Sunday, 20 October 2013

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:

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 ever 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):  

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.


  1. Hi. I would love to know your opinion on what to do during pregnancy...I know some of the things Tracy recommends can't be used during pregnancy. I had almost the same story with my son during my pregnancy with him. Bad skin...okay skin...then I gave birth and it was terrible...I nursed for 23 months and it was bad. All around my chin, mouth and jaw line. Mostly on my right side. So weird. My diet wasn't great during my pregnancy but for the last year and a half I have cleaned it up so much. Cut out foods, natural skin care, lots of different supplements. It is discouraging because my skin never got 100% better. I am almost 18 weeks pregnant. First trimester...I ate some processed foods and things I hadn't been eating because I couldn't handle certain foods. But for the past couple of weeks I have gone back to my old healthy diet. I think it is helping some, but I totally think it is so hormonally linked and I am super annoyed that I can't figure out what to do. I would love to know if you have any updates on things to specifically do while pregnant. Thanks so much!

  2. Hi Jeanne, first - congrats on your pregnancy! I feel your pain about the skin problems. Why oh why does this have to happen to us? So unfair. It is definitely something about the hormone surges during pregnancy that cause so much grief for some.

    Berberine is out for you for the next couple of years, so what would I suggest in the meantime? Well, I'm actually trying for baby no 2 now so I'm feeling a bit like 'the big skin test' is going to be coming up for me soon. First, I'd suggest cutting out ALL sugar except for fruit. No honey, no brown sugar, no agave, zip. It'll be tough for a week or so, but you can do it. Just have a lot of apples until you get over the hump. ;) Even try and avoid the gestational diabetes test unless you have risk factors (I had a midwife so they are all about informed consent. The test isn't necessary unless you have risk factors such as age or weight, etc.)

    Does dairy seem to cause you troubles? No more milk then, stay away from soy for sure. Take plenty of probiotics to help your gut bacteria. Have you tried making bone broth and drinking that? It could help. Basically I would try and do a modified candida diet with limited gluten and grains and zero sugar. It sounds like you are already trying to stick to a healthy diet so maybe some small modifications would help.

    A super healthy food to eat while pregnant and one that I found made my skin glow while I was breastfeeding are beets. Beet juice preferably. It's a nightmare to juice yourself, but natural health food stores carry it bottled. A cup a day at least should be good. And it is the best thing for your growing baby! :)

    One thing that my naturopath and massage therapist have both felt contributed to my skin problems was a sluggish lymph system. That's why my acne and bumps were so concentrated along my neck and around my mouth - a place where the lymph system runs really close to the surface, just dumping toxins because it was so taxed during pregnancy from the extra blood volume. Something possibly worth trying is dry brushing or going to a massage therapist for some lymph massages. Another thing that could tax your system is fluoride in your drinking water. If your municipal water is fluoridated, purchase Culligan water or another filtered water and solely drink that. I did that for about a year.

    After baby arrives and a few months postpartum, you could try a true candida cleanse. I did my first one when my son was 10 months old. The concern isn't toxins going into your milk, but that you're getting enough calories while doing the cleanse (according to my midwife). Thorne Research Formula SF722 is an anti-fungal that is safe while breastfeeding. You may want to check with a naturopath if you have one, or call the company up and see if you can take it while pregnant. As soon as I started those pills my inflammation cleared up significantly in a few days. It was incredible.

    I hope this advice helps! Keep me posted on how it's going.


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  4. Wow! I actually am having this same issues two years after a birth control set it off!!! I definitely feel your pain!! It flares up and NOTHING I have ever tried has worked to clear it up... Funny how the same little bumps you mentioned started on me before it flared! I wish I had some advice for you! I’m hopefully going to a doctor soon (I’ve put it off for two years because the doctor who prescribe the birth control told me it was my age I was 20 at the time I don’t believe her it is never worse at anytime during the month than the other and everything and anything sets it off especially the sun! If I have any new info from my new doctor I will be sure to let you know! Good luck!

  5. Thanks, Kat! I was actually able to clear it completely and keep the dermatis away even during a second pregnancy and post partum period. Check out my posts on berberine and what clearing perioral dermatitis: