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    Severe Perioral Dermatitis, MD advice needed!!!
    June187 posted:
    I will try to keep this as short and to the point as possible. I have had recurring bouts of what I have now come to determine is perioral dermatitis of some form. I am positive of this fact due to my rash being contained to my chin, edges of nose, naso labial folds and under my eyes. Always excluding the ring around my lips. It is bright red in color with papules and pustules similar to rosacea but also has skin flaking as specified in eczema. Even the gentlest of cleansers sting and burn over the rash area. I was diagnosed with rosacea by a GP (I believe this is incorrect) and my doctor had given me metrogel which I used for a total of 2 months. I never seemed to help but with the inflamation of the papules. The rash has progressed from a small dry spot on my chin (which I always thought of as eczema) to this full blown outbreak which is as severe as any of the worst pictures of POD I have seen online. I have been on Doxycycline 100 mg/day for about a month now which I do believe helped clear up the rash the first time. After a sever reaction to mosquito bites overseas (I have always been a bit allergic to mosquitos) I was given an oral corticosteroid which I believe has contributed to this current worst flare up yet, which happened even with the doxy. I have used Apple Cider Vinegar and distilled water as a facial toner which I believe helps keep the rash at bay, and also helps keep my skin clear (I have suffered from mild to moderate acne most of my life). I have also removed all sulfates from my beauty products (shampoo etc), no moisturizer excepting the occasional use of an all natural callendula calming cream (baby product) on sore spots which helps, using all natural veg glycerin shea butter soap (black african shea soap) and wearing practicly no makeup excepting small ammounts of cover up and mineral powder (bareminerals veil), no lip products excepting unrefined shea butter, non fluoride toothpaste, non fluoride water (drinking), a chlorine filter on my shower (seems to help with the temporary itchy bumps and red splotches I always got after showering). Now I want to add two interesting points, the first being while away in a country that doesn't fluoridate water this rash went completely away, the other being that my mother was recently diagnosed with some similar form of dermatitis without the papules/pustules (they are not sure) and given protopic which she says helps keep it from peeling but it never goes completely away. I myself have used tiny ammounts of protopic for this last serious bout but the possible carcinogenic quality of this ointment scares me, it also makes me break out with plain ole pimples bc it is so thick. I have done so much research and it seems that this is the 'bermuda triangle' of skin diorders. Nobody knows what causes it or how to get rid of it. Thus far everything I am doing is only treating the symptoms of this disorder, but I have a feeling that unless I find the root cause I will never be rid of this debilitating disorder. Some have suggested the root cause to be internal candida overgrowth, poor mineral absorption, dairy allergy etc. Is it possible a 'cleanse' would be benificial? Being my mother has such a similar issue with her skin I have been looking for similarities in our day to day lives. The only one I have come up with is genes and the water we drink/bathe in. I have been told it is impossible to absorb fluoride through the skin. Is this true, is it possible to have a contact reaction with fluoride chemical? I am not a doctor thus I DESPERATELY need help with this. Dermatologists seem not to know what to do with this issue. I want to be rid of this horrid rash and take back my life! I just don't know what else to do. I wish someone would take on this mystery rash and figure out how to treat it because as I have found online, I am not the only one out there suffering. Please any advice or experience you have in treating Perioral Dermatitis would be greatly appreciated Thanks
    Susan Evans, MD responded:
    Dear June 187,

    Because you are under the care of a doctor, I am really in no position to offer a second opinion to your condition.

    You bring up a couple of interesting points, however, that might benefit from further evaluation.

    You mention that your symptoms disappeared when you were out of the country. While fluoride is one additive in our water, there are hundreds of other compounds that are dissolved in our water system, and these change from water system to water system. Different parts of the country have different dissolved minerals in the water and your skin can certainly react to these.

    Some patients have benefited from bathing in softened water which removes many of these compounds from the water.

    You also mention that your mother is suffering from a similar condition, and perioral dermatitis is typically a condition of young women. Has your mother been diagnosed with the same condition as you?

    I sincerely hope that you find some answers to your situation.


