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Just Call Me OCD

Perioral Dermatitis? Rosacea? Allergy? (Pic)

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I'm at a loss. I went off antibiotics (Minocycline 100 mg) a month ago and was fine for a couple of weeks. Then things started to get progressively worse. I get a weird rash around my mouth, chin, and nasolabial folds when I sweat or wear makeup. I wish I could tell you other triggers, but I'm not sure. I just know that sweat is a huge one. The rash sometimes goes between my brows and onto my forehead. Right now, I wake up with new clogged pores every day and/or discover new red bumps that weren't there a few hours before. It's so confusing. I saw the dermatologist last Wednesday. She said it was just acne. She told me to reintroduce Retin-A 0.025% to 3 times per week since I was only using it once per week during winter. I've been using Elidel once or twice a day to quell the rash since November, but it's never been this widespread, red, and zitty-looking. She prescribed Solodyn 55 mg, upped my Spiro from 50 to 75 mg, told me to gradually quit Elidel, told me to stay on Yaz, and instructed me to use Soolantra twice per week. I can't get Soolantra until next week since the pharmacy is out, but I've started doing the other stuff. Maybe I apply too much Elidel, and maybe my skin is now addicted to it even though it's not a steroid? Things are just getting worse. I discovered a new bump tonight that wasn't even there 3 hours ago, and now it's big and red. All I can figure is that I chewed cinnamon gum between them and now? I chew a lot of spicy gum, and it's never been a problem. Maybe that's a new trigger... But these bumps don't itch or hurt. That's why I don't think it's acne. They look like closed comedones for a while, then they randomly become big and red. What is this? Will Solodyn help? I'm so depressed. I can't wear makeup to cover the rash. It multiplies if I do. Help...image.jpeg

(You can't see how red these bumps are in this picture, but they're pretty darn red.  You also can't see how many bumps are lurking under the skin.)

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The mass is even bigger tonight, and I have more of these giant bumps forming on the chin. Help? I'm so depressed. Using Elidel and Avar-E tonight. It's a gamble to try the Avar-E. Also picked a zit in my smile line that now is bigger and redder even though I got pus out. That was this morning. Don't think I got everything out. Forehead breakouts continue. Anyone have this experience with Solodyn or when increasing Spiro? The bumps don't hurt. They just linger forever. That's why I don't think they're zits. Rosacea papules? Stress isn't helping. Tomorrow is another Retin-A night.image.jpeg

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And it's definitely a cyst.  It hurts now.  I am breaking out all over.  All over.  My skin is a wreck.  Has anyone else experienced a major purge with Solodyn, increasing Retin-A (from 2 to 3 times per week), or increasing Spironolactone (from 50 mg to 75 mg)?

I went to the pool for a little over an hour today and splashed my face with chlorine a few times to see if it helped.  I guess it didn't.  I guess it made things worse.  I also took a really hot shower tonight, which probably screwed things up more.

Applied Retin-A (pea-sized amount) once skin was dry, followed by Elidel.  Extra Elidel on problem areas.  I think Elidel has clogged my pores more, but I'm scared to not use it since it decreases inflammation.

I loathe myself.  Anyone have words of advice/support?

I haven't exercised since Saturday because my skin has been so horrible.  I'm scared to sweat and make it worse. :(

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Hi there....I have the same issue!  New bumps pop up out of nowhere.  They are red and when I pick, because of course I do that, they almost seem to have a dry patch on top.  I'm so frustrated because I've tried so many different products and make up.  Nothing helps!  Did you ever get a diagnosis or treatment?  If so, please help!

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I wish I had an answer!  Still no diagnosis!  Retin-A 0.025% every other night, Tazorac 0.5% on the off nights, Elidel every night, Minocycline 150 mg, Spironolactone 75 mg, and Yaz.  What a long list of meds!  I'm still purging hardcore from Retin-A/Taz, particularly around the chin area.  I suspect thyroid issues, but the basic thyroid blood panel has come back normal twice.  There are apparently more comprehensive thyroid panels that may show something different, and I'll probably resort to another blood test at some point.  I also wonder if it's PCOS since I've historically had menstrual issues, but I don't really fit the bill for PCOS overall.  An MRI (for an injury) in February revealed one ovarian cyst, but nobody has ever suggested PCOS.  My gyno said she didn't suspect it, but that was a year ago.  Still searching for answers...

