Perioral Dermatitis: An Update, Plus Tips & Tricks!

Since I wrote my original post about perioral dermatitis treatment, I've received hundreds of comments, emails and messages from all over the world about how the solution I found--Clotrimazole 1% topical cream--has helped other people, too. A lot of other people.

(I've always dreamed of using my writing to help people. I never thought this would be the way it ended up happening, but hey...I'll take it!)

I decided to write this follow-up post to Perioral Dermatitis Treatment: My Story and provide everyone with an update on my condition, plus some tips and tricks for clear, healthy skin I've picked up along the way.

Did it come back? 

I do have occasional flare-ups of perioral dermatitis. Any number of factors can trigger them: stress, hormones, diet, lack of sleep. I've learned that the better care I take of myself, the less likely I am to have a flare. But hey, life can get crazy, and that's not always possible!

When I get a flare, it's about 5% as bad as the original case of perioral dermatits was for me--mostly just some redness and a few bumps under one side of my nose. The same treatment I discovered originally, my (absolutely lifesaving) Clotrimazole 1% still clears it right up within two to three days. I also sometimes use a small amount both morning and evening as a preventative.

But in addition to that, because I hate perioral dermatitis (even at 5%!) so, so much, I continue to actively seek solutions to help keep my skin in check and reduce the flare-ups as much as I can. Here's what's been working:

Moisturize & Cleanse

In my quest to find natural treatment options for both my perioral dermatitis and my combination skin in general, I no longer use conventional moisturizers. It was definitely a leap of faith to use straight oil on my face after a lifetime of being told never to do that, but I'm so glad I finally gave it a try. My skin has never looked better, and I'm pretty sure I'm never going back! In the mornings, I use organic, cold-pressed jojoba oil mixed with aloe vera gel in after I wash my face. In the evening, I use a blend of equal parts jojoba, hemp seed and rose hip oil (mixed myself from the products listed below.)

Teddie Organics Rosehip Oil
Leven Rose Organic Jojoba Oil
Renewalize 100% Hemp Seed Oil
Earth's Daughter Aloe Vera Gel

In addition, I've started washing my face with a sulfur soap and using sulfur ointment as needed. Before the invention of corticosteroids, sulfur was the go-to treatment for perioral dermatitis. It dropped out of fashion in the '70s, but some doctors are returning to this treatment plan. It didn't work by itself when I originally used it for my PO, but for daily maintenance, I find that it keeps my skin clear and bright, and makes a noticeable difference in the lingering redness around my nose that my PO seems to have left behind. My pores appear noticeably smaller when I'm using the sulfur soap regularly. I use the sulfur ointment as a spot treatment for flare-ups (use as directed and remember, a little goes a long way!)

Branfells Labs Sulfur Soap
Branfells Labs Sulfur Ointment

Vitamins & Supplements

After a terrible, seemingly endless round of chronic ideopathic urticaria last year (I know, I know, I'm a medical disaster sometimes...but that's a whole different post) I started experimenting with supplements for my skin and overall health. I currently take a multivitamin, evening primrose oil capsules, a probiotic, and vitamin D and omega-3 supplements. I've seen measurable improvements in skin since I've started taking these: fewer breakouts and smoother overall skin tone. My favorites:

Nordic Naturals Ultimate Omega
Barlean's Organic Evening Primrose Oil
Naturewise Vitamin D3
Align Probiotic

Diet & Exercise

When I eat better, my skin looks better. I still love Oreos and ramen noodles and pizza (and and and) but after successfully completely my first Whole 30 earlier this year, I'm committed to healthier eating 80% of the time and I can feel a difference in my whole body inside and out, skin included. I highly recommend giving it a try at some point! I'm also a (fifteen years strong!) devotee to hot yoga, which has dramatically changed my physical, mental and emotional health :)

For more information on Whole 30 living, check out:

The Whole 30: 30-Day Guide to Total Health and Food Freedom

Makeup

Since I've yet to find a 100% guarantee that this nasty condition will ever go away for good, finding makeup that gives me my confidence back has been a lifesaver. This product has been an absolute lifesaver!

It Cosmetics Bye Bye Redness Neutralizing Correcting Cream
(applied with the It Cosmetics Pointed Precision Brush, which is also awesome)

(AND, as a PSA, because I'm finishing a novel and getting up at 4:00AM every day to do it so really know my concealers at this point, the It Cosmetics Bye Bye Undereye Concealer is also pretty much a miracle product)

So that's my update! Thank you to everyone who has written to say my original post helped them. It means so much to me, and I hope people struggling with the frustrating reality of perioral dermatitis continue to find helpful answers here and elsewhere on the internet. Cheers!

