Hello, Perioral Dermatitis
Let me begin with a montage of a day in summer marathon training.
Wake up, brush teeth, get in shower. Shampoo, exfoliate face, rinse. Conditioner, body wash, rinse. Moisturizer with sunscreen in it because I'm responsible. Quick make-up and off to work. After work, run, sweat profusely, swipe at dripping forehead and chin with meshy shoulder fabric. Sometimes straight home, sometimes pizza. Shower again, exfoliate again, dab face with toner, sometimes moisturizer again, chapstick, go to bed. On long run days, add a whole bunch of sunblock and 2-3 hours of exercising in intense heat into that mix. I've always been easily flushed, and after running in the summer my face stays pink for hours afterwards to the point where people at work ask me if I'm okay.
As it turns out, my summer marathon training, regular (responsible?) skincare routine, and the fact that I'm a fair-skinned woman between the ages of 20 and 40 made me the perfect candidate for a really fun skin condition called Perioral Dermatitis. But I didn't know that yet.
It began with what looked like acne on my chin in mid-August. I used more toner and waited it out. Then it began to dry out in the strangest way, like raised scales underneath both sides of my lower lip and at the sides of my nostrils. I moisturized the heck out of it and tried to cover it up with make-up, with varying success depending on the day. After a month of this, I sought out a dermatologist. He told me after one quick look at my face that I had a "bit of dermatitis" and sent me on my way with an (exorbitantly expensive) prescription for Elidel cream and that was it. No explanation, no further information or warnings of any kind. I'm not really sure what good the cream did; it seemed to help a little but the red spots were moving--filling out more of my face in almost a complete ring around my mouth. I was also using extra rich Eucerin but couldn't seem keep up with it--my face felt dry and itchy all the time.
I went back to the dermatologist twice more in the fall, and he told me to continue the Elidel. I obeyed until a little before Christmas. The only thing I knew about dermatitis was that it was similar to eczema, so I gave up on the Elidel and went out and bought some Hydrocortisone. I used it once or twice a day and moisturized every time I started to feel dried out or itchy (all the time). I went back to the dermatologist on MLK Day and he offered me a new medication. I was given a topical antibiotic to use twice a day for a month or so. About a week in, I wasn't noticing any change. I was still moisturizing all the time but had discontinued the Hydrocortisone.
That's when I started Googling.
Honestly, I can't believe I hadn't looked sooner. I am a compulsive researcher. I cross-compare reviews for restaurants before I visit. I will scour the entire internet to find a specific product. I recently took my co-workers to an escape room challenge, and I probably spent 6 hours comparing and looking for deals before I booked one. Anyway, nearly six months of frustration and somehow I didn't Google once.
One quick search of "dermatitis around nose and mouth" turned up this monster: Perioral Dermatitis. I took one look the pictures and knew it was what had been plaguing me. Guess what--not at all the same as eczema. Also--treatment for one is VERY BAD for the other.
Pretty much everything about my life was exacerbating the issue. I love hot showers (worst thing you can do for dermatitis). Every morning I slathered on moisturizer and then applied foundation (second worst thing you can do). I was running in the oppressive heat every day and wiping down my face during those runs with unforgiving fabrics (ouch). I love exfoliating (bad). I often went to bed still wearing makeup (very bad). I was training for a marathon in the height of New York City Summer ("avoid sunlight, heat, and situations that make your face flush"). After long runs we often went to brunch and hung out before showering (bad, bad, bad).
I read about a thousand articles about PD, and the real kicker is that there's no one proven "cause," which makes treatment a real puzzle. One known trigger is use of steroid cream, but that wasn't the case for me, at least when it first started. The internet told me it could have been anything from fungal infection, hormone imbalance, cosmetic ingredients, fluoride toothpaste, to diet. It was tempting, while reading everyone else's blog posts about what worked for them, to try everything. Apple cider vinegar, yogurt masks, diaper cream, and even stranger suggestions. I decided to pick one possible "cause" and address that for a while to see if it worked. I abide by the Gilmore Girls diet, so changing everything about what I eat was not my first choice. I was a little skeeved out by the fungus/yeast idea, so I chose to ignore that one. I wasn't entirely sure what do about a hormone imbalance, so I chose cosmetic/toothpaste ingredients, because they were mentioned by nearly everyone and seemed easier to control. Plus, there was really fun stuff to research.
I pinpointed the following 4 things that seemed most likely to be exacerbating my face:
Sodium Lauryl Sulfate (SLS) - #1 Most Evil
Parabens (any ingredient that ends in paraben) - #2 Most Evil
Cocamidopropyl Betaine
Methylisothiazolinone
I looked at all of my lotions, shower products, and cosmetics and discovered that virtually every one of them was chock full of this crap, including the Eucerin I had been slathering all over my face. Awesome.
Unfortunately, (or maybe fortunately?) I was stuck on Long Island in a blizzard and every pharmacy and store nearby was closed. So I went cold turkey. No lotion. No make-up. No shampoo, conditioner, nothing. I did use toothpaste, mostly out of consideration for others. For a day and a half, my skin totally dried out. It was pretty uncomfortable and gross. But amazingly, it also CALMED THE F DOWN. It was still red, but once I stopped poking the bear, it got less angry.
Then began the process of rebuilding my entire bullpen of basic skin and hair products. That's where this blog comes in - I have tried a LOT of things. Some have been great, others made my hair feel like straw. I'm happy to say that cutting out chemicals and finding the right products has kept my skin clear of Perioral Dermatitis for the past 15 months! I'm here to share what I've discovered and learn new tricks from those of you who are also experimenting with natural, sulfate-free, paraben-free products. What prompted you to make the switch?