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if it is perioral dermatitis, spectro jel cleanser for blemished skin has great reviews for clearing it up. its expensive because its only sold in canada. but it also comes in a larger size that might be worth it. it smells funky and has no lather but i really like it. a lot of people say its the only thing that cleared up their pd in these reviews: https://www.amazon.com/Spectro-Jel-Cleanser-Fragrance-200ml/dp/B00CUIKYJW/ref=sr_1_2_a_it?ie=UTF8&qid=1467999945&sr=8-2&keywords=spectro+jel+cleanser+for+blemish+prone+skin

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You guys, I personally know what ypu mean its like bumps pop up, you can feel them before you can see them then they get cyst-y or if you're very lucky, they go back down.
My feeling is its from a food allergy, question is which one?! If I eat dairy or too much sugar I get them but once in a while I'll get one and have no idea from what.
I put crushed aspirin on them as soon as I feel it, seems to help diminish most of the time.
Defi itely don't use fluoride toothpaste. I've been using coconut oil+ baking soda but I might pay the $6 for the Toms one cause its so messy.

On 6/21/2016 at 9:54 PM, Just Call Me OCD said:

I wish I had an answer!  Still no diagnosis!  Retin-A 0.025% every other night, Tazorac 0.5% on the off nights, Elidel every night, Minocycline 150 mg, Spironolactone 75 mg, and Yaz.  What a long list of meds!  I'm still purging hardcore from Retin-A/Taz, particularly around the chin area.  I suspect thyroid issues, but the basic thyroid blood panel has come back normal twice.  There are apparently more comprehensive thyroid panels that may show something different, and I'll probably resort to another blood test at some point.  I also wonder if it's PCOS since I've historically had menstrual issues, but I don't really fit the bill for PCOS overall.  An MRI (for an injury) in February revealed one ovarian cyst, but nobody has ever suggested PCOS.  My gyno said she didn't suspect it, but that was a year ago.  Still searching for answers...

my gyno didn't suspect it either but I have it. All I had was acne\ oily skin irregular periods and excess hairs on my back and chin...not a lot either.
On 6/20/2016 at 5:40 PM, MVET19 said:

Hi there....I have the same issue!  New bumps pop up out of nowhere.  They are red and when I pick, because of course I do that, they almost seem to have a dry patch on top.  I'm so frustrated because I've tried so many different products and make up.  Nothing helps!  Did you ever get a diagnosis or treatment?  If so, please help!

it might be hidden food allergies.
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Derm still thinks that it's just purging of clogged pores.  I can't pinpoint a cause except that I was using Elidel all those months that I had stopped Retin-A, then going off the antibiotics made the bacteria return.  Also, the season changes are never kind to me.  So I think my skin was used to unclogging and regenerating every night with Retin-A, then I stopped almost cold turkey (only using once or twice a week), and now I'm dealing with the deep clogged pores.  I started the Retin-A 0.025%/Tazorac 0.05% regimen on alternating nights about 3 weeks ago, and I'm purging so badly.  I can't even describe it.  I got 5 whiteheads on top of a super-cyst within the span of 5 days.  A clogged pore that was just barely visible when I stretched my mouth yesterday has now become an inflamed whitehead overnight.  I guess this is a good thing?  Rapid skin cell turnover.  Derm upped my Minocycline to 200 mg and recommended that I increase the Taz to 4 times per week with Retin-A 3 times per week, then keep upping the Taz and phasing out the Retin-A.  I got 4 more cortisone injections yesterday (2 of which were re-injections of cysts she injected 3.5 weeks ago), only to have many more zits rear their ugly heads by this morning.  The cortisone shots don't really work because the pores are so clogged that the cysts won't stop reforming until the pores get unclogged.  Trying so hard not to pick the whiteheads, but the 2 that I picked a few days ago emitted majorly long strings of hard pus.  Some whiteheads I pick heal faster.  Others don't heal because I can't get all of the pus out, then they become cysts.  I've been seeing the derm every other week on average.  This is ridiculous.  I never had an initial breakout from Retin-A the first time I used it 2 years ago.  I now know that you can never stop using retinoids, especially if you use something like Elidel.  It suppresses the immune response, which means that zits may shrink and look less red, but those pores are clogging up and will have to come out eventually.  I took so many walks in the heat and humidity when the weather first changed, and I wasn't using Retin-A to deal with all of the sweat that was clogging me up.  Just Elidel.  Then I stopped Minocycline.  Just a horrible situation.  I'll never stop retinoids again.  And I'm done with Elidel.  And I'm addicted to antibiotics.