Disclaimer: The links that appear here are affiliate links, which means I receive a small percentage if you place an order through Amazon for the products I mention (at no cost to you.) Thanks for your understanding and support!

Calling Myself a Writer: Write Doe Bay 2015

The first time I attended Write Doe Bay, I was tagging along with my friend Claire, who was a teaching artist for the weekend. She convinced me it was something I needed after months of listening to me complain of a creative stagnancy that was making it hard for me to focus on my current project. So I went with her--on a plane, in a car, on a ferry boat and then another car and then a hike through the woods to this place that would end up changing me forever.

I'd been writing since I was old enough to hold a pencil. Making up stories in my head for as long as I could remember. I'd published essays, gone to graduate school, won writing awards. My memoir had been published just ten months earlier. I didn't call myself a writer. 

It's hard to explain the magic of Doe Bay. And yes, I do mean magic. It's near enough to visit for the weekend, but so far from the "real" world that I had to strip layers and layers away just to get there. Nestled on tiny Orcas Island off the coast of Seattle, it is quiet, and serene, and stunningly beautiful, but also charged with an subtle, palpable energy that vibrates through you--an energy that is both a calming and an awakening in every breath.

I taught writing, published writing, breathed writing...but I didn't call myself a writer.

And Write? Write is a room full of magic and creativity and community and art. It's hot coffee and scribbled-in journals and learning new things. It's cracking your craft wide open and seeing everything upside down in a way that makes perfect sense. It's a whole lot of people who get it, who get you, and aren't afraid to hear you out and lift you up until you're different than you were when you walked in the door.

A little braver. A little more honest. A little more determined to go back to your regular life and kick some serious creative ass.

Today, I call myself a writer. 

Write Doe Bay helped me realize that being a writer isn't something you can define. It doesn't come all wrapped up in red ribbon when you publish a poem or or finish your first novel or hit the bestseller list. It's this tiny, unquenchable flame that comes from within you, and either you're born with it, or you seek it out, or you stumble on it by accident somewhere along the way. It's knowing yourself and respecting your craft enough to say the word "writer" out loud--without fear, without shame, without expectation of any outcome other than to do, and be, and believe. And more than anything else, it's a flame that needs oxygen and faith, hard work and community, and a willingness to chase impossible dreams in order to keep on burning.

Last February, I was honored to return to Write Doe Bay as a teaching artist, where I shared knowledge and space with another incredible group of writers, artists and creatives. In the midst of the support and revolution of that particular Write weekend, I made the life-altering decision to quit my marketing job and, for the first time in my life, focus exclusively on my career as an author.

This October 8-11, as I complete the manuscript for my first novel and continue to chase down new writing dreams, I'm returning to Write Doe Bay once again as a teaching artist, along with talented writers, musicians and creators Nikki McClure, Kris Orlowski and Jonathan Zwickel. I'm honored to share their space and hear their stories, and I'm excited to settle, once again, into the fabric of the magical Write community that unlocks new stories every day. If you've heard me talk about Write Doe Bay before and are thinking about attending, I hope you'll take the plunge and meet me on Orcas Island this fall for an unforgettable experience.


The details:

WRITE DOE BAY is an intimate 2.5 day writer's retreat and multi-workshop event held on beautiful Orcas Island, WA at Doe Bay Resort. We host award-winning authors/ writers of genres ranging from memoir, fiction, screenplay, songwriting, poetry, and more. We welcome participants at any stage of their creative path including those who are ready to take their first steps. 

WHEN: OCTOBER 8-11, 2015

FEES: $800 for workshop tuition, resort accommodations, and meals.

FORMAT: Workshops are held Friday and Saturday morning and afternoon. Evenings include a writer's open mic (for participants, teaching artists, and staff to share pieces of their work) and singer songwriter showcase set by Kris Orlowski. Sunday morning includes a closing ceremony and time for personal writing and exploration of the resort. 

For more information, teaching artist profiles and to register, visit http://www.writedoebay.com/

If you have questions about the retreat, please email writedoebay@gmail.com (or send them my way!) Looking forward to sharing some magic together...

Perioral Dermatitis Treatment: My Story

Hiding behind a coffee cup...my favorite place to be with perioral dermatitis.

UPDATED 10/1/16: For my most recent update, including new products, tips & tricks, check out my new Perioral Dermatitis Post here!

UPDATED 1/14/16:

First of all, thank you for all the emails and comments on this post. I never dreamed my story would be able to help as many people as it has, but I'm so glad it did.