Wake up, brush teeth, get in shower. Shampoo, exfoliate face, rinse. Conditioner, body wash, rinse. Moisturizer with sunscreen in it because I'm responsible. Quick make-up and off to work. After work, run, sweat profusely, swipe at dripping forehead and chin with meshy shoulder fabric. Sometimes straight home, sometimes pizza. Shower again, exfoliate again, dab face with toner, sometimes moisturizer again, chapstick, go to bed. On long run days, add a whole bunch of sunblock and 2-3 hours of exercising in intense heat into that mix. I've always been easily flushed, and after running in the summer my face stays pink for hours afterwards to the point where people at work ask me if I'm okay.
As it turns out, my summer marathon training, regular (responsible?) skincare routine, and the fact that I'm a fair-skinned woman between the ages of 20 and 40 made me the perfect candidate for a really fun skin condition called Perioral Dermatitis. But I didn't know that yet.
It began with what looked like acne on my chin in mid-August. I used more toner and waited it out. Then it began to dry out in the strangest way, like raised scales underneath both sides of my lower lip and at the sides of my nostrils. I moisturized the heck out of it and tried to cover it up with make-up, with varying success depending on the day. After a month of this, I sought out a dermatologist. He told me after one quick look at my face that I had a "bit of dermatitis" and sent me on my way with an (exorbitantly expensive) prescription for Elidel cream and that was it. No explanation, no further information or warnings of any kind. I'm not really sure what good the cream did; it seemed to help a little but the red spots were moving--filling out more of my face in almost a complete ring around my mouth. I was also using extra rich Eucerin but couldn't seem keep up with it--my face felt dry and itchy all the time.
I went back to the dermatologist twice more in the fall, and he told me to continue the Elidel. I obeyed until a little before Christmas. The only thing I knew about dermatitis was that it was similar to eczema, so I gave up on the Elidel and went out and bought some Hydrocortisone. I used it once or twice a day and moisturized every time I started to feel dried out or itchy (all the time). I went back to the dermatologist on MLK Day and he offered me a new medication. I was given a topical antibiotic to use twice a day for a month or so. About a week in, I wasn't noticing any change. I was still moisturizing all the time but had discontinued the Hydrocortisone.
That's when I started Googling.
Honestly, I can't believe I hadn't looked sooner. I am a compulsive researcher. I cross-compare reviews for restaurants before I visit. I will scour the entire internet to find a specific product. I recently took my co-workers to an escape room challenge, and I probably spent 6 hours comparing and looking for deals before I booked one. Anyway, nearly six months of frustration and somehow I didn't Google once.
One quick search of "dermatitis around nose and mouth" turned up this monster: Perioral Dermatitis. I took one look the pictures and knew it was what had been plaguing me. Guess what--not at all the same as eczema. Also--treatment for one is VERY BAD for the other.
Pretty much everything about my life was exacerbating the issue. I love hot showers (worst thing you can do for dermatitis). Every morning I slathered on moisturizer and then applied foundation (second worst thing you can do). I was running in the oppressive heat every day and wiping down my face during those runs with unforgiving fabrics (ouch). I love exfoliating (bad). I often went to bed still wearing makeup (very bad). I was training for a marathon in the height of New York City Summer ("avoid sunlight, heat, and situations that make your face flush"). After long runs we often went to brunch and hung out before showering (bad, bad, bad).
I read about a thousand articles about PD, and the real kicker is that there's no one proven "cause," which makes treatment a real puzzle. One known trigger is use of steroid cream, but that wasn't the case for me, at least when it first started. The internet told me it could have been anything from fungal infection, hormone imbalance, cosmetic ingredients, fluoride toothpaste, to diet. It was tempting, while reading everyone else's blog posts about what worked for them, to try everything. Apple cider vinegar, yogurt masks, diaper cream, and even stranger suggestions. I decided to pick one possible "cause" and address that for a while to see if it worked. I abide by the Gilmore Girls diet, so changing everything about what I eat was not my first choice. I was a little skeeved out by the fungus/yeast idea, so I chose to ignore that one. I wasn't entirely sure what do about a hormone imbalance, so I chose cosmetic/toothpaste ingredients, because they were mentioned by nearly everyone and seemed easier to control. Plus, there was really fun stuff to research.
I pinpointed the following 4 things that seemed most likely to be exacerbating my face:
Sodium Lauryl Sulfate (SLS) - #1 Most Evil
Parabens (any ingredient that ends in paraben) - #2 Most Evil
Cocamidopropyl Betaine
Methylisothiazolinone
I looked at all of my lotions, shower products, and cosmetics and discovered that virtually every one of them was chock full of this crap, including the Eucerin I had been slathering all over my face. Awesome.
Unfortunately, (or maybe fortunately?) I was stuck on Long Island in a blizzard and every pharmacy and store nearby was closed. So I went cold turkey. No lotion. No make-up. No shampoo, conditioner, nothing. I did use toothpaste, mostly out of consideration for others. For a day and a half, my skin totally dried out. It was pretty uncomfortable and gross. But amazingly, it also CALMED THE F DOWN. It was still red, but once I stopped poking the bear, it got less angry.
 |
| Day 1 of NO evil products |
Then began the process of rebuilding my entire bullpen of basic skin and hair products. That's where this blog comes in - I have tried a LOT of things. Some have been great, others made my hair feel like straw. I'm happy to say that cutting out chemicals and finding the right products has kept my skin clear of Perioral Dermatitis for the past 15 months! I'm here to share what I've discovered and learn new tricks from those of you who are also experimenting with natural, sulfate-free, paraben-free products. What prompted you to make the switch?
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