Skincare Journal: Perioral Dermatitis My Story

Perioral Dermatitis is an infuriating skin condition where several factors lead to dry, irritated skin that has a compromised barrier.

My Perioral Dermatitis began somewhere in my early to mid twenties. I had been on birth control, a steroidal drug, anti anxiety medicine, anti depression medicine and a pain killer. After being tired of taking so much medicine for so long, I (foolishly) decided to take myself off of all my medicine, all at once....cold turkey. It felt as if all parts of me were at war with each other. Not only had my mental and emotional health gone awry, but physically I wasn't up for such a challenge either.

My once semi-normal skin (some dryness on the cheeks and the occasional mild break out) had erupted quite violently. I was now bearded with pustules that were embedded in dry and flaky skin. "WONDERFUL!" I cried out in frustration, followed by a quietly knowing "....shit....".

Now, it is at this point, I had NO idea what had developed on my face. In my previously limited experience with problematic skin I assumed I could assess my skins needs completely by myself. Just look at all those TV and magazine adds with women taking their health and beauty by the reins and making it work for them. My journey to the dermatologist wouldn't come until years later. 

"Pimples! I have pimples, so I must need face care for acne!" I, resolutely, decided. Salicylic acid washes, toners, peels, oil-free creams, spot treatments and scrubs crowded my bathroom counter. Not a one really worked. Some worked a little. Clearing up the angry little sacs, but each one healed was replaced by another (or more). This went on for quite some time.

When tax season had given me a bit of extra money and desperation had given me poor judgement, a trip to the esthetician was what I decided on next. I do not even remember how I had come to pick this lady, but she had beautiful skin so who was I to question. She agreed that I had acne and what I needed was an extraction session (why yes, yes it IS as painful as it sounds) followed by a micro dermabrasion scrub, a mask treatment and a few "necessary" take home products. I left red, blotchy, bleeding, covered in clay and several hundred dollars poorer. My cousin (love you Chris!), who had come with me for support, walked me out. He lifted my spirits and cracked jokes to get my thoughts off of my hemorrhaging face. I was hopeful.

Scarred, temporarily cleared, but still incredibly irritated skin was what I was left with. I seem to remember using Murad's lotion for acne prone skin at this time and being relatively pleased. Eventually, things quieted to a dull roar. My skin was still dehydrated and pustules were cropping up every few days, but at least it was days instead of hours. More products, etc.

I started working in the health and beauty department of a natural foods grocer. I couldn't wait to try all of the supplements and beauty regimens found to be effective (some too effective in what they do, but we'll get to that later), yet proudly natural. I now had access to a vast library of guilt-free skincare. Over the next several years I exhausted many options, discovered truths and tales and began to get a better understanding of what my skins likes and what it abhors.

Still believing I had acne, I sleuthed out reviews (makeupalley.com and youtube are pretty great) and recommendations and requested samples. As luck would have it, a large package of Herpanacine (the old formula without Zinc) samples came in and the vitamin buyer decided to give it to me to try. Over the course of six weeks I took two capsules twice a day and then two capsules once a day for maintenance. My pustules started to slow and the irritation was still present, but moderately mild. I was relatively clear for the first time in years and I was happy.

Now that my skin was becoming somewhat normal, I decided it was time that I begin a formal skin care regimen. I had something I could work with. I tried MyChelle Dermaceuticles, Earthscience, Nude Skincare, Organic Apoteke, Dr. Hauschka, Duchess Marden, Camocare and TONS more. Nothing fit right. Too drying or too oily, never quite balanced.

A few products did more harm than good. MyChelle's reformulated Fruit Enzyme Cleanser had become so potent that when I had washed my face twice (once to get makeup off and once again to clear off the residue) it had resulted in an entirely enflamed face. Hundreds of tiny angry pores glowed red and raised. It took roughly 5 weeks of using nothing but Dr. Hauschka's Cleansing Milk, a little rose water and Rose Day Cream to (mostly) calm it. Anything with SLS or citrus (most acids, really) was a no go as well.

After a lengthy amount of trial, error and irritation, there really wasn't anything outside of the Dermatologist office that I could do. The pustules on my chin began to resemble more of a rash that had spread to the outer corners of my eyes. I finally had access to moderately priced healthcare and so, made my appointment.

"You have Perioral Dermatitis," she said. "Your face is basically very inflamed. Do not put anything on it that I don't give you. Do you understand?" I nodded in agreement. This was the first time that I had realized that not only did I not have acne, but in treating it as such I basically did my skin more harm than good. She prescribed me antibiotics and a topical cortisol ointment (normally you don't put cortisol on PD because it will clear it temporarily and then make it worse, but she must have had her reasons) and told me to get a natural sunscreen. The very next morning, the pustules had stopped and the irritation had gone down by half. Over the course of two months my skin cleared and the redness was nearly all but gone.

It has come back full force once since then. I repeated the prescribed course, which took longer and hadn't completely rid me of irritation. I am off the tail end of it now. At the moment, she wants me to continue taking a small dose of antibiotics and I'm fine with that. We'll see how it goes. I am also still trying to find a simple, yet effective skincare routine that doesn't leave me out of balance.

So far, the best regimen I have used is:

Makeup Remover: Clinique Take The Day Off Cleansing Balm or olive oil
Cleanser: Fresh Soy Face Cleanser or LUSH Angels On Bare Skin
Toner: Plain old rosewater
Moisturizer: First Aid Beauty Ultra Repair Cream
Sun Protection: EltaMD SPF 46 for Face

Although the above products have worked decently for me I still feel like my skin becomes dull and flaky like it needs moisture and a mild exfoliant.

Ulta was having a special on Dermalogica, which has come highly recommended, so I will be trying that over the next month or so (unless it causes a reaction). I will do progressive posts with pictures in the following days / weeks.

I understand that this is a lengthy post, but it is a lengthy process. In addition to regular skincare updates I will probably do a future post of what I KNOW causes reactions. I wasn't able to report an extensive list here without sacrificing the flow of the story. If you have any suggestions please feel free to politely post in the comments section below. If you have PD, I'm really very sorry. It's quite a process, but hopefully you will have found something useful and maybe comforting here. I refuse to believe that I can't have good skin so I'm just going to keep trying.

I am not a doctor, esthetician or any other sort of skincare specialist. Any and all information obtained from my story is used at ones own discretion. I am not responsible for the decisions (and subsequent results) you make for your skin. Please be responsible.