Clotrimazole 1% , the over-the-counter antifungal cream that cured my POD, has continued to work its magic for the past eight months. If my perioral dermatitis flares up, I use a small amount of the cream and it goes away. Clotrimazole is NOT a corticosteroid (ie hydrocortisone)--those medications can make POD much, much worse. It's an antifungal and sold in most pharmacies as a treatment for athlete's foot. 

I recently saw an incredible allergist for an unrelated problem (OMG what a year) who confirmed (as the two dermatologists I saw previously did NOT) that my perioral dermatitis WAS a fungal infection, caused by yeast, which is related to allergies. In fact, he's written the premier study in the field on this exact topic, and he confirmed that the use of Lotrimin or the equivalent generic is an appropriate treatment. For once, my obsessive 3:00am medical Googling turned out to be right!

PLEASE NOTE that I'm not a medical doctor, and that any time you undergo any treatment, even non-prescription, as Lotrimin and its generics are, you should consult your regular doctor about it. Even my above statement regarding my allergist's recommendations don't count as actual medical advice. 

My original post:

What is perioral dermatitis? Slightly itchy, slightly bumpy, reddish and really really annoying inflammation of the skin around the mouth. It affects mostly women between the ages of 20-50 and might have a hormonal element. Ugh.

I was diagnosed with this condition about a year ago, after a stubborn, bumpy red rash under my nose and on my chin just wouldn't go away and I finally dragged myself to a dermatologist (NOT the way I'd prefer to spend my rare kid-free, work-free hours.) Though the doctor laughed when I suggested it, I'm fairly certain the perioral dermatitis was brought on by over-zealous use of my Clarisonic Mia--I've always been a huge fan of exfoliating and just couldn't help myself with all those scrubby rotating bristles...but then this rash broke out and it looked TERRIBLE and no matter what I did, it wouldn't go away. The Clarisonic just made it worse, and I finally had to stop exfoliating all together.

The dermatologist sent me home with a month's worth of oral antibiotics and a prescription for sulfur face wash. I really, really hate taking antibiotics unless it's absolutely necessary--but I also hated having a gross embarrassing rash on my face. So I took the antibiotics, I used the face wash...and nothing happened. The rash cleared up a tiny bit (maybe?) with the antibiotics, and then the minute I stopped taking them? It came right back.

I tried just the face wash. I tried drinking more water. I tried a different face lotion (typically I only moisturize with coconut oil). Nothing helped.

A few months later and fed up again, I went back to the dermatologist. This time I was given Finacea cream, Metronidazole gel, and more sulfur face wash. All of which was expensive and, for me at least, totally ineffective. I used all three as directed for several weeks and saw absolutely NO change in my POD. The label on the Finacea says it can take up to eight weeks to see results...really?! Because this rash was ON MY FACE. Where OTHER PEOPLE COULD SEE IT. Eight (more) weeks just wasn't an option.

So I went where I probably should have gone in the first place: the internet. I scoured every blog post and article and comment I could find on perioral dermatitis treatment, specifically looking for natural remedies for perioral dermatitis, since I've been trying to rid our home of as many chemicals as possible and really hoped for a cure that would not only get rid of the rash, but be as natural as possible.

Below is a breakdown of what I tried, what worked and what didn't, and what finally ended up being the cure--for me. I write this blog post with the hope that someone, somewhere, finds it helpful in beating a stubborn, truly awful condition.

After all my research, a ton of trial and error, and hundreds of treatment dollars spent, the truth about perioral dermatitis seems to be this: no one really knows what causes it. No one really knows how to treat it. But most importantly, the cause--and the cure--seem to be different for every person. So the best advice I can give anyone suffering from POD and looking for a solution is to try everything you can, keep an open mind about possible causes and treatments, and know you're not alone in the struggle.

What Didn't Work:

• Oral antibiotics
• Finacea
• Metronidazole
• Tea tree oil
• Sulfur face wash
• Aloe vera 
• Oral zinc tablets
• Evening primrose oil capsules
• Calendula salve

What Helped (a lot!) but didn't actually fix the problem:

• Switching to a fluoride-free toothpaste
  
• No more sodium lauryl sulfates (SLS) in beauty or household products**
• Switching to SLS-free makeup (and tossing out all the old stuff!)
• Taking a daily probiotic
• Using BB creamwith zinc oxide as the active ingredient
• Washing my face only once a day with cleanser (I fell in love with this one) and using ONLY water in the morning/after working out
• Aloe vera gel
  (used once daily as a toner, pre-coconut oil)
• Coconut oil as moisturizer*

*I should note here that my perioral dermatitis has always been classified as MILD--so mild, in fact, that J continues to deny ever noticing I even had it (this, of course, is because he loves me and thinks I'm beautiful no matter what kind of creepy skin condition I have, but still...) Anyway. I DID have it, but it wasn't nearly as bad as it could have been. If you Google image POD you'll find some seriously scary stuff, and I'm blessed to have never had this condition to the full extent possible. I am 100% convinced that using coconut oil as a daily moisturizer kept the worst of my perioral dermatitis at bay. 

