PERIORAL DERMATITIS COMBAT

I suffered from a skin problem for a couple of years before discovering it had a name. He had these horrible bumps around his mouth, under his nose, and at the outer corners of his eyes. I 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 started reading a book by a dermatologist named Dr. Jessica Wu called FEED YOUR FACE that I realized that this condition was called perioral dermatitis. In the book, he describes this condition and it exactly matched my symptoms.

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: thins the skin. Another reason is that it can cause perioral dermatitis, which is a chronic condition, but unfortunately, if you keep using hydrocortisone cream, it will turn into a terrible cycle and the rash will reappear over and over again, getting worse over time.

This was particularly painful 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 were found in higher numbers on skin that had been exposed to topical steroids (hydrocortisone). Eek! If skin thinning and a rash weren’t enough to get me off things, the skin mite idea certainly was. Since then I have not applied hydrocortisone cream to my face and do not plan to do so. Always.

Years ago, a well-meaning internist recommended that I use hydrocortisone on my acne. However, this doctor was not a dermatologist, so he apparently did not know that hydrocortisone thins the skin and can cause skin mites to grow. However, in defense of that doctor, even my dermatologist has recommended hydrocortisone, on rare occasions, to the face. There is a laser procedure that removes red spots from my skin and when I had this procedure my dermatologist gave me a small sample of hydrocortisone to alleviate the redness. She didn’t 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 long-term use.

I did using it for long periods of time, because the internist had recommended it and I wrongly assumed it was safe.

When I stopped using 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 him what I had learned in Dr. Wu’s book. He looked me in the face and said that I did indeed have perioral dermatitis and that it was a chronic disease. She told me that the medications she would prescribe would probably work, but would not “cure” the condition; it would probably flare periodically. Excellent.

He prescribed Minocyline, an oral antibiotic, and Protopic, a topical antibiotic. Protopic is very expensive. My insurance didn’t cover it and it cost more than $ 100 per tube.

I filled both prescriptions, but was concerned about the side effects and decided not to use them right away. Instead, I kept them as a last resort and did an internet search 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 will certainly never want one again.

So, I tried almost everything suggested in the 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 and I used “natural” soap. I was already eating a low glycemic diet, but stopped allowing myself the occasional bit of raw honey or coconut sugar.

I also tried some 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.

The results were only fair. ACV applied directly to the rash helped, but not reliably. Sometimes the rash responds well and goes away after use, and sometimes it doesn’t. ‘

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

The Protopic seemed to be effective too, but he didn’t 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 feeling that occurred after using the product. This burning would persist after the mediation had been removed and was aggravated by sunlight.

So the bad news is that he 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 again, never more severely than when I stopped using hydrocortisone to treat it.

I find that when I start to get a few bumps from perioral dermatitis I can combat it by drinking ALOE VERA JUICE, which kills bad bacteria in the digestive system. I recommend pure aloe vera juice, the kind with no 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 under control for me. The juice doesn’t taste very good, 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 aloe vera juice in a pitcher at Trader Joe’s. They also sell jugs at Wallmart, in the pharmacy section.

Another thing that seems to help keep the condition under control 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 don’t find tea tree oil as effective in 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 likely be stronger and more expensive than benzoyl peroxide. If you are reading this before visiting a doctor, you can try aloe juice and a little benzoyl peroxide to see if that helps you first. For me, the smallest amount of benzoyl peroxide, smeared in a thin layer on the rash, works very well. And if I drink a little aloe juice every other day, I seem to avoid breakouts entirely.

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

If you have this condition, I sincerely hope that my recommendations are helpful. I know how miserable it is to have a rash on my face that doesn’t seem to get better. While I am not an advocate for medicine, especially antibiotics, having been through this, I recommend that if your outbreak is unmanageable and your doctor prescribes it, take it and eliminate it. So keep your skin clear as I have suggested. Hopefully, you won’t need to take the antibiotic again.