support. Anyone with PD knows that the journey is different for everyone, and each friend always caveated with something like “here’s what worked for me, give it a try.” All of the recs included a change in diet and pulling back on skincare products.
Given I was now in the middle of a big move, I was doing a deep cleanse of all my belongings and boxing up my entire apartment (meaning the dust and stress of logistics did not help my case). Once you have your first breakout, stress is the easiest thing that triggers how quickly it will clear up or stick around. Timing-wise, things were not working on my side. I was still in the process of trying new remedies, but I knew this wasn’t going to go away until I was settled into my new place. Which with a new move you know takes a bit of time. I knew I had to be patient and allow my personal life stuff to calm down and get to a steady place before I could throw my hands up and just “live with my new rashy face.” Luckily once I was finally somewhat moved into my new apartment and felt like my Tinkerbell bungalow was a decent place, I was able to come up for air and had fewer stressors in my life. With a healthier lifestyle in place and the two all-natural items that have worked consistently for me, I was able to clear up my PD and (so far) keep it a bay.
Before I get into what worked and didn’t work for me, I’ll give a more formal definition of perioral dermatitis.
What is perioral dermatitis?
As we shared in our different types of skin conditions story, where we had Eric Lovato, PA-C, of the Dermatology and Laser Centre of Studio City, provide his expertise, PD is characterized by red bumps on the lower face and clustering around the mouth (the meaning of perioral), and yet it differs from acne. “These bumps are tender and can be itchy,” Lovato shares. “Patients often complain of burning or sensitive skin. The term ‘adult acne’ is a misnomer, as perioral dermatitis is a type of rosacea and should be treated accordingly. It is most common in adult women, and it’s not contagious.” In common terms: it’s red and bumpy, super irritating, and can burn like a mofo.
Common factors include (but are not limited to) stress, skin pH, skin flora, diet, gut flora imbalance, genetics, hormones, IBS, OTC nasal sprays, and toothpaste with fluoride.
And without further ado, here’s my treatment journey. I’ll start with all the things that didn’t work (sad face).
Prescriptions:
(Oral) Cephalexin: an antibiotic to treat infections. I was on this for five days, taking one pill three times a day. I was hopeful about being on a prescription, but unfortunately, it wasn’t the right solution for me.
(Topical) Mupirocin: another antibiotic but in an ointment form, which I used for five days straight, applying to the area three times a day. This definitely provided relief since the ointment soothed the area and kept it under control, but it did not help to clear up my PD.
Heavy creams: I already shared I was doing this right at the beginning not knowing what I was dealing with at the time.
Vaseline: I’m embarrassed to even admit this one, but I used this during a very low point when I was in so much pain I didn’t even care about healing it, I just wanted some relief from the discomfort. I do not recommend this. It’s probably the worst thing you can do because as I learned, the rash needs to breathe in order to go away, and this thick protector suffocates the area.
Simple changes to my diet: eating more greens and omega 3s like this fish dish. And of course, less alcohol. I’ll admit, I still have work to do with my diet and eating healthier on a daily basis, but if I even feel like there’s the slightest chance a breakout is heating up, I immediately shift what I’m eating.
Neem supplements:
I am religious about taking two neem supplements every morning to keep my PD under control. It’s an Ayurvedic herb for skin health that naturally helps with fighting bacteria and reducing redness. I can’t recommend these supplements enough. Big-time game-changer for me! I have a subscription set up on Amazon so I don’t have to think twice about remembering to restock.
The Poosh team has recommended this fragrance-free zinc-based bar of soap to so many people dealing with skin issues. Not only does zinc help clear up acne, but it’s also amazing for perioral dermatitis flare-ups. Don’t overuse it though, as it can dry out your skin. Continue to use it for a couple of days after the irritation goes away, but then pull back on using it every few days instead of in your everyday rotation. During my height of PD, I was using it daily until I slowly started to see the rash shrink and fade away (around 1-2 weeks). Praise be!
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