COMBAT PERIORAL DERMATITIS

I suffered from a skin problem for a couple of years before I found out it had a name. I would get these ugly bumps around my mouth, under my nose, and at the outer corners of my eyes. I would put hydrocortisone on the irritation and it would go away briefly, then come back a day or two later. I eventually got to the point where I was using hydrocortisone cream almost daily.

It wasn’t until I started reading a book by a dermatologist named Dr. Jessica Wu called FEED YOUR FACE that I realized this condition went by the name perioral dermatitis. In the book, she describes this condition and it matches my symptoms exactly.

To my horror, one of the causes of perioral dermatitis is the only thing that seemed to fight it: hydrocortisone cream! Yuck. I did some research and found that using hydrocortisone cream on the face is not recommended for a couple of reasons. One: thin the skin. Another reason is that it can cause perioral dermatitis, which is a chronic condition. Unfortunately, if you continue to use the hydrocortisone cream, it will become a terrible cycle and the rash will come back over and over again, getting worse over time. .

This was particularly distressing to learn, because hydrocortisone cream seemed to be the only thing I could find that would help soothe my skin so it could look normal.

Even MORE horrible 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 is worse. According to PubMed, one study found that mites occurred in greater numbers on skin that had been exposed to topical steroids (hydrocortisone). Eek! If thinning skin and a rash weren’t enough to put me off using, the thought of skin mites certainly was. I haven’t put hydrocortisone cream on my face since, and I don’t plan to. Ever.

Years ago, a well-meaning internist recommended that I use hydrocortisone on my acne. However, this doctor was not a dermatologist, so she apparently did not know that hydrocortisone thins the skin and can cause the proliferation of skin mites. However, in that doctor’s defense, even my dermatologist has recommended hydrocortisone, on rare occasions, on my face. There is a laser procedure that removes red spots on my skin and when I had this procedure done my dermatologist gave me a small sample of hydrocortisone to calm the redness. He didn’t tell me to use it on pimples, and he never recommended using it for long periods of time, although he also didn’t warn me about the potential risks of long-term use.

I did use it for long periods of time, because the internist had recommended it to me and I mistakenly assumed it was safe.

When I stopped using the hydrocortisone, the condition became overwhelming and unbearable. I looked so bad that I didn’t want anyone to see me.

I went to my dermatologist and told her what I had learned in Dr. Wu’s book. She looked me in the face and said that yes, she did have perioral dermatitis and that it was a chronic condition. She told me that the medications she would prescribe would probably work, but they would not “cure” the condition; she was turned on periodically. Great.

He 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 a tube.

I completed both prescriptions but was concerned about side effects and decided not to use them right away. Instead, I saved them as a last resort and did some research on the internet to find some “natural” alternatives. I prefer not to take antibiotics unless absolutely necessary, because they kill the good bacteria that keep candida (yeast) at bay. If you’ve ever had a yeast infection, you probably never want to get one again.

So, I tried almost everything suggested in articles and forums dedicated to perioral dermatitis. Some of the recommendations were: stop using florida toothpaste, stop using anything with sodium laurel sulfate, 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 in them, and I used “natural” soap. I was already on a low glycemic diet, but I stopped indulging in some raw honey or coconut sugar every once in a while.

I also tried a few non-toxic topical remedies that I read about, including aloe vera gel straight from the plant and apple cider vinegar applied to the rash. I also drank some vinegar in water several times a day, which was also suggested to me.

The results were so-so. ACV applied directly to the rash helped, but not reliably. Sometimes the rash would respond well and go away after using it, and sometimes not.

After three weeks of resisting the dermatologist’s meds, I finally went ahead and tried Minocycline and Protopic. I ate a lot of natural yogurt to avoid a yeast infection. The minocycline cleared up the rash in a few days and my skin looked amazing.

The Protopic also seemed effective to me, but I did not like it at all. It is 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 feeling that came after using the product. This burning would persist after the mediation had been removed and would be exacerbated by sunlight.

So the bad news is that I needed the internal antibiotic. The good news is that in two years I have not had to repeat the antibiotic. However, the condition has flared up, never as severely as when I stopped using hydrocortisone to treat it.

I found that when I start to get some bumps due to perioral dermatitis, I can combat it if I take ALOE VERA JUICE, which kills harmful bacteria in the digestive system. I recommend the pure aloe vera juice, the kind that does not have added sugar. You don’t need that much, about 4 ounces added to a glass of water (6 to 8 ounces) every other day seems to keep it in check for me. The juice doesn’t taste very good, I’m sorry to say, but the results are good. If you have acne and perioral dermatitis, the juice may also help with pimples. You can buy the aloe vera juice in a pitcher at Trader Joe’s. They also sell jars at Wallmart, in the pharmacy section.

Another thing that seems to help keep the condition in check is a small amount of 5% benzoyl peroxide applied to the rash. In the past, I have avoided benzoyl peroxide and preferred tea tree oil for acne, but I do not find tea tree oil to be as effective for perioral dermatitis. Dr. Wu cautions that acne medications exacerbate perioral dermatitis, but this has not been my experience with benzoyl peroxide. It is a topical antibiotic and dermatologists will prescribe some type of topical antibiotic for the condition, but it will probably be stronger and more expensive than benzoyl peroxide. If you’re reading this before visiting a doctor, you might want to try aloe juice and some benzoyl peroxide to see if that helps first. For me, the smallest amount of benzoyl peroxide sprinkled on the rash works great. And if I drink a little aloe juice every other day, I seem to avoid breakouts altogether.

I should also mention that I can use toothpaste, shampoo and normal soap, without any problem. I am not convinced that Florida or SLS are causes of perioral dermatitis. It is possible that they do, but it is not known for sure what actually causes the condition. That is, however, hydrocortisone is known to make it worse.

If you have 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 am not an advocate of medicine, especially antibiotics, having been through this, I recommend that if your flare-up is unmanageable and your doctor prescribes it, take it and get rid of it. Then keep your skin clear as I have suggested. Hopefully, you won’t have to take the antibiotic again.