Perioral Dermatitis – My Latest Skin Nemisis


I was a little terrified of what my skin would be like if I ever got pregnant. I knew I’d definitely have to give up my chronic antibiotic use as that was a no-no. I did find some solace in the fact that most women have glowing, beautiful skin during pregnancy. That would be me, right?

It was . .. sort of. The first trimester started with cystic acne, but then got fairly clear. I definitely had that ‘glow’ in the second trimester and quite beautiful, clear skin at times. In fact, I snapped a picture one day because I couldn’t believe it:

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With the start of my third trimester, my skin started developing tiny bumps on my chin and seemed to be reacting to my moisturizers and most things I would put on my face. I stopped wearing foundation on the bottom half of my face. The bumps began migrating down my neck. And the closer my due date approached the worst it seemed to be getting. I’d had it with being pregnant. Not because I was really that uncomfortable, but because my skin felt out of control. I couldn’t wait for the baby to be born and my skin to calm down a bit. It would get better like everyone told me, right?

They couldn’t be more wrong. Within a couple weeks of my son’s birth, the skin on my chin and around my mouth broke out in the most painful, inflamed bumps I’d every experienced. It could be described as an acne rash. I was so distraught and upset. I couldn’t bear to be seen in public, have my picture taken with my new baby, or look in a mirror. I booked an appointment with my doctor.

He prescribed hydrocortisone cream and finacea cream (used often for rosacea) and booked a follow-up for two weeks later. The creams really dried out my face but sort of seemed to be working. Two weeks later at my appointment he looked at my face again, took out his iPad and looked up something called perioral dermatitis. He told me to stop using the cortisone cream and prescribed tetracycline and continued use of the finacea cream.

When I got home I looked up perioral dermatitis and was quite horrified to discover that while it can be caused by hormone surges (like during pregnancy and when breastfeeding), it is most often caused by use of topical steriods, which are often prescribed for skin conditions but can MAKE IT SO MUCH WORSE! What? Thank god I didn’t use that cream for very long and my doctor figured it out. Perioral dermatitis can also be aggravated by the use of sodium laurel sulfates (nasty surfactants that are basically in everything that foams and produces bubbles). I tossed the Oil of Olay face wash I had been fanatically scrubbing my face with day and night and switched to Burt’s Bees royal jelly cleanser. I stopped using synthetic moisturizer and switched to coconut oil only. I switched out my shampoo for one without SLS in it. My skin began clearing up and was looking much better within a month or so. I think it was a combination of the antibiotics, skin care routine and hormones leveling out.

However, about a month ago (at around 8.5 months post partum) my skin has started getting nasty again. I’d attribute it to a breastfeeding hormone surge that also made me drop five pounds of my baby weight and helped me fit into my pre-pregnancy clothes again (there are pros and cons to everything, I suppose). Here is what it looks like now (I can’t believe I’m posting this. Yikes):  

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Yes, it’s really bad. It’s depressing, painful and makes me want to cry. It’s enough to make someone run screaming to their dermatologist for a prescription to Accutane. Which is pretty much the place I’ve come to: More drugs? Or, is it time to go in a totally new direction?

Update: Wondering what works to cure perioral dermatitis? Check out my blog post about what seems to help and how I now have glowing, gorgeous skin.

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