You wake up one morning and discover a strange, bumpy rash on your face.
Maybe it’s next to your mouth or between your lips and nose. It might extend down to your chin or even around your eyes. You’re not sure what it is, but you dab a little steroid cream on it and it goes away, only to return when you stop. Except this time it’s worse. SO much worse. It might burn, it itches, and it seems like every single thing you do just makes it worse.
Perioral dermatitis is a skin condition - a kissing cousin to rosacea and eczema - affecting primarily women of childbearing age, though you can also see it in children. Most often it just starts flaring up for unknown reasons, very often during pregnancy or other times of hormonal fluctuation. While non-contagious in nature, perioral dermatitis can be unsightly and it is very stressful. The last thing you want to deal with - ever - is a painful, bright red, bumpy face rash, right?
Let me validate you, here. Perioral dermatitis can feel like the end of the world.
I had my first bout with this in 1991, while pregnant with my first daughter. My midwife mis-diagnosed it, and the treatment she recommended made it oh, so much worse. Once it cleared up, I was so happy. But just like the Cat in the Hat, perioral dermatitis comes back. It came back with a vengeance during my second pregnancy, and I’ve experienced several more bouts over the years. The first, and most important thing I learned was this:
While steroid creams are the cure of choice for many forms of dermatitis, perioral dermatitis is not one of them.
Using steroids will make it go away for a short period, and then it will come back 3x worse than before. Just don’t use them.
It's really important to let your dermatologist and/or primary care doctor know that you are pregnant, as tetracycline antibiotics are contra-indicated for the 2nd and 3rd trimesters of pregnancy. The most common treatment for this condition is to prescribe tetracycline antibiotics for a period of several months. Obviously, you are going to want to ask your doctor to help you find alternative treatments that are safe for both you and baby.
In my own personal journey with perioral dermatitis, I have found a few things to be helpful and I'm listing them here as things you might want to explore or talk about with your doctor.
Skip the cover up.
I know you want to cover it up with makeup. Don’t. Go clean-faced for a while. Makeup can just irritate it more.
Read the labels on all of your skincare products.
There is a lot of anecdotal evidence that sodium laurel sulfate (SLS), glycols, fluoride, and parabens can irritate and worsen PD. You might want to eliminate them. Look for SLS free products that have been formulated for skin conditions like eczema, acne and rosacea. Whatever you use, you want to find something gentle and non-irritating.
Toothpaste, especially whitening toothpaste, is a suspected trigger for PD.
During pregnancy, great dental hygiene is super important, so don't stop brushing your teeth! There are some great non SLS/fluoride free toothpastes available on the market. Talk to your dentist and make sure your choice of alternative products are supporting your best dental health.
Shampoo can affect PD.
Consider going to a gentle, SLS and sulfate free, no-poo regimen while your skin heals and even after. There are some fantastic options available now, thanks to all the curly girls out there.
Perioral dermatitis likes to be left alone.
Don’t touch it or rub it. It just makes it hurt, and look, worse. Plus, it spreads faster.
Food can be a trigger for some people.
You know your body best, so if you feel like something you are eating is having an adverse effect on your PD, make a note and try eliminating it. Obviously, if a suspected trigger food is an important source of something you need during pregnancy, you will want to find an alternative. Look for a second blog post on common food triggers, coming next week!
Pay close attention.
Keep a product and food diary. You will begin to see patterns.
Perioral dermatitis can take several months to fully heal, but once you've eliminated your triggers, it does go away. With the right care, you can soothe the burn and keep it from being too angry looking while you’re in the healing phase. It’s important to treat yourself with patience, compassion and care while you’re healing. With perseverance, I promise you will get through this!
You aren't alone.
A quick word of warning:
Supplements: There are some supplements that are commonly recommended to treat perioral dermatitis. They can be very toxic for your baby and for you too, at the wrong dosage - or at all. ALWAYS double and triple check these with your doctor before you take anything.
Essential oils: EO's are powerful chemicals. Please don't ingest or put EO's directly on your skin or your child's skin. You can set yourself up for lifelong problems, including sensitization, allergies and organ failure. If you are considering essential oil use, please talk to your physician or midwife and also seek a consultation with a qualified professional - a certified or clinical aromatherapist - who has trained through a reputable and accredited program, not a random "wellness advocate" from an MLM company.
Your health, and that of your baby are too important to risk.
(Originally posted at Great Valley Doula.)