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4 hours ago, Just Call Me OCD said:

Derm still thinks that it's just purging of clogged pores.  I can't pinpoint a cause except that I was using Elidel all those months that I had stopped Retin-A, then going off the antibiotics made the bacteria return.  Also, the season changes are never kind to me.  So I think my skin was used to unclogging and regenerating every night with Retin-A, then I stopped almost cold turkey (only using once or twice a week), and now I'm dealing with the deep clogged pores.  I started the Retin-A 0.025%/Tazorac 0.05% regimen on alternating nights about 3 weeks ago, and I'm purging so badly.  I can't even describe it.  I got 5 whiteheads on top of a super-cyst within the span of 5 days.  A clogged pore that was just barely visible when I stretched my mouth yesterday has now become an inflamed whitehead overnight.  I guess this is a good thing?  Rapid skin cell turnover.  Derm upped my Minocycline to 200 mg and recommended that I increase the Taz to 4 times per week with Retin-A 3 times per week, then keep upping the Taz and phasing out the Retin-A.  I got 4 more cortisone injections yesterday (2 of which were re-injections of cysts she injected 3.5 weeks ago), only to have many more zits rear their ugly heads by this morning.  The cortisone shots don't really work because the pores are so clogged that the cysts won't stop reforming until the pores get unclogged.  Trying so hard not to pick the whiteheads, but the 2 that I picked a few days ago emitted majorly long strings of hard pus.  Some whiteheads I pick heal faster.  Others don't heal because I can't get all of the pus out, then they become cysts.  I've been seeing the derm every other week on average.  This is ridiculous.  I never had an initial breakout from Retin-A the first time I used it 2 years ago.  I now know that you can never stop using retinoids, especially if you use something like Elidel.  It suppresses the immune response, which means that zits may shrink and look less red, but those pores are clogging up and will have to come out eventually.  I took so many walks in the heat and humidity when the weather first changed, and I wasn't using Retin-A to deal with all of the sweat that was clogging me up.  Just Elidel.  Then I stopped Minocycline.  Just a horrible situation.  I'll never stop retinoids again.  And I'm done with Elidel.  And I'm addicted to antibiotics.

sometimes it seems like an endless cycle of fucked- upness.
ive never heard of Elidel
 
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Exactly.  Neverending clogged pores coming to the surface and becoming giant whiteheads or whitehead-covered cysts that don't go away.  I never, never had problems like this before this year.  Just a couple zits here and there.  This is ridiculous.

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Could it be pityrosporum folliculitus? That's a kind of overgrowth ( fungal or bacterial I'm not sure) you can get it from antibiotics. Maybe ask for a skin culture analysis. 
Try taking a garlic pill as few times a day and turmeric. They are anti microbial, anti fungal etc. What can it hurt...

Edited by snarkygirl
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I don't think so.  I did the research on that when it first started happening, too.  Haha.  I looked up EVERYTHING!

It's just a gross Tazorac purge, I think.  Elidel suppresses the immune response, so I was just suppressing these clogged pores with it.  Once you stop using Elidel, the inflammation and redness returns...

I actually bought some bone broth to see what happens.

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Maybe looks like the beginning of perioral dermatitis? I was literally just at the doctor today and told that is what i have, mine looks like yours but redder and flaky. If you also start to get it around your nose and smile lines i would say theres a good chance its dermatitis.

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On 7/10/2016 at 7:02 AM, Just Call Me OCD said:

I don't think so.  I did the research on that when it first started happening, too.  Haha.  I looked up EVERYTHING!

It's just a gross Tazorac purge, I think.  Elidel suppresses the immune response, so I was just suppressing these clogged pores with it.  Once you stop using Elidel, the inflammation and redness returns...

