DEALING WITH PERIORAL DERMATITIS
My Journey With Auto Immune Disease (UC) & Suffering With Perioral Dermatitis & Migraines
The last couple of years have been quite the health awakening for me. If you’ve been a reader for a while then you may remember me talking a little bit about living with an auto immune disease and having ulcerative colitis, despite living with many of my issues for years, I only got diagnosed at the of 2016 with UC (took me a whole lot of time to actually accept what was going on and go to the doctor) and since then it’s been an ever growing list of ailments but also awareness of what’s going on in my body.
I’m considering sharing a post to talk about my UC in more detail and how i’m trying to manage my auto immune disease as there’s a lot to cover, but for now a ‘quick’ back story to set the (potential) context of my Perioral Dermatitis.
I’ve always had bad tummy since I was a kid and suffered IBS (it’s very much in my family, my mum and nan suffer terribly from IBS, and in the last year my sister has also been diagnosed with UC), things got exceptionally bad and quite frightening for me a fewof years back, and after finally going to hospital for tests after a particularly bad ‘flare up’, I got diagnosed immediately with Ulcerative Colitis. Alongside the stomach issues I faced, I also was suffering (and still am) from chronic migraines on an almost weekly basis (they can wipe me out for 24 – 48 hours), and whilst the least ‘severe’ issue from a health point (but the most negative from a confidence point of view), I started to suffer with a skin rash on my face that looked like acne. As someone who had never had spots as a kid, this was really devastating and It’s only now I realise how much it’s impacted my confidence.
Once I got diagnosed with Colitis and begun having regular tests and hospital appointments, my Colitis consultant referred me to a dermatologist as he thought my skin inflammation could be linked and also causing me extra stress (at this stage It hadn’t dawned on me that my skin, stomach, stress and migraines were linked), it was, and the dermatologist very quickly confirmed that no, I wasn’t suffering adult acne but instead Perioral Dermatitis – an inflammatory rash.
Typically PD is known to be caused by things like steroids, fluoride, dairy, birth control or bacteria, and most people just need a cream or set of antibiotics to clear it for good. Sometimes people can pinpoint the cause immediately (e.g. they’d used a steroid, or gone off makeup etc) other times it’s really unclear what the cause is and the process for dealing with it can be much more trial and error (in terms of eliminating things and healing for the long term). The latter is true for me, sadly mine is probably linked to my auto immune disease, hindered by stress, gastro problems and inflammation etc, I’m also at the point where I am wondering if the pill and I have reached out point of break up. Despite the remaining ‘unknowns’ for me, I still now kick myself for sitting on this for so many years and not getting a professional opinion sooner.
MY TREATMENT JOURNEY
How To Heal, Deal With & Eradicate PD
I was prescribed antibiotics (tetracycline for 4 weeks) to clear the rash last year, and it worked immediately, clearing my skin back to normal aside from a few red marks within two days. However, a couple of days post the final antibiotic, I got the same old rash on my skin and over the course of a few weeks deep spots and sores. Not as bad as before, but nonetheless it was back, and has remained back since. It was only really at this point I realized how much the skin issue had impacted my confidence and how I saw myself, and now I’ve become much more actively engaged in getting myself better, as the thought of going back to ‘that’ is horrendous. Funny how the one symptom that causes an aesthetic impact, is the one that’s driven me to action the most, despite the fact my migraines and UC make me the most ill and unwell.
It was at this point of desperation and also driven by my migraines becoming more unbearable, that I decided to visit an Acupuncturist / Eastern doctor to help. Migraines are also in my family, and my Aunty swears by Acupuncture to help prevent hers, so it was a long time coming for me to get help here (it’s a theme, i’m slow to help myself). The journey I’ve been on in the last month or so since beginning TCM (traditional Chinese medicine) has been really positive. Largely because it’s helped me understand how my skin, migraines and UC are all intrinsically linked (its all part of having an autoimmune disease and suffering with inflammation), and secondly it’s helped me realise the importance of me making actual lifestyle changes to properly help myself and start to heal from the inside out. It’s also helped me carve out time each week to look after myself, as currently I am going weekly, although this will become less frequent once ‘balance’ is restored.
Of course my exploration with Eastern Medicine and treatment is about more than just my perioral dermatitis, but some of the treatments and lifestyle changes I’ve embraced as part of this journey would certainly help anyone suffering with the skin condition, let alone stress as a general issue.
My current lifestyle changes fall into three areas, and combined these things are starting to help clear my Perioral Dermatitis and improve my health overall actually. My PD hasn’t cleared up, in fact right now I have a bastard spot appearing deep under the skin, but it’s certainly no where near as bad as it has been and I must keep remembering it’s a journey to get it to properly go for good.
