A stubborn case of perioral dermatitis that just would not quit

I had this client come in about nine months ago with what looked like a simple rash around her mouth. She'd been using a new toothpaste, so we thought it was a contact thing. I gave her a gentle routine, cut out actives, the whole deal. It cleared for a week, then came back worse. I mean, we tried everything I could think of: switching to a zinc soap, fungal acne protocols, even cutting out all oils. It took me six full months of tweaking her home care, trying different calming serums, and finally getting her to a derm for a short course of prescription cream to really get it under control. I've never had a skin condition take that long to pin down before. Has anyone else dealt with a perioral dermatitis case that just seemed to laugh at your usual fixes?

2 comments

2 Comments

uma_reed261mo ago

What did the derm end up prescribing for her? I've seen a few cases where the usual calming stuff just makes it angrier, like the skin barrier is totally shot and needs that medical nudge to reset.

noahcampbell1mo ago

Honestly, they gave her this super gentle steroid cream, like the weakest one they make. My skin would probably laugh at it and ask for something stronger, I've messed my barrier up so many times trying every product under the sun. I once used a "calming" mask that made me look like I had a bad sunburn for a week. So yeah, I get needing that medical reset for sure.