I actually bought some bone broth to see what happens.

Hey girl, I was wondering how your skin is now and what you found out. I currently have perioral derm and what you were experiencing seemed like that. It was probably due to the spiro, I broke out horribly when I upped the dose. I then went in accutane an I was clear for about a year but the acne returned and I ended up doing too much to my skin and it freaked out and I ended up getting perioral dermatitis unfortunately. I feel like I was doing so good with my skin and then it took a million steps backwards like the damn presidential election. I blame trump for this lol
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I never got a diagnosis.  Things cleared up for about a month, and now I'm back to having worse skin than ever.  The season change prevented me from using Tazorac every night, and heavy moisturizers broke me out more.  Now I have more clogged pores and zits on my chin than ever.  It's worse than it was when it all started in May.  It's so depressing.  My derm has recommended a light peel.  My chin is where most of the issues are.  Tons of clogged pores that make their way up to the surface and form large red pimples that seriously do not go away.  They don't go away.  Still on Spiro 100 mg, Yaz, and Minocycline 150 mg.  I am now using Elidel again after weaning off of it in the summer.  I can't go without it because my skin is always raw and irritated now.  I'm also using Retin-A 0.025% every other night instead of Tazorac.  Nothing is getting better.  Only getting worse.  I'm at a loss.

Updated picture from tonight.

IMG_5506.JPG

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I don't know if anyone still follows this, but things are seriously worse than ever.  Extractions and injections don't get rid of the bumps.  They keep coming back in the same places, and then they spread.  They never fully go away, even if they diminish temporarily.  I've tried using Clotrimazole instead of Retin-A or Elidel on my chin for the past week, and it's quelled the rashy areas temporarily, but I've ended up with spreading of the rash and even a couple of painful cysts in return.  The hard keratin/sebum plugs can sometimes be pulled out with tweezers, and then other times, they get stuck and result in cysts.  I'm at the end of my rope.  I see the dermatologist in two days, but I feel so sick about everything.  Minocycline doesn't do anything anymore.  Spironolactone doesn't prevent anything.  Yaz isn't working.  Retinoids are too drying.  Elidel makes me too greasy.  I had to wear makeup for the holidays, so the rash spread.  The bumps are worse.  My life sucks.

What do I tell the derm?  I saw her at the beginning of the month.  She told me to stop Minocycline and start Oracea, stop Elidel entirely, and use Retin-A at night and Finacea during the day.  I'm terrified to shake things up that much.  The antibiotic to antimicrobial shift (from Mino 150 to Doxy 40) will be too drastic, and I'll end up with an even bigger issue all over my face.  The Finacea may cause too much irritation and make the rash worse.  What do I do?  Opt for a laser treatment?  Blue light therapy?  Help.  Please.

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Saw the derm today.  (Side note... She said that Clotrimazole makes people's skin look better because it's moisturizing and soothing, not because they necessarily have a yeast infection on their faces.  In fact, very few people do have an actual yeast infection.  Just FYI to all who have experienced improvement with Lotrimin or another antifungal cream.  So much for that.)  She fussed at me for not following her instructions earlier this month, but I told her I couldn't shake things up so much right before Christmas.  I've determined that I'm allergic to nearly everything, including Everyday Minerals makeup (which I only spot cover with anyway).  I also sweat profusely 90% of every day, whether or not it's hot inside or outside.  After wearing makeup to multiple holiday events, I've ended up with rashy, zitty grossness in areas where I usually don't have a problem... And, naturally, in the areas where I've had an ongoing problem since May.  Because the esthetician in her office is on vacation, the derm refused to extract a whitehead that I had extracted last night, but which refilled.  I talked her into at least injecting it with Kenalog 2.5.  She didn't want to mess with anything else and just told me to follow her instructions from a few weeks ago:

1) Stop Minocycline 150 mg and Elidel.
2) Stay on Yaz, Spiro 100 mg, and Retin-A 0.025% as often as my skin can tolerate it.  Add Vanicream Lite Lotion to buffer the Retin-A.
3) Start Oracea (Doxy 40 mg every day) and Finacea 15% foam on the nights I don't use Retin-A.  She wanted me to use the Finacea in the morning, but I sweat so much when I'm awake that it seems like it would ruin my skin and create irritation.
4) Start Robinul 1 mg to deal with sweating.  On the fence about this.  I hate adding more pills, but it may help.  I also have been told that my "sweat bumps" are actually very mild sebaceous hyperplasia.  They come and go.  Sucks.

Because I'm desperate for an answer, I intend to at least follow steps 1, 2, and 3.  I may need Elidel to quell some sweat bumps every now and then... Just because I'm not sure if the other stuff will work on those.  And I'm terrified because I'm adding another topical (initial breakout potential), I'm cutting a strong antibiotic dose to a low antimicrobial dose of another drug entirely, and I'm adding a moisturizer (allergic to most moisturizers I've tried in the past).  I've scheduled another light salicylic acid peel for next week to speed up the purge.  May need extractions then, too.  Hoping to only need the peel on my chin, but I may need it in other areas (forehead, especially) if things don't improve between now and next Wednesday.

Anyone out there who can offer some hope?  Tips?  Prayers?  This could go really well, or it could go really badly.

Just to add...

I will not be wearing any makeup because all it does is clog me more and spread the rash/zits.

This means I will go grocery shopping and do nothing else.

My life sucks.

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Hi there :)
This really sounds like what happened to me 4 years ago. It's horrible and I'm so sorry your going thru this :(
Looks so similar to mine was, all arond the chin and I believe my skin had a pinkish tint around the mouth/nose aswell.
I got it from using a steroid too strong for my face; when I stopped using it the rash blew up.
It was like 100s of comedones came out of nowhere.
I was put on 100mg of Minocycline as well and given Metrogel (for perioral dermatitis) 
I also used organic apple cidar vinegar (diluted 50/50 with water) and used this as a toner!
I didnt use floride toothpaste for YEARS in fear of making it come back.

I ended up taking Accutane when it went away and I havent had a problem since.
(I was put on it because she told me not to use any acne creams for a while but I still had some active ones)
Let me know if you have any Q's; I know there isn't much information out there for this!
Cheers!  xx

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Thanks so much for sharing! I am 90% a hermit right now because I can't bear the way I look / can't go out in public without feeling horrible. Alternating Retin-A and Finacea every other night, but I've already had to take one night off due to irritation. I'll have to do the same tomorrow night. Too much raw, red skin. Finacea is on tonight, and even though I'm not supposed to anymore, I'm spot treating a few bumps with Elidel. I have several new ones, despite not wearing makeup for the past week now. It's sickening.

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From the pictures I totally used to have the same thing. I quit eating dairy and that took care of the cysts around my chin and under the corners of my mouth. I also ended up discovering I Have an egg intolerance. My skin didn't really recover until I started drinking kombucha and repopulating my good bacteria! I now use dried papaya powder and Braggs applecider vinegar to get rid of the old scars. Find a gentle cleanser, a toner, and a facial oil (yup, oil. It mimicks sebum and your pores don't need to secrete more!). I highly recommend Annmarie Gianni, or living libations! My skin looks better than it has in years. Good luck!!

Edited by Fredbad
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I use Retin-a aswell! I do find I cant wear it on my lower half of my face as it dries it out way too much; not even moisturiser helps that lol. 
Any luck yet?? Really hope you give the apple cider a go :)

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I'm trying to trust the derm... Another peel coming up this week, and I'm getting extractions this time.  My skin looked okay for a few days before the peeling started post-peel last time, then the peeling dredged up tons of zits and colorless bumps.  They're going nowhere and continue multiplying.  Now I need those extracted, plus another peel to help them heal and dredge up more closed comedones, I guess.  It's all so confusing!  Is there an end to this, or am I just making it worse?  Thanks for checking in!  I still think the colorless bumps are either a sweat allergy or a fungal infection, though I don't know how to gauge or fix either!

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Hi again,

When that happened to me and my doctor told me they where 'just pimples' and proceeded to pop them for me..they spread. Perhaps thats whats happened with you? Maybe let them heal? When I got in to see my derm after that she told me I shouldnt be popping anything that doesnt have a head. 
For fungal infection I honestly reccomend the apple cidar vinegar :)
Hope it's gotten better!
 

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