Getting on top of my UC has clearly been four years in the waiting. I am now (finally) religiously taking my medicines (5 tablets a day) and for the first time in a very long time am experiencing what it feels like to be ‘normal’ again. I came to accept the issues I faced as normal, and that’s not how it should be. After a bad flare up at the beginning of this year, I’ve really got serious about ensuring I take all my medicines. Thankfully the medicine I am currently taking (which is something I will have to take forever) is really having a positive impact for the first time since I got diagnosed, and given how linked everything is, this could of course be helping my skin too (although I suspect the other things I am doing are helping my skin more).
From a skin point of view, my dermatologist has recently prescribed me another course of antibiotics for my PD specifically (this time Lymecycline which is apparently a newer and stronger antibiotic) and a retinoid aimed at skin irritation called Differin, but with so many other lifestyle ‘changes’ I am making, I am going to wait to see if I need these before beginning the next course, as I would love to eradicate the cause rather than just treat the symptoms.
TRADITIONAL CHINESE MEDICINE
As part of my TCM treatment I’ve been undergoing Gua Sha and Acupuncture to clear ‘toxic heat’ which Chinese medicine believes can cause the issues I face, largely this is focused on my liver and stomach. The doctor is incredibly clear with me that all my inflammatory issues (skin, tummy, migraine) are due to my auto immune disease and that stress clearly has been a big factor in this, her approach is to help heal from the inside and return the body back to balance.
In the space of 4 weeks the cha in my body has cleared via gua sha and the lifestyle changes I am making, quite incredible to see really (effectively when I first started Gua Sha my back would be covered in huge areas of bruising and redness, and week by week this has cleared, this week I had not a single mark appear despite the same ritual). I’m continuing to have acupuncture which she’s focused on helping hormonal imbalance and inflammation – largely these have been in my feet, knees, arms, forehead and chin. I am excited and hopeful that this will continue to help me overall … especially my migraines.
On top of my regular sessions with her I’ve also had to make some lifestyle changes to help everything …
Lets cut to the chase: no dairy, no gluten, no refined sugar (I don’t consume much of this anyway), daily turmeric, fish oil, pro-biotics and digestive enzymes. This is again to help me overall, but for people suffering PD, cuting dairy and introducing some inflammatory herbs (like tumeric and fish oil) can be really helpful.
On top of this, the dermatologists recommend avoiding fluoride (noted as a potential trigger of PD) so I’ve moved to fluoride free toothpaste (I found mine in Sainsburys), and overall dermatologists recommend simplifying all skincare to avoid skin irritation.
I have cut back my skincare routine to avoid harsh products that will hinder the inflammation (avoiding acids, anti ageing products, certain retinols and too much makeup etc) and have started using creams that are all about healing hormonal imbalances and irritation.
I’ve been really loving Elemis SOS cream and believe this has really helped sooth my skin and I’ve been using overnight as a deep healing treatment. I’ve been prescribed Dermol as a face wash which Is meant to help PD as it is exceptionally gentle, i’m using this alongside micellar water and every now and then my Elemis or Darphin cleansers as they’re just so soothing I can’t help but use it every now and then. And after reading lots of positive review, I’ve also bought La Roche Posay Miclellar water (because it’s so gentle and ideal for a quick cleanse), La Roche Posay Toleriane Ultra Cream (meant to help calm skin irritation and be ideal for allergic skin) to use as my daily moisturiser, as well as La Roche Posay Rosaliac Intense for ‘localised’ treatment at night (helps reduce redness and irritation). The latter two are new additions to my skincare as I’ve read a lot of reviews suggesting they help PD, but I’ve also used La Roche Posay Redermic C10 (for day) and B5 (for night) for a long time which I think are brilliant, but more aimed at anti ageing so I’ve stripped those back for now. For people with skin conditions this brand always seems to come out highly recommended, i’m actually considering swapping to the Toleraine foundation too.
If it comes to it, my next step is to come off the pill (I have been on the mini pill for 10 years) as this is noted as a potential cause of PD and in addition my Eastern Doctor thinks it could be causing hormonal imbalance and not helping my autoimmune problems.
So there you have it, the worts n’ all summary of all the steps I am undertaking to help heal my PD (and other inflammation problems – migraines, UC etc). Of course, the measures I am having to take are not just because of PD, but the broader autoimmune disease and issues that causes me so hopefully if you too are suffering with Perioral Dermitis, the road to recovery will be slightly simpler. Like I said, aim to reduce stress, stop steroid use, try a flouride free toothpaste, streamline your skincare, and worst case scenario try antibiotics as that typically clears it.
For me the journey isn’t short or simple, it’s a lifestyle change for the future. All of my inflammatory issues are linked and quite clearly extremely impacted by stress – when this all started 4 years ago, I was the most stressed I have ever been in my life as a result of work, and whilst I did and do still look calm on the surface, I’ve learnt the hard way how not looking after yourself, and protecting yourself from stress can damage you. For me this is a lifestyle change that I hope in time will heal my skin and migraines and help keep my UC in check.
I really hope me sharing this story might be helpful to you or a friend if they suffer in a similar way, or simply give you a little more insight into my life. It isn’t all as instagram would make you believe.