Tuesday, January 31, 2012

Face Rot

As I've referenced, I'm experiencing a bit of face rot condition. That's not the official name, but I like it.  I went to the dermatologist last week and it's perioral dermatitis.  For those who didn't take Latin, let's take a moment:

Peri - about, around, near
Oral - relating to the mouth
Derm - skin
Itis - inflammation of

Now a picture:

Can we collectively take a moment to say, "no shit!"  

(By the way, I didn't want to drag anyone else into this, so I took shots with the backwards iPhone camera.)

I'm almost never in pictures, so trouble finding a true baseline.  This was in the last week of December though, so when it had barely started on teh chin, but was nowhere else.  I was very amused by the hat.

Now that I've drawn you in, I'll take a step back and talk through the history of this face rot.  Outside of a typical level of teen acne, I've never really had facial skin problems.  It just kind of trucks along.  Around the time I figured out I was pregnant, I noticed this weird patch under my left lip.  Kind of a cross between acne and a rash.  But, I had bigger things on my plate, so other than using the hypoallergenic cleanser and hydrating it with a hypoallergenic lotion, I didn't do anything.  Then it spread to the right corner of my mouth.  Still haven't done anything.  And we get the left side above the mouth and the right side up towards the nose.  Making fun of it more with friends and referring to it as the skin rot, but still not doing anything.

Then, it spread to my left eye.  And the skin is sensitive there and so it actually kind of hurts:
So, after just three weeks of this I went in to the dermatologist and she told me perioral dermatitis.

It's apparently most likely due to stress and the normal treatment would be a couple of months of antibiotics.  However, that is not a good plan with two growing fetuses who we would prefer not to have to endure teratogenic effects.  So, she wants me to try a topical steroid called Desonide.  But, it is also a category C.  And while it may make it better, there is a distinct possibility that it will actually make it worse.  I called the OB and after some discussion, they decided I should wait until today when I would be 13 weeks to do it and to try to use it sparingly.  The reason to try it is that it has the risk of causing actual infections and as it is spread to the eye, it's a pretty significant inflammation. 

I dropped it off, but I'm still not sure about using it.  The internet makes it pretty clear that it REALLY can make it worse. Also, these shots are in the morning when it is at its best.  True to a stress-based condition, it gets worse throughout the day.

I can almost hear you asking, "why don't you just cover it up?"  And while my makeup skills are pretty lacking, I'm sure I could apply a base layer to really handle much of the redness and the fun crusty bits.  However, the dermatologist said in no uncertain terms to apply NO PRODUCT to it other than Cetaphil (a moisturizer).  I'm even supposed to be careful to not get any toothpaste in contact with the skin and even consider using toothpaste without fluoride for a while.

Zero Rot at the beginning of December!

 And a year ago, as both more evidence of the pre-rot and because Chiron was so tiny!

So, what's the conclusion?  First, the dermatologist is officially non-helpful and the label of the condition almost annoys me more.  Second, I'm apparently under stress of some sort without really recognizing it.  Third, I don't think there is any real good approach to managing it.  My current plan is to continue washing it with the Cerave and hydrating it with the Cetaphil and I'm leaning towards trying the prescription very sparsely and very tentatively at first.  On some level I'm hoping it will run its course and kind of fade away.  The dermatologist said it was highly unusual for this to show up having never happened before.

Anyone have any brilliant insights into skin care?  I definitely have never mastered these types of skills, so don't be afraid to state blatantly obvious things.  If it's beyond clean, moisturize and don't touch, I probably haven't thought of it.

And I'm sticking with calling it the face rot.


  1. Can you get another dermatologist to weigh in? I feel like the wait to for new patients at derm offices around here is stupid long though. My go-to skin solution is a lotion with lactic acid (like this one: http://www.drugstore.com/amlactin-moisturizing-lotion/qxp16753) because it makes everything better...but this sounds way more complicated. My other thought, could one of the "compatable with pregnancy" antibiotics work? that sucks, but that baby Chiron picture about melted my heart.

  2. You need a scrip for metrocream 45GM. or metronidazole (generic)
    It may a few weeks to start looking better.

    We happen to have that cream at my house right now.

    another option is to use some eucerin + lotion. It's a pretty heavy lotion for your face though....you might get rid of the rash and cover it up with zits :)

    It's not bad. At least you can tell it's a rash.
    If anyone asks...tell them you have thrush.

    1. Doing a search on this with perioral got me into some good literature showing that it actually does work, is a class B and seems more consistent with the diagnosis.

      I think I'll hold off on the other prescription until I see the OB Monday and get her thoughts.

      Apparently stopping washing my face entirely other than letting water run over it and applying no moisturizer might work, but that seems so counter-intuitive that I'm scared to try!

    2. SERIOUSLY consider trying that. I used to have horrible breakouts that I swore were zits, until I stopped putting ANYTHING on my face except cetaphil wash and moisturizer. voila, problem solved. at the very least, I guarantee you it will not make your problem worse.

  3. Really? You think you might be under "some stress"? REALLY?! I'm surprised your whole head hasn't exploded after the last few months -- heck, the last YEAR -- you've had! It's amazing how internal stress manifests itself in physical ways. Sucks that it's on your face, though, and not someplace you can cover with sleeves or cute tights or some such. You need to have a talk with your body. "Hey, listen here. When manifesting stress in physical ways, please pick locations that are more fashion-friendly. Thanks."
    I have no good advice about what to do about this, sadly. It's good news that the docs think this will go away. Unlike my stolen-curls. Which may never, ever come back.

  4. Oh honey.. this must suck. I second the Dr. in NOT putting make up or anything on this.. can you say throwing gasoline onto a fire!? ;o)

    Personally the worst I have dealt with is eczema (not on my face). My derm wanted me to use topical steroids which I tried many years ago but all they did was thin my skin and cause peeling. Awesome. Not.
    Fast forward a few years and there are two products I LOVE that, though they are for eczema I think they might work for this as well- worth a shot esp. considering the beans who are cooking. ** ASK your OB before if you use these- one is herbal!***

    At whole foods- Florasone cream. Active herbal is Cardiosperum. Works exactly like a steroid when diligently applied but it's not a steroid. Cool.

    Also- Four Elements- Look ma, no xema
    BUT it has a lot of NO-NO prego ingredients: Ingredients: Almond oil. pure water, beeswax, certified organic chamomile flowers, comfrey root, shea root, calendula flowers, comfrey root, shea butter, evening primrose oil, vitamin e and borax. 2 oz. jar.
    Maybe save that for use after the beans are born safe and healthy!

    Wish I could be of more help but I would def. look in to the Florasone as a possibility!

  5. Also- what about a THIN tiny layer of aquaphor? Just thinking....

  6. Ugh...sorry for the stress causing the face rot! I hope it goes away on it's own.

  7. nice... can you share your treatment?

  8. It all started after starting infusions for Rheumatoid Arthritis.I was misdiagnosed with seborreic keratosis. Given a steroid cream (Mometasone). Don't ever use a steroid cream for POD! Finally got into a Dermatologist and given the correct diagnosis of POD. Given 2 months of antibiotic, told to use Cetaphil cleanser and moisturizer only. Dr said it could be a month before I see improvement. improvement. It's been 2 weeks and it seems to be worsening. I was told to expect this because I'd used steroid cream for a year or so. We shall see. It's a miserable condition, at the severity mine is at. Please, don't use steroid creams:(