Hey everyone,
So I am going to go on a rant here. I've been analyzing others posts for a couple of years and have decided to make one which describes my personal battle with acne/perioral dermatitis.
I have been dealing with this problem for a long time and I am determined to find a cure or treat myself since I cannot let this take over my life and let it affect my confidence. I know I will be able to cure myself soon and help others. I will save the emotional trauma I went through due to this condition for another post.
Quick background. I am 22 years old, studying engineering in North America and have had acne problems since I hit puberty.
So here goes.. When I turned 12, I started to get pus filled acne around my mouth region. They were not a lot, and were not inflamed, just 4 or 5 here and there.Still, I let it get to me and did some research online. I should also mention that I had dandruff as well and a very oily skin.
Found a lot of people suggesting benzoyl peroxide so I made my dad get it for me (He's a doctor). Now, I used BP in the most eff'd up way ever. I used to put it at night and take a hot shower (BIG MISTAKE) in the morning. My skin started to clear up but it started to get sooo messed up and I did not even realize it since I was a kid. I was basically burning my skin every single day with that hot shower and not realizing it. I became so sensitive to sun light, I would go red if I stayed outside for more that 2 minutes. My acne problems continued but I learnt to ignore them and now that I look back, I have no idea how I did that.
In grade 12, I started to get more concerned about my looks and my dad finally put me on Doxycyline. Cleared me up in no time and I was acne free for a couple of years.
I shifted to North America for further studies, and this is when all hell broke loose. I got acne around my mouth region, red and pus filled. Just around my mouth, under the nose, beside my lips and on my chin. No where else. So now that I was more mature and had more resources, I decided to tackle this problem logically. So i started to look for a pattern and realized I had cystic acne ONLY around my mouth. Next I realized my skin was always slightly red and inflamed even where I had no acne. I googled 'cystic acne around mouth' and 'Perioral Dermatitis' kept popping up everywhere. I ignored this term at first but then I decided to look into it and realized I do suffer from this condition. Well at least now I had a name for it.
I thought it is the cold weather. My acne would come and go away randomly. There were days my skin was clear and days when it was not.
Finally in my second year (last year) I realized I had had enough. I was sick of not making a lot of friends, not feeling confident and not being able to enjoy my life. So i got the doc to put me on antibiotics(doxycycline 100mg/day). My skin cleared up in like 4 days and the next few months (aug 2012-dec2012) were the best months of my life. BUT THEN, for some dumb reason I went off doxycycline. Skin remained clear for 2 weeks and then Jan 2013, I had the worst break out ever. I stopped going to classes, hid myself from everyone and got another dose of antibiotics. Unfortunately, they were not working this time and I realized going off them immediately was a big mistake. Went to doc, and I remember the look on the nurse's face when she saw my face lol.
My doctor upped my dosage to 100mg twice a day. Finally, after 2 weeks, my skin started to clear up. Felt like a miracle, and I was acne free again in no time.
It stayed that way till July 2013 and I finally became resistant to doxycycline. I refused to believe this and continued with it till Sept. 2013, till I got another major breakout and I went to the doc again. Out of desperation, I asked them to prescribe me Minocycline since I had just started an internship and didn't want to go to work with 15 small whiteheads around my mouth. Again, my skin cleared up in no time.
I have been on minocycline 100 mg/day since but now after all my research and knowledge I know that I will get resistant to them as well. Even though I have a clear skin right now, I am not happy because I wake up every morning knowing that i can become resistant to these antibiotics any day. I am taking 10bil probiotic thing, because I came across some theory that antibiotics kill good bacteria in the gut so take probiotics as well bla bla.
So I am on a mission now. To find an alternate cure for this. i have spent countless hours on the internet looking for ANY treatment that might work. From what I have researched so far, I realized that I might have had seborrheic dermatitis since I was young which somehow turned into perioral dermatitis. You see, as a kid, I had a lot of dandruff. I used to scratch my head a lot and I realized that sometimes I had yellow clusters or something on my head and i would keep scratching it till I felt some type of liquid oozing out. I never got treated for this and I think this somehow got to my face and infected me in someway. I have similar yellow flaky thing around my ear and when I get a PD (perioral dermatitis) attack, its yellow, crusty kinda red at the same time. To confirm my theory, I found this thread and this is something I think I will look into
I noticed a few other things. I have bad oral hygiene. Maybe this is why I get acne around my mouth? I forget to wash the corners of my mouth after I eat. Another reason? I came across yeast infection theory which is floating around on the internet.
