r/Perioral_Dermatitis_

Used differin 3rd time on Sunday. Tuesday morning I had a feeling like a spot coming through. I don’t have herpes and confused to know if this is a cold sore or irritation/purging from differin

28(F). Been really struggling for the past year with a severe case of periorficial dermatitis - started as perioral and then progressed to my eyes.

I developed some minor perioral dermatitis in 2021 after wearing masks extensively during covid. It cleared itself up after about 2 months. But last summer, I got really sick with autoimmune issues (ulcerative colitis) and was facing extreme burn out. At that time, my perioral dermatitis came back with vengeance. It's gotten worse and worse over the months with no signs of let up and my mental health is severely declining due to self image issues.

Things ive tried with no success:

• zero therapy and makeup free

• SLS and fluoride free toothpastes

• switching all my household products to hypoallergenic & frequently changing towels and bedsheets

• vanicream cleanser and moisturizer

• avene ciclafate

• de la cruz sulfur masks

• metro cream - made it way worse

• rozivier cream (ivermectin) - made it way worse

• anti-fungal masks and treatments

• fungal acne safe products

• the ordinary azealic acid moisturizer

• purito gel and oat moisturizer

• antihistamines

• avene toleraine gentle cleanser

• zinc diaper rash cream

I am legitimately going to lose my mind. I am on immunosupressants for my UC - one that is used to also treat psoriasis - but have not seen progress here either.

What should I do next???

I have tried everything from chlorhexidine, ketoconazole, sulfur, azeliac acid, hypochlorous acid, oral fluconazole, fungal acne safe products and nothing will get rid of it! Started on my back and spread to my chest, neck and face - the spurs themselves have got bigger and increased in quantity over time. Everything I try will seem like it’s working for a few days then makes it worse - I’ve seen my GP three times now and a referral to the dermatologist will take over a year (I live in England).

Hi! 37/F/Minnesota USA/caucasion

Duration: off and on for a few months, this flare up is going on 4 days

Location: vermilion border of lower lip, also upper lip but not as pronounced

Timeline: Saturday it blew up and now today it was a bit less swollen

Symptoms: Tight, swollen lip skin, red/flaky/heat sensitive on the border. Burns when hot water is on it.

Treatments tried: I've tried doing nothing. I've tried using just plain Vaseline. I tried carmex, lanolips, lotramin, desanide and also tacrolimus. Tacrolimus seems to work after a few days but it tingles/burns. I've tried Metrogel in the past and it didn't help.

To note: **I am a dental hygienist and I firmly believe this is not a cold sore as it lacks vesicles and doesn't break/then dry out like those I've seen**

I have noticed that this pinkish/red flaky skin issue has now travelled to my eyelids but that doesn't get as bad as my lip. I get random red flaky patches on my cheeks sometimes.

Medical history: I have been taking a glp1 (tirzepatide) since 2024. I take a daily multi vitamin, an iron supplement, a probiotic, and propranolol. Occasionally Xanax when having a panic attack. I drink alcohol occasionally, mostly 2-6 white claws on the weekend. If I go on a deeper drinking adventure, it does seem to cause it to flare up worse but last weekend when this occurred, I was only drinking a little.

I have no food allergies that I'm aware of (I have been patch tested in the past and am allergic to rag weed and dust mites).

I have a dermatologist appt this week but I'm curious what you guys all think. I was wondering if it might actually be fungal? It's frustrating and ugly. 😭

I wanted to share my journey because this subreddit gave me hope when I was losing mine. I'm a Pharmacy Technician in Tanzania, where access to gentle, fragrance-free skincare is limited. If I can heal here, you can too.

The Flare-Up:

This started after using a steroid cream (Betamethasone) for about two weeks. At first my skin looked great, but when I stopped, it rebounded hard. Around the same time, I used an apricot facial scrub, which I'm sure made things worse. I don't know if it was the steroid, the scrub, or the combination, but my face erupted. Redness. Bumps. That rough, sandpapery texture.

I was terrified to put anything on my skin.

What I Did:

1. Water only for cleansing. No soap. No scrubs. My skin was too angry for anything else.
2. Metronidazole gel on active bumps. This helped calm the pustules significantly.
3. Doxycycline 100mg twice daily - oral antibiotic. This did the heavy lifting. Always taken with food.
4. Non-comedogenic face wash once my skin calmed down enough to tolerate it. I won't name a specific brand because availability varies. Just find one that's gentle and non-comedogenic.
5. Moisturizer - my skin healed but my cheeks became dry and chapped. I found one that worked (Neutrogena Refreshingly Clear) and patch tested for 72 hours. No reaction. Now it's part of my routine.