While it wasn't strong enough to get rid of the POD totally, coconut oil is a natural antibacterial, anti-inflammatory and antioxidant and has worked absolute wonders on my skin. And my hair. And on bug bites, sunburn, and eczema. And my cholesterol, which my doctor called "fantastic" at my last checkup. It's also amazing on toast. And in my coffee. OK, so I'm a bit of a fanatic. If you want more information on the (seriously amazing) health benefits of coconut oil before I get around to writing a love letter blog post about it, check out the book The Coconut Oil Miracle.

** for almost three years, I've been practicing something called the Curly Girl Method for Wavy hair (you can read my blog post about it here) and gave up hair products containing SLS ages ago...and I've never used those products on my kids. But I was much less diligent when it came to body wash, dishwashing liquids, hand soaps, etc...I had no idea that all those sulfates could be harming my skin just as much as they were harming my hair!

What I Never Got Around to Trying (but the internet says might work):

• Apple cider vinegar (topically. I take a few tablespoons a day mixed with hot water and lemon for general health reasons, which I highly recommend. Using ACV as a toner is a popular suggestions for natural treatment of perioral dermatitis, but I never got around to trying it.)
• Diaper rash cream containing zinc oxide
• Violet extract
• Calendula cream (different than calendula salve, above)

And finally...

What WORKED!!! (for me):

Clotrimazole cream, 1%

Yep. You read that right. After almost twelve consecutive months of frustration, trial and error, and hating the way my face looked in the mirror, the only treatment for perioral dermatitis that actually WORKED was Clotrimazole, a $4.99 tube of anti-fungal cream, most commonly used to treat athlete's foot. I found this humble suggestion buried DEEP in the comment section of another blogger's frustrated post about her battle with POD. The comment was short and to the point. It said that perioral dermatitis was nothing more than a common yeast infection, and the cure was equally as common: buy a tube of Lotrimin (or generic, which Clotrimazole is) anti-fungal cream at the drugstore and call it a day.

I ran to the drugstore basically right that minute and applied the cream that night before bed. Within hours (because yes I got up in the middle of the night and checked), the bumps had gone away and my skin was noticeably smoother. By morning, my perioral dermatitis had improved by 80%. 24 hours later? It was almost completely gone.

It's now been a full week, and other than some residual redness around my nose, my perioral dermatitis is a distant memory and I can leave the house without makeup on for the first time in a full year without feeling like everyone is staring at my weird face rash thing. I'll continue to use the clotrimazole cream for two full weeks to make sure the infection is gone, as the directions on the package suggest. Finding a cure for my POD is liberating, exciting, and such an incredible relief. Thank you, THANK YOU, anonymous internet commenter...you've saved my skin.

Will clotrimazole cream work for everyone with POD? I truly don't know, and my guess is that because so many different factors contribute to and exacerbate POD (hormonal, environmental, nutrition, etc) that it probably won't work for some people. I've read blog posts that tout miracle cures for perioral dermatitis that simply didn't work for me. But if you're suffering from POD and haven't found your cure yet, this is definitely something worth trying!

After finally finding a cure for my perioral dermatitis, I'm surprised and thrilled to say my skin looks better than it has in my entire adult life, thanks to some awesome new products I've discovered along the way. Here's a list of products I've kept as part of my daily routine that are truly outstanding...I love them all!

• Dr. Jart+ Premium Beauty Balm SPF 45
• Tarte BB Tinted Treatment 12-Hour Primer Broad Spectrum SPF 30 Sunscreen
• RMS Beauty Tinted "Un" Powder
• Tarte Cheek Stain True Love
• Era Organics Natural Face Wash
• Aloe Vera Gel By Earth's Daughter
• Marrakesh Original Shampoo + Conditioner 
• Jason Sea Fresh Toothpaste, Deep Sea Spearmint

I suppose I should have an "after" picture to post here...and at the moment, I don't (and no "before" pictures, either...because who wants THAT documented for posterity??) But if I get around to taking one, I'll update the post. For now, you'll just have to take my word for it...

Do you suffer from POD? Did you find a perioral dermatitis treatment that worked for you? Please share in the comments below...I'd love to hear your story!