    Dr. Evans
    June187 replied to Susan Evans, MD's response:
    Thank you for your reply,
    Much like myself, my mother has no definitive diagnosis (with a different doc). They are thinking seborrheic dermatitis for her now. I do not believe that it is SD.. it appears more like eczema and only on her face. I suppose at 47 she is a bit out of the age group for PD. Unfortunately I seem to have reached the limit of treatment options with my current doc. I suspect I should be seen by someone who may have some other ideas of what to do. I wonder if you could possibly reccommend a very good derm in Minnesota?
    agombos replied to June187's response:
    June187- Did you ever find a solution for your PD? My condition sounds very similar; rash/redness around mouth outside of nose and under eyes and on my eyelids. I have been on doxycyline for 3 weeks. I have seen 6 doctors, none of which can give me an answer.
    June187 replied to agombos's response:
    It's been 1 year, but I can still remember how bad that rash felt! They never did figure out what exactly I was suffering. It ended up being closest to Seb. Derm I think. I stopped the antibiotics and used a ketoconazole 2% topical cream on my face (which has isopropyl myristate and caused some blackheads buth worth it) and OTC Aveeno hydrocortisone (sparingly) which helped my rash subside. I also washed my body and hair with Nizoral shampoo (OTC ketoconazole shampoo). I started back up with the salicylic acid topical on my face which I think is key to keeping this rash at bay. I know that cold weather is a trigger. When I vacationed in the sun my rash nearly went away. I am now using a gentle natural cleanser (neutrogena naturals purifying facial cleanser), topical salicylic acid (Peter Thomas Roth AHA/BHA acne clearing) during the day, Differin .1 @ night combined with Mandelic acid, and CeraVe PM (this last part for acne and my rash was gone before adding these two). I also use the Olay facial brush for exfoliation as I found scrubs irritate me and trigger the slightest symptoms of the rash. I am NOT a doc but if the doxy isn't helping perhaps talk to your MD about stopping that (no need to take a pill that doesn't help) and perhaps try the Ketoconazole cream 2%, Aveeno hydrocortisone and Nizoral combo. I will note that later on in my sfferings my scalp started itching which lead me to trying the ketoconazole. I am not sure of all your symptoms but this is perhaps an idea of something to try. My mother still uses the protopic and her rash is not completely gone, but perhaps is something different. It is however, much more under control. I will also say that I had this rash all winter and then it went away with warmer weather. I hope you will not suffer so long, but if you do.. remember that summer should relieve you some and perhaps give you a chance to get things under control like me. If the rash is dry and ouchy, I did find California Baby Calming Calandula Cream or Organic Neem Oil to help (the Neem Oil is applied a few drops to a damp face after cleansing and is also Anti-fungal) I hope this can help a little and I hope you get better soon! Take care, J.
    Skinsonew responded:
    Hello you probably know this by now but fluoride is one of the worst things for perioral dermatitis and yes it will absorb in your skin. Use fluoride free toothpaste...a plant base is the best made by Weleda and use all chemical free products...go to Body by Pure products on ebay formerly Homebrewedwear and her Tea Tree body butter is the absolute best can also get chemical free shampoo/conditioner/body & face soap and eye make up remover. This is the only really pure site of products without chemicals. Also take L-Arginine 500 mg 4 to 5 a day. Get at a health food store. It has really made a difference in my skin and I have been dealing with this for 7 years. Hope this helps
    casperatos responded:
    Dear Sir/madam,

    For my Masters' thesis I am looking for (English) people who have Rosacea or who have a family member with Rosacea.

    I have developed a survey about Rosacea and your input will provide me of important information that will reinforce the outcome of my thesis. The survey is anonymous. It will take around 7 minutes to complete.

    Title: "Market research on Rosacea in the UK"

    I would deeply appreciate your help in filling out this survey. Click on the link below to fill in the survey:

    If you have any questions please don't hesitate to contact me. If you like I can send you the results of the survey afterwards
    Thank you in advance for taking a moment of your time!

    Wishing you all the best.
    Kind regards,

    danarochelleh responded:
    Dear June,
    I know this is an old post, but I just wanted to share my story as well. I have been dealing with perioral dermatitis for over 10 years. I have been to the derm who told me to quit using toothpastes with whitening and tartar control I them. I did that, no luck. Used "organic" everything with no luck! I was only getting relief by living on doxycycline and topical steroids (cutivate) and then protopic. The doxy made me sick if I ate it without food so half the time I would forget and would get another nasty flare up. Mine were so bad at times it would even be in my eyebrows. I have used all the yucky toothpastes and even changed all my hair/body products to fluoride and SLS free just trying like crazy to determine what I was allergic to. I finally broke down in Aug 2013 and went to an allergist. Had all the test (prick and skin tests) done and nothing was found!! I was so upset since I had to spend all the extra money (insurance only covered a small portion for allergy testing) only to have zero answers. Well here it is Jan 2014 and I have had no flare ups AT ALL since Dec 2013, right after Christmas. You see, my friend finally convinced me to try Plexus products because I was trying to lose some weight. One of the products I was using in conjunction with that was their ProBio5. I had only been using the products for a couple weeks when I went out of town after Christmas. I was gone for 3 days and when I got home it dawned on me that I hadn't taken my doxy the entire time I was gone and my face had no signs of flare up. So I continued to NOT take my doxy and I have still NOT had the first sign of a flare up even coming. I KNOW it is the Probio. I swear, any of you out there that are and have been suffering and dealing with this MUST try the ProBio. I actually signed up to share the products so if you have any questions PLEASE contact me. I am not a scammer, I am living proof that it works. You can go to and get my email if you want to message me. You can also get the product from that site. I have been FREE of the flare ups, FINALLY!!!!!

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