Perioral Dermatitis

This is for anyone who has Perioral, I decided to share my story in hopes that someone might stumble on it when they're doing research and it could help them in some way the same way researching helped me quite a bit.

I have dealt with Perioral since 2009 - but just recently learned what exactly it was on my face and how stubborn it can really be.  I am only 19, the first flare up was a month before my 17th birthday (May 2009) and it was nothing like what's been going on with my face this year.  The first flare up was more like dry skin, some oozing and burning/itching.  It did spread, and it was uncomfortable.  My mom who had suffered with this before told me to go straight to the Vitamin E oil and start applying it every day after showering or washing my face.  I tried it, and it worked.  It was cleared up in about a week, so I figured I just had issues with dry skin and that would be it.  WRONG!

It came back last summer (2010) but barely noticeable, I didn't think too much of it and pretty much let it be - tried not to touch it, didn't put anything on it (besides the occasional sun screen - I live in NC and am at the beach as much as I posasibly can) and when fall rolled around, it had dissapeared with no problems.

This final breakout happened in July of this year.  The fact that it always appears in the summer says something to me - I don't know what because there's little information you can find about the root cause of Perioral, but I do know my face and I do believe it has something to do with the extreme heat/humidity we get here in eastern NC, along with the fact that summer is the only time I really sweat at all.

This flare up was definitely the deal breaker for me - it started out small like usual, I'd seen it before so I wasn't worried.  I started with the vitmain E oil again, because it was small enough to deal with but also big enough that it was noticeable.  Needless to say it didn't work, I won't say it made it worse but I know it didn't help.  By the end of July it was pretty bad - starting in the creases of my nose and making its way down around my upperlip, a little had spread into my nostrils and also spread out towards my cheeks.  This isn't the worst it could have been - I've seen worse pictures and realize I've been lucky, but it doesn't change what it is and it sucks to have it no matter how severe it is.  It wasn't the worst, but I surely did make it way worse then it needed to be!

I became frantic (I had a job interview the following week - got the job, and my starting date was August 17th) so I tried everything I had near me.  Very, very bad idea.  PLEASE: If you think this is what you have, GO TO THE DERMATOLOGIST!!!!!!! Not your family doctor, which I will explain why later, and do not try to fix it yourself - it is something you seriously need professional help with, or else you might make matters worse depending on what you're using.

A list of what I applied in hopes of clearing the Perioral up in time for the new job:

Vitamin E: Does nothing, good or bad.  If you have dry skin, this may be something you can look into.

Vaseline total moisture conditioning lotion: I had been using this on my face after showering before the Perioral started just to help with a little dry skin I had, so I decided to try it to help.

Aquafina hand lotion with shea butter:  Bad, bad idea.  I used it for a few days while working to help with the flakes that started along with the Perioral.  Burns, stay away!

Eucerin Aquaphor healing ointment: I was really betting on this to help a lot, soley because it says, "for dry, cracked, or irritated skin"

Hydrocortisone cream:  DO NOT USE THIS.  It burns like anything, and you can not trust the whole "If it burns, that just means it's working!" thing with Perioral.  No doubt this along with everything else made it worse.

Aloe vera gel:  It did soothe the burning, and if you buy a brand that is all natural I don't think it will worsen the break out, mine was probably about 10 years old and was a bad idea in my case.

Sunscreen:  I did research, someone said to try it - so I figured why not.

Tea tree oil: I only used this on a little spot, I was too scared to try it on the whole flare up, but I have heard mixed reviews on this helping.  If you do try it, you must dilute it - seriously.  One or two drops of the oil on a cotton ball, soak the cotton ball up with water and squeeze it out. 

Covergirl foundation:  Just to cover it up, even though I knew in my head this would probably make it worse.

Now, I tried all of this within a week - no joke.  So I can't tell you for sure if anything helped at all.  I would try one product for a day, swiching to another product the next, which is where I definitely did my skin very wrong.  By the end of the week (and the week before starting the new job, yikes) my face was covered in thick, white flakes that itched and burned along with the red Perioral underneath.  I was so upset, and figured I couldn't defeat this on my own so I called and made an appointment the following monday with my family doctor.

My doctor took a look at my face and first noticed the dry skin - I made sure to tell him THIS IS NOT JUST DRY SKIN - after telling him everything I had used on my face to try and clear it up he understood why it was in that condition.  He looked at where exactly the break out was on my face, and decided that I had Seborrheic Dermatitis.  Now I had already done my research and pretty much told myself that I had Perioral Dermatitis - so I did question him, and asked him how come it's not Perioral.  He told me because of the fact it started in the creases of my nose that it had to be Seborrheic.  He's a doctor, so I didn't argue.  He prescribed me Nystatin and Triamcinolone Acetonide cream, and told me that in a few days it would start clearing up and if there were any other problems then call.

I started that day - the cream is white, so that on top of the flaky red was even better for my self-esteem.  I called back to ask if there was anything to help with the dryness - they told me not to put ANYTHING else on it - except water when I shower.  Morning and night, I put the cream on - 4 days later, it was clear besides a little red underneath my nose.  I was amazed and ecstatic.  I kept up with the cream for a week, then deicded to ween myself off.  After two days of only applying once a day, it came back.  Not too much, a couple bumps.  So I started back, and I did this for a little over a month - I'd go a week or two applying then take a few days off - I couldn't see how putting this on every single day could be good.  On one particular day off not applying the night before or that morning - I woke up to my Perioral at it's worst (minus right before I saw the doc.)  It was an angry, fierce red with tons of bumps - starting on the sides of my nose, coming out to my cheeks and spreading down around my mouth, inside the nostrils again and this time down to my chin.  I was shocked and this was the time when I really just broke down, and figured there is no hope for this - until I called a dermatologist.

I arrived at my appointment, got seen by the nurse and told her what I had been on and how long this had been going on (at this point I'd been dealing with it for about 3 months) blah blah.  The Derma. came in shortly after, took one look at both sides and said, "You have what we call Perioral Dermatitis." and of couse I pretty much jumped off of the exam table saying "THAT'S WHAT I SAID!!" and she laughed, and told me that I had been putting the wrong cream - which was only making matters worse, which explains the ugly flare up right before my visit with her - the whole time.  So, that's about 2 months of pissing my skin off.  She prescribed me Oracea to take once a day, which is a pill taken for Rosacea to help with the bumps and it says for the inflammation but I think it's mainly just for the papules and pustules.  She also prescribed Metrogel (which BTW - even with insurance would have cost me $140 dollars so I called back to get the generic version - $15 - called into my pharmacy) the generic version is called Metronidazole topical cream 0.75%, applied morning and night after washing your face.

Now, it's only been a little over a week since I saw her, but let me tell you.  I have no bumps at all, no dry skin, and I am only red underneath my nose and near my chin.  I don't know for sure if this is "IT" but I can tell you I'm the most relieved I've been since July.  She asked for me to come in after 4-6 weeks of treatment, which will be towards the end of November, so we'll see how I'm doing then and what she tells me to do next, I have a feeling it will be to ween myself off Oracea and continue with the cream (which is clear - so no worries about dried up white ointment on your face or what I called my "milk mustache" when I was using what my family doctor gave me) but only for a certain period of time and then eventually stopping treatment all together.

I don't know if this will help anyone, but I have read a lot of other stories written by others with Perioral and it did help me - I did feel alone, none of my family or friends had this so it was too hard to try and explain to them to make them really understand.  I'm not a doctor or anywhere close, all I know is what was a bad idea and now what to do if this happens again.

For those who have it, or are pretty sure you have it, please go see a Dermatologist.  They will direct you on the right path to getting your normal skin back!