Can’t identify or treat this rash - getting worse - please help! 🙏
hellooo wonderful redditors!
I’ve got a mysterious facial rash since February — and it’s only getting worse.
I’m completely stumped.
It started small, just below my left nostril, then spread to below my left side of my mouth and chin, then migrated to the right side of my mouth and nostril area. The left side is always worse.
Background / possible triggers:
• Moved recently — the water in my new place is very hard (stays gray and salty-looking for 10–15 seconds after pouring. Got a shower head filter and tap filter for drinking water — didn’t help)
• Bathroom has no ventilation, gets very steamy
• High stress life situations
• Recently diagnosed with low thyroid and high cholesterol (may have been building for a while, but perhaps relevant?)
Things that seem to make it flare:
• Heat — even mild warmth from yoga (not hot yoga, just getting blood flowing)
• Warm showers
• Possibly sugar / dairy
What I’ve tried:
• Steroid cream — fixed it initially when it was tiny, then it came back much worse (rebound flare — learned this was a bad call!)
• opzelura + metronidazole (prescribed by dermatologist) — kept it somewhat at bay but didn’t clear it; stopped the opzelura after reading it can have a corticosteroid-like effect
• Clotrimazole 1% (antifungal, like for jock itch) — seemed to cool things down on the half of my face I tested it on, but didn’t fix it
• Fluconazole (oral antifungal, one pill/week for several weeks) — taken for a concurrent yeast infection; didn’t clear the rash, which makes me doubt it’s purely fungal
• Switched to non-fluoride toothpaste
• Eliminated all skincare products — just a gentle face wash at night and a light moisturizer
• Changed pillowcases, washing everything regularly
Diagnoses I’ve received:
• Perioral dermatitis (first dermatologist visit)
• Contact dermatitis (second visit)
• Possibly fungal (telehealth consult)
My dermatologist won’t do a swab/culture, saying it takes weeks and isn’t useful. I have a low-dose antibiotic prescription I haven’t filled because of the recurring yeast infections, and I’m not convinced it’s