Finding out that this might be a fungal problem has gotten my hopes really high since I have never tried to treat this condition with that in mind. I just purchased Head and Shoulders clincal therapy shampoo for seborrheic dermatitis which has selenium sulfide present in it. It has worked for some people and I was like might as well try treating seborrheic derm and maybe it will take away perioral derm. People say selenium sulfide is a good antifungal or something and I have no idea if this is working because I`m on minocycline anyways right now and my face is clear.
List of items I have tried that have not worked for me -
Pro eczema by Mama Nature (great moisturizer) (cured PD for some people)
Tea Tree Oil
Violet Extract (cured PD for a couple of people)
Oil of Oregano (cured PD for a couple of people again)
Also, I used to eat a lot of spicy food, suffer from constipation and had a lot of chocolates as a kid. I read somewhere that acne around mouth is due to bad diet and you need to clear up your intestines. So i stopped eating chocs like I used to, took out all the spices from my diet and have been trying to go to the washroom a lot more but only end up going like once in 2 days. Could this be a contributing factor?
There have been days that I have been so depressed about it even though I have clear skin ONLY because I know I have limited time while i am on these antibiotics. I know it can come back anytime and since mino is the strongest, I doubt if any other antibiotic will work after this.
Guys I have so much more to share and to talk about, I have found out so much , but I feel if I write a really long post, no one will read it. So I just thought I will get write up something and carry on this discussion forward.
Can anyone out there relate to this story? Does anyone think this problem might be fungal and not bacterial?
Let's try to tackle perioral dermatitis/acne together! I am determined and I will try to answer all your questions and try to share every single piece of info I have gained over these past years.
Update: got this ointment 'prosacea'. It basically had sulphur in it which I think is really helping. Also came across a research article which said that sulphur was used in the 60s and 70s along with hydricrostine cream to treat perioral dermatitis. Let's see..I'm still on mino 100mg once a day and thought I might have to increase the dosage. But that hasn't happened yet. Got a small breakout though lasrcweek and used prosacea which made but go away.
Do some research on the links between dermatitis and histamines...if you get itching and redness along with acne, you might have a histamine problem. In that case, sulphur can actually make your skin worse. You want to avoid sulfates (esp. SLS) and salycylates in skin products.
Change your toothpaste. Buy something without fluoride, all-natural, etc. Perioral dermatitis is usually caused by an external antigen. I'm very sorry to hear that you went through all those topicals and antibiotics, because they were likely not necessary and could have made other problems for you.
If you're really determined, in addition to changing toothpaste (and making sure that you're not putting anything on or around the area, including acne medications, cosmetics, etc), you could try changing your diet. Strict paleo + toothpaste change and I would be very surprised if you still have a problem by the end of a month (unless you have digestive issues, which could take time to resolve).
Hey guys, just an update. I read a review about De La Cruz Sulfur cream and purchased it. Reviews said it is supposed to help with cystic acne.
Well I think my minocycline is finally stopping to work after 4 months of use. I was on 100 mg a day. So i got a little breakout around the corner of my mouth. However, this time even before it surfaced, I applied the Sulfur cream and my rash calmed down quite a bit. It didnt even turn into that big cluster of acne that i usually get because of perioral dermatitis. I have high hopes with this product. Its day 3 with sulfur and the flare up is going away which is amazing as my acne before would last for atleast 2 weeks as whiteheads and make that region really red.
Even though its not a huge breakout, I cried for the first time last night as I realized I was becoming resistant to minocycline and didnt want to imagine what I would look like next week. 
But I'm glad the Sulfur is helping!!
Anyways, just thought i would update you guys. Let me know what you guys think!
