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Which Kiehl’s face oil is your favourite? Not good. You’ve been using that smooth Elemis washing balm for years. Even worse. Your friend’s “miracle” hydrocortisone cream? disastrous. Not to mention stress, which all come together to cause my seasonal enemy, perioral dermatitis, a skin condition that acts like a wasp in a wine glass.
To be clear, perioral dermatitis is not the same as acne. Although it may appear and behave like acne, it is not. Larger, deeper acne spots typically appear along the forehead, cheeks, and jawline—the traditional oily T-zone. Additionally, acne can leave scars. Fortunately, perioral dermatitis does not.
And it’s not eczema. or rosacea. Thousands of people, particularly women between the ages of 20 and 45, are afflicted by this unholy mix of all three. It frequently starts as an enigmatic tiny cluster of bumps that arise out of nowhere, settle in, and gradually begin to spread across the aforementioned locations. If left untreated (or treated incorrectly), it begins to burn, itch, and tighten (yes, sexy). The abundance of high-end lotions and potions you have been using to treat your skin exacerbates the condition.
Additionally, because it mimics the appearance of acne, many general practitioners misdiagnose it as a general outbreak and recommend topical steroid creams or abrasive cleansers, which only make the condition worse. After a round of hydrocortisone steroid cream, my face looked like a burnt pizza; a fast dab relieved the redness for a day before it returned with the zeal of a toddler denied toys.
The emotional aspect comes next. Perioral dermatitis feels like someone is rubbing sandpaper all over your face. Mentally, it’s a gradual decline into two in the morning as you browse Mumsnet forums in an attempt to find answers before persuading yourself that you will never look normal again. In an attempt to cover my nose and chin while strolling down the street, I cancelled social events, completely avoided taking pictures, and transformed my winter scarf into an improvised balaclava. I sobbed too. A lot.
Two weeks after the disease first appeared, my skin… I had not noticed any advancement.
I threw money at the issue and made an urgent appointment at the suggested Harley Street Dermatology Clinic around week two (pictured) after finishing the drugs my doctor had given and seeing no improvement at all. I had asked the NHS for a dermatology referral, but the waiting list was more than six months long. Unless everyone agreed to turn down the lights till spring, I couldn’t wait that long.
After speaking with the dermatologist for five minutes, I was correctly diagnosed with perioral dermatitis. I was informed that I had to immediately give up my beloved, heavenly-smelling cosmetics and start a skin diet. Heavy moisturisers are over. Not a single essential oil. Avoid using exfoliants. Makeup should not be applied to the afflicted area.
This is due to the fact that rich emollients lead to more inflammatory lesions. Oh no. I’m done using Elemis Miracle Balm. Additionally, I was told that peroral dermatitis is not a one-time rash but rather an underlying illness. With the most delicate skin care practices, it can be controlled and prevented for the rest of one’s life.
I was given a large bottle of Dermol 500 as a cleanser, which is a leave-on moisturiser and unfragranced soap alternative, and a 12-week daily course of oral Tetralysal (300 mg), which cures everything from bacterial infections to severe acne. I went to the chemist with the private prescription, and it came to just under £100. Oh no. However, I now had a name for the angry mess that had been residing on my face, along with the right products to deal with it.
Tetralysal pills are used to treat everything from severe acne to bacterial infections.
My skin after I’ve discovered the right products to address my issue
It’s important to note that some people get better very quickly. Others (hello) have multiple existential crises within the course of six to twelve weeks. But persevere. Improvement does occur, but sometimes more slowly than watching paint dry.
Additionally, not everyone will benefit from what was suggested for me. Dermatologists may suggest metronidazole, azelaic acid, or clindamycin for people experiencing a particularly intense flare-up. These medications don’t sound particularly glamorous, but they all work and are much better than sobbing in front of the mirror and believing that coconut oil is the solution.
Although having perioral dermatitis isn’t enjoyable or appealing, learning how to handle it has given me a peculiar kind of acceptance. Knowing what your skin needs and what it definitely does not is comforting. Flare-ups may still occur occasionally, but they no longer knock me off balance or keep me glued to Mumsnet. My face has finally returned to something approaching normalcy with the correct regimen, the appropriate guidance, and a little perseverance. I’ll accept it.
Put an end to the steroids
The largest trigger of all. Get rid of all steroid creams including hydrocortisone unless absolutely necessary. They only provide temporary relief from the illness. then make a quick comeback.
Make everything simpler.
Reduce your routine to its most basic elements: mineral SPF, light moisturiser, and mild cleansing. Completed. Overly intricate skin care regimens are a breeding ground for perioral dermatitis.
Steer clear of bulky items
I apologise, but I don’t use thick creams, balms, facial oils, petroleum jelly, or anything that is considered “rich.” Allow your skin to breathe.
Avoid using fragrances.
In skincare, perfume equals irritation. Use dull yet calming recipes.
Examine your toothpaste.
If you think it might be a trigger, switch to a fluoride-free option—this is surprisingly frequent.
Put the exfoliation on hold.
No retinoids, no acids, and no scrubs. For now, stay away from anything that promises “radiance,” tingles, or stings.
Keep your hands off
No “just checking it in the mirror” or picking. It only spreads when you touch it. Believe me.
Keep the area clear of makeup.
At least while a flare-up is at its peak. Makeup exacerbates the situation by trapping heat and microorganisms. Additionally, if you apply makeup again, replace your sponge on a regular basis.
Take prescription assistance into consideration.
Stubborn instances can be quickly resolved with topical metronidazole, azelaic acid, pimecrolimus, or a brief course of oral antibiotics.
Consider it an underlying illness.
You have to take long-term care of perioral dermatitis. Once it begins to clean up, avoid using fragrant creams again. Your best defence is trigger-spotting and gentle routines.
