Several years ago, I noticed small bumps around my mouth. Smaller than acne, but similar in appearance. At first just a few bumps, but it got progressively worse. After looking at some pictures on the internet, I saw that it was perioral dermatitis (aka muzzle rash). I read that steroid creams can cause it, but I never used those or any other steroid treatments before the appearance of the problem.
Treatment by Dermatologist
After a few years, it got bad enough that I went to see a dermatologist. He prescribed a low-dose steroid cream which was mixed with sulfa. This cream was relatively expensive ($50) because it had to be made at a compounding pharmacy. This cream helped a little, although I was not thrilled with the thought of putting steroid cream on my face indefinitely. Then, he prescribed doxycycline (an antibiotic which you have to take for several weeks), which gave me severe abdominal cramps. But it did clear the perioral dermatitis.....for awhile. About a year later I tried the doxycycline again, hoping that the abdominal cramps would not return, but they did.
Alternative Treatments
I then turned to some alternative remedies I found in various places on the internet. I tried them all at the same time, and I have not experimented by stopping and starting the various remedies to see which are working. It could also just be coincidence that my perioral dermatitis cleared up. I do still get a very occasional bump that clears up within a couple days. I have no hard evidence any of the alternative treatments are effective.
The remedies I am using are (in order of perceived effectiveness):
- I wash my face with antibiotic liquid soap, such as Neutrogena Oil Free Acne wash (although I usually buy the generic).
- Before I go to sleep, I wash my face, and I do not apply any moisturizer, astringent, or anything else. This took some getting used to, because sometimes my face feels very dry. But it does seem that every once in a while when I try to use a moisturizer, I get a bump the next day. And I've tried several different moisturizers.
- I stopped using petroleum jelly to moisturize my lips at night. Instead, I use a non-petroleum based lip product such as Burt's Bees. During the day, I still will use a petroleum based product on my lips, always something containing sunscreen.
- I always wash my face after I brush my teeth, to make sure all toothpaste is cleaned from around my mouth. I also switched to toothpaste which does not contain sodium laurel sulfate. So far, the only toothpastes I have found are Biotene (a dry mouth toothpaste), and Burt's Bees. They are both expensive.
- I use astringent before applying any sunscreen or makeup. Specifically, I use Clean & Clear Deep Cleansing astringent.
- If I notice a bump, I dab it with a solution of 50% purified water and 50% apple cider vinegar.
- I try to eat more yogurt.
More Information
Here are a couple articles on the condition:
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002426/
http://www.webmd.com/skin-problems-and-treatments/guide/perioral-dermatitis