How is your PD? I wanted to share what has worked for me. I do not have a diagnosis from a dr. But I am positive I have PD. So originally I thought it may be a fungal infection due to exposure to an infant whose fungal jnfection behind her ears, and under her armpits was not properly taken care of for months! My case was pretty mild, small red itchy bumps on my chin only that dried up, flaked off and then flared up again immediately. I then started researching and thought it was seborrheic dermatitis. For a few weeks I used acv, sea salt, numerous oils, ect. I finally caved and used a prescription antifungal steroid cream that I had at home. It worked! And then it came back worse a week later, probably because I stopped using it. I kept researching and came to the conclusion it was not seborrheic, but perioral and since the fungal worked the first time I decided to try an otc fungal WITHOUT the steroid, since almost all perioral discussions reccomend NOT using them. So, now my " cure" has been clotrimazole 1% mixed with mupirocin anti bac that I already had, 3 x's daily. I also used lotrimin powder, miconazole nitrate, every morning and evening patted on top. I have cut back to two times a day cream mixture, and once lotrimin. I am taking an omega supplement and yeast control supplement ( that one gives me gas, so I only take it a few ti es a week, not every day) and a strong probiotic. I also bought eucerin oil free redness relief night cream for when It gets flakey and gross looking. I think oil free was
important, fungus feeds on oils in my opinion. I can honestly say I am 99% PD free! I am so excited! I dont even care that I couldnt find a natural way to cure it! The one thing I am going to do it continue my cream/ powder routine for another week then buy a different fungalcream, so hopefully I don't become resistant. I am also going to look into an oil free antibacterial gel or something, the cream contains mineral oil and I'd hate for it to feed the fungal, also its prescription and I need something otc. I have terrible insurance and it would take hours of my time to get a diagnosis much less the right prescription. I hope you have it under control or that my experience has helped someone....I dealt with this for 3 almost 4 months before I figured out what would work and I know many people go much, much longer.
I was checking your other post and it seems the above routine has stopped working for you.
I am still on minocycline but now I'm starting to get resistant to it and see occasional break outs. However, the sulfur ointment I got has been amazing so far. Whenever I see my skin is about to break out, I apply this ointment and next day its gone or it disappears in 2 3 days which is much better than having to sit with it for 2 weeks only to see another break out while this one dies. You should give it a try!
OK guys time for an update. So as predicted I did become resistant to minocycline (100mg) and I do not want to up the dosage to 200 since I just want to stay away from antibiotics. So after doing a lot of research I came across de la Cruz sulfur cream which I use as a spot treatment and it makes the rash go away in a few days.
However, I thought this Is my cure but it wasn't since I don't respond to it that well anymore.
Few weeks a go I ran out of white rice and decided to just settle for whole wheat pita bread instead for a a week. It was then that I noticed that my cystic acne around the mouth started to decrease. Having cut out all sugary and spicy stuff already I almost got 80% clear. I was still on mino but I knew it's not working anymore since sugar gave me instant cystic acne. I looked into this and came across low GI diet stuff which talks about how high carb and sugar diet spike your insulin levels which in turn has an effect on your androgens. So cutting out white Rice really helped since it has a very high GI and GL!
Cut out potatoes too and my only source of carbs is whole wheat bread!!
I'm not sure why spices break me out though. I cannot really have any spicy food and that's kind of depresssing
Any type of refined sugar gives me acne. Even the smallest piece of cake or chocolate results in a good 6 7 cystic acne around my mouth. Not sure how to fix this but people on here say it maybe because I have a low insulin sensitivity and taking chromium supps can help. However cr supp are linked to hair loss and I don't want to deal with that right now.
I take multivitamins, probiotics and vitamin d3 as my daily supplements. I started on vitamin d3 last week so let's see if that helps. Also drink 2 L of water every day and a green smoothie every other day!
My only wish is that I want to go back to eating spicy and sugary food like I used to because I miss it as hell and I wish there was a way to fix myself.
But yeah, seriously guys if you're dealing with cystic acne around your mouth just try cutting out white rice, potatoes and white bread along with all types of sugar and you'll see the difference!
Let me know what you guys think.
Silver Light
You may have fungal acne. Fungal acne is caused by taking antibiotics and some other meds, although some antibiotics (including minocycline) can control fungal acne for a short while, and the the fungal acne breaks out BIG TIME..
Try applying the following treatments -
1. Buy clotrimazole topical antifungal cream (often sold as Canesten - no prescription needed) and apply it to the areas with "acne" 2-3 times a day.
2. Wash your hair in an antidandruff shampoo.
3. Do NOT apply any moisturisers or organic oils to the areas with fungal acne unless your skin becomes very dry. Fungus loves moisture.
I am happy to hear how things go.