What To Do If You Have Perioral Dermatitis
COMBATING PERIORAL DERMATITIS
I suffered from a skin problem for a couple of years before finding out that it had a name. I’d get these ugly bumps around my mouth, under my nose and at the outer corners of my eyes. I’d put hydrocortisone on the irritation and it would go away briefly, then reappear a day or two later. Eventually it got to the point where I was using hydrocortisone cream almost daily.
It wasn’t until I began reading a book by a dermatologist named Dr. Jessica Wu called FEED YOUR FACE that I realized this condition had the name perioral dermatitis. In the book, she describes this condition and it matched my symptoms exactly.
To my horror, one of the causes of perioral dermatitis is the one thing that seemed to combat it: hydrocortisone cream! Ugh. I did some research and found that using hydrocortisone cream on the face is not recommended for a couple of reasons. One– it thins the skin. Another reason, is that it can cause perioral dermatitis, which is a chronic condition.-Unfortunately, if you keep using hydrocortisone cream, it will become a terrible cycle and the rash will reappear, again and again, becoming worse over time.
This was particularly distressing to learn, because the hydrocortisone cream seemed to be the only thing I could find that would help calm my skin so I could look normal.
Even MORE horrifying in my opinion is that according to Dr. Wu another cause of perioral dermatitis is the DEMODEX MITE. Apparently, this mite lives on our skin-even healthy skin, but with perioral dermatitis it’s worse. According to PubMed one study found that the mites occurred in greater numbers in skin that had been exposed to topical steroids (hydrocortisone). Eek! If thinning skin and a rash wasn’t enough to get me off the stuff, the idea of skin mites certainly was. I have not put hydrocortisone cream on my face since, and I don’t plan to. Ever.
Years ago, a well-intentioned doctor, an internist, recommended that I use hydrocortisone on my acne. This doctor was not a dermatologist, however, so she apparently wasn’t aware that hydrocortisone thins the skin, and can cause the proliferation of skin mites. In that doctor’s defense, though, even my dermatologist has recommended hydrocortisone, in rare occasions, on the face. There’s a laser procedure that removes red spots on the skin and when I’ve had this procedure, my dermatologist has given me a small sample of hydrocortisone to soothe the redness. She did not tell me to use it on pimples, and she never recommended using it for extended periods of time, nor did she warn me of the potential risks of extended use, though.
I did use it for long periods of time, because the internist had recommended it and I erroneously assumed it was safe.
When I stopped using the hydrocortisone, the condition became overwhelming and unbearable. I looked so bad I didn’t want anyone to see me.
I went to my dermatologist and told her what I’d learned in Dr Wu’s book. She looked at my face and said that I did, indeed, have perioral dermatitis and that it was a chronic condition. She told me that the medicines she’d prescribe would probably work, but that they wouldn’t “cure” the condition; it would likely flare up periodically. Great.
She prescribed Minocyline, an oral antibiotic, and Protopic a topical antibiotic. Protopic is very expensive. My insurance didn’t cover it and it cost over $100 per tube.
I filled both prescriptions, but worried about the side effects and decided not to use them right away. Instead, I kept them as a last resort and did some internet scouring to find a few “natural” alternatives. I prefer not to take antibiotics unless absolutely necessary, because they kill the good bacteria that keep candida (yeast) in check. If you’ve ever had a yeast infection you certainly never want one again.
So, I tried just about everything suggested in the articles and on the forums dedicated to perioral dermatitis. Some of the recommendations were: stop using toothpaste with Floride, stop using anything with Sodium Laurel Sulphate, stop eating sugar and other high glycemic foods, and take omega 3s.
So, I brushed my teeth with baking soda. I washed my hair with vinegar and baking soda, because most shampoos have SLS and I used “natural” soap. I was already eating a low-glycemic diet, but I stopped allowing myself the occasional bit of raw honey or coconut sugar.
I also tried some non-toxic topical remedies I read about, including aloe vera gel directly from the plant, and apple cider vinegar applied to the rash. I also drank a bit of the vinegar in water a few times a day, which was also suggested.
The results were only so-so. The ACV applied directly onto the rash did help, but not reliably. Sometimes the rash would respond well and disappear after using it, and sometimes it wouldn’t’.
After three weeks of resisting the medications from the dermatologist, I finally did go ahead and try the Minocycline and Protopic. I ate lots of plain yogurt to avert a yeast infection. The Minocycline knocked the rash out within a few days and my skin looked amazing.
The Protopic also seemed to be effective, but did not like it at all. It’s oily and I found it messy. Also, it created a burning sensation on my skin. There was no actual burn. It was just an uncomfortable sensation that occurred after using the product. This burning would persist after the mediation had been removed, and was exacerbated by sunlight.
So, the bad news is that I did need the internal antibiotic. The good news is that in two years I have not had to repeat the antibiotic. The condition has flared up again, however, never as severely as was when I stopped using hydrocortisone to treat it.
I find that when I begin to get a few bumps from perioral dermatitis I can combat it if I drink ALOE VERA JUICE, which kills bad bacteria in the digestive system. I recommend pure aloe vera juice, the kind without added sugar. You don’t need that much, about 4 oz added to a glass of water (6 to 8 ounces) every other day seems to keep it in check for me. The juice does not taste very good, I’m sorry to say, but the results are good. If you have acne as well as perioral dermatitis you may find that the juice helps with pimples also. You can buy the aloe vera juice in a jug at Trader Joe’s. They also sell jugs of it at Wallmart, in the pharmacy section.
Another thing that seems to help keep the condition in check is a tiny amount of 5% benzoyl peroxide applied to the rash. In the past, I’ve avoided benzoyl peroxide and favored tea tree oil for acne, but I don’t find the tea tree oil as effective on perioral dermatitis. Dr. Wu cautions that acne medications exacerbate perioral dermatitis, but this has not been my experience with the benzoyl peroxide. It’s is a topical antibiotic and dermatologists are going to prescribe some kind of topical antibiotic for the condition, but it will likely be stronger and more expensive than benzoyl peroxide. If you’re reading this prior to visiting a doctor, you might try the aloe juice and a little benzoyl peroxide to see if that helps you first. For me, smallest amount, of benzoyl peroxide spread thinly on the rash works very well. And if I drink a bit of aloe juice every other day, I seem to avoid flare ups altogether.
I should also mention that I’m able to use toothpaste, shampoo and regular soap, without a problem. I’m not convinced that floride or SLS are causes of perioral dermatitis. They may, but it isn’t known for sure what actually causes the condition. It is, however, known that hydrocortisone makes it worse.
If you’ve got this condition I sincerely hope my recommendations are helpful. I know how miserable it is to have a rash on your face that doesn’t seem to get better. While I’m not an advocate of medicine, especially antibiotics, having gone through this, I do recommend that if your flare up is unmanageable, and your doctor prescribes it, take it and knock it out. Then maintain your clear skin as I’ve suggested. Hopefully, you won’t need to take the antibiotic again.