My Current Routine:

• Morning: Gentle face wash + moisturizer
• Evening: Gentle face wash + moisturizer
• Doxycycline 100mg BD (continuing for two months total)
• Metronidazole gel only as needed on active bumps
• Avoid the eye area with new products

What I Learned:

• Patch test everything. For 72 hours. Even if you're desperate.
• Moisturizer is not the enemy. A broken skin barrier makes PD worse.
• Steroid creams can cause rebound flares when stopped. Be careful.
• Harsh scrubs on compromised skin are a bad idea.
• Doxycycline takes time. Don't taper too early.
• You can heal even with limited products. You don't need a 10-step routine. You need patience, the right treatment, and a very simple routine.

Disclaimer: This is my personal experience, not medical advice. Always consult a healthcare professional.

Happy to answer questions. I know how isolating this feels. Hang in there, it does get better.

I’ve been using tretinoin 0.025% and about 2 weeks ago I started getting a really dry, irritated patch around my mouth.

At first it was mostly just extremely dry/red, but now I’m noticing a few small bumps and it’s a little itchy.

I’ve been using tret pretty consistently, so I’m wondering if I irritated my skin barrier or if this could be perioral dermatitis. I attached a picture.

I’m planning to stop tret around my mouth for now, but I’m wondering:

Does this look more like tret irritation or dermatitis?

Can this go away on its own if I stop tret and simplify my routine?

How long did it take yours to clear?

I’m moving out of state for college next week, so I’m trying to figure out if I should see my derm before I leave or if I can manage it at home. Any advice/experiences would be appreciated! My skincare is renewing SA cleanser by CeraVe then tret at night an intensive moisturizing cream and aquaphor all over it and my lips. And the morning I use the same but BHA liquid blackhead liquid by corsx instead of tret.

Hi all, I have never had PD before but after some research I'm pretty positive this is what my skin is currently dealing with. I've been using Differin adapalene .1% for the past 5 months and recently introduced Paula's Choice AZA, and I believe it was too much for my skin barrier. I've now totally stopped the actives, and just picked up these items this morning:

• Avene cicalfate restorative cream
• Good Molecules hypochlorous acid spray
• De La Cruz sulfur ointment mask
• + a flouride-free, mint-free, SLS-free toothpaste

I do already use Sofie Pavitt clean cleanser, so I'm going to stick with that.

Any thoughts on this protocol? Any other suggestions? Thank you in advance!

This is the second or third PD flare up I’ve had, I didn’t start getting this until my 20s, I’m now 25. I’ve put two and two together, that my flare ups occur when I am the most stressed in my life, which makes sense. In the past, I’ve been prescribed metronidazole cream, but that never did help. My current issue is that I do not have health insurance anymore, and cannot afford to see a doctor for antibiotics. In the past, it’s usually gone away after two weeks or so. The redness is what’s getting to me the most.

I’ve been following this page and have bought almost all the products most people recommend, but this flare up has lasted almost a month, which is the longest my PD has ever stuck around. I have tried for a few days to apply absolutely nothing, just washing with water, but it becomes too dry and itchy I can’t stand it. I’ve stopped wearing makeup and stopped my normal skin care routine, but it’s starting to spread still.

I’ve had the same skin care routine for about 2 years, the same toothpaste for 8 years, and same shampoo forever. So I know it’s not those that cause it. I think it’s stress, along with terrible humidity while wearing makeup. Either way, I guess I’m just asking if there could be aaaanything else I can do that doesn’t require a doctors visit? I am going to get Avene Cicalfate today.
I included a picture of the products I’ve tried (I stopped the hydrocortisone cream because I hear it makes it worse).
Apologies for the long post, I’m just desperate for some guidance.

I've tried Metrocream, Advantan, Tacrolimus, nothing works. I feel disgusting. What else is there to do??

11 year old has this for past 5 weeks. He wears oversized glasses and that rim of glasses sits right about there. And that spot does look oily.

After 2 weeks I made sure he was washing his face 2x daily. Did benzoyl peroxide at night and have also used hypochlorous patches for less than a week. Kind of waxes and wanes.

Pediatrician thinks maybe acne. Wrote a script for clindamycin wipes.

I’m reading if it’s acne you have to use clindamycin and benzoyl peroxide. If it’s POD have to use just clindamycin.

Not sure what to do. I told him to take a break from wearing glasses while at home to let that area breathe and he refuses to do that.

Should I start both? Or just clindamycin and see if there is improvement for a few days and then add benzoyl peroxide.

Pics are not the best and he won’t sit still. Generally they look like bumps that don’t sit on a red patch.