I don't want to brag or anything, but face rashes and I go way back. I've had perioral dermatitis (POD) for over 5 year, which makes me a particularly ancient breed of witch. Also, when I was a kid, I had a persistent rash along the sides of my nose, making me a particularly precocious breed of teen witch. I eventually "grew out of it," but based on I what know now, I think that nose rash was POD as well.
About 6 months after I started on 0.05% Retin-A, I finally got in to talk to my doctor about the perioral dermatitis. I came to the appointment armed with lots of Internet research and many deeply intrenched notions, because I know doctors love it when you do this. I planned this moment in my mind for years, and came into the appointment ready to battle.
When my doctor told me that I needed to try treating the rash with a low-dose steroid cream, my pupils constricted. I said, Doctor. Steroids make this worse. And she told me to only use a tiny bit. Like a dot on the pinky worth, and only on the affected area. And I said, But doc, I'm supposed to get an antibiotic for this. And she said that I had the rash for too long, antibiotics do not make sense, try the steroid cream for two weeks, then let her know what happens.
So I did.
And this is what happened:
I emailed my doc the evidence, and that my friends is how I go my first proper dermatology referral in a decade. So I guess the steroid cream did its job.
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This is the dermatologist's office. While you cannot see me in the pic, I can assure you I was beaming. |
INGREDIENTS:
- Metronidazole Gel 0.75% (MetroGel) (active: metroidazole / gel: carbomer 940, edetate disodium, propylene glycol, purified water, sodium hydroxide / preservatives: methylparaben, propylparaben)
- Doxycycline Hyclate 100Mg Capsules (active: doxycycline hyclate / inactive: lactose monohydrate, microcrystalline celllulose, magnesium stearate, gelatin, diacetylated monoglycerides, acetic acid, sodium lauryl sulfate, silicon dioxide, titanium dioxide, ferrosoferric oxide, butyl alcohol, propylene glycol, alcohol, fd&c blue no. 2, fd&c red no. 40, fd&c blue no. 1, d&c yellow no. 10)
- Doxycycline Hyclate 50Mg Capsules (active: doxycycline hyclate / inactive: magnesium stearate, microcrystalline cellulose, FD&C Blue No. 1, gelatin, silicon dioxide, sodium lauryl sulfate, titanium dioxide)
- Hydrocortisone Cream 0.5% (active: hydrocortisone / inactive: benzyl alcohol, glycerin, glyceryl monostearate, isopropyl palmitate, lactic acid, paraffin, polyoxyl 40 stearate, potassium sorbate, purified water, sorbitan monostearate, stearyl alcohol)
- Jojoba Oil / Tea Tree Oil (10:1 ratio)
- Aztec Clay Mask (as needed) (see my review + instructions here)
METHOD:
- Wake up, splash face with cool water, and dry.
- Apply a thin layer of metronidazole to the affected area (which for me was my chin and below my left eye, but I applied it all over my face because medicine is good).
- Apply some jojoba/tea tree oil as a "moisturizer."
- The doxcycline needs to be taken once a day, at the same time each day, with food, but not dairy. (Because breakfast is the meal that I am most willing to abstain from cheese long-term, I opt for morning doxy.)
- Decide that a banana is a meal.
- Throw up blue banana mush 15 minutes later.
- Adjust meal plan accordingly.
- Do your normal skincare routine at night, careful to avoid applying anything to the POD areas (except maybe oil).
- Repeat daily for as long as you can avoid breakfast cheese.
Are you ready for some good news, guys? Well, after about 1 week, the acne on my forehead and cheeks cleared. My doctor said that the doxy would take about a month and a half to start affecting anything, so this was a just freaking treat, y'all. I was using the 0.1% tretinoin at the same time, so that might have had something to do with it.
From the time I started treatment until my follow-up appointment at month 3, I did not experience any new perioral dermatitis flares. I wasn't applying anything to the POD areas except oil and the metronidazole during this time. At this point, my doctor recommended I stay on a lower dose (50mg) doxycycline for 6 more months, and that I can start easing in Retin-A on my chin, once per week.
After a few weeks on the lower dose doxy, my acne starts to get a bit worse, although I'm not sure if it's because of the antibiotic or due to other products I was testing concurrently. My chin doesn't seem to tolerate the Retin-A yet, so I stopped applying it there.
Toward the end of my lower dose doxy supply (60 pills), my skin is looked a bit smoother. I started using the clay mask once a week on days I wasn't using Retin-A. I also became very lazy with my pill popping. At the time, I told myself I was weaning off the doxy, when in actuality I missed my breakfast cheeses. I decided to not refill the prescription after the bottle ran out. In all, it was about 5 months of oral antibiotic treatment, which means I only did 55% the prescribed regimen. I'm a very bad patient, do not be me. I'm still using the metronidazole though, so that's gottta count for something.
Note: These pics only go to month 4 because I wanted to show the actual progress I saw. I started using other products during month 5 (MONTH FIVE IS TAINTED Y'ALL), so I will be posting those pics on their own with their appropriate product review.
Ultimately, I'd say this trial was worth it. Although I was not immediately able to apply whatever products I wanted to the POD affected areas, I haven't really had major problems since the doxy. And, bonus side effect, my acne improved drastically. I also have a proper protocol whenever my POD is being a PITA:
- Jojoba/tea tree oil 1-2 times per day (after I wash or rinse my face)
- Metronidazole every other day, or every day if it's flaring.
- Periodic clay/ACV masks on bad days (calms a flare almost immediately for me)
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PS: As I was putting this review together, I finally realized that my lip balm addiction could also be triggering POD flare-ups. I gradually weened myself off lip balm over the course of about three weeks. I did this by switching to a non-wax, non-petroleum based balm, then reduced the frequency of applying that. I'm now at the point where I apply lip products whenever, but I don't feel compelled to reapply every few hours like I was doing before. Although I didn't properly test this, I feel like it has been helpful for curbing my perioral dermatitis.
This is Part 3 of my 3 part Perioral Dermatitis Series:
Part 1: Guide to Perioral Dermatitis Part 1 - The Basics
Part 2: Guide to Perioral Dermatitis Part 2 - Treatments
Part 3: MetroGel + Doxycycline Review
And for the Acne Peeps: Visit The Acne Experiment MOTHER HUB
This is Part 3 of my 3 part Perioral Dermatitis Series:
Part 1: Guide to Perioral Dermatitis Part 1 - The Basics
Part 2: Guide to Perioral Dermatitis Part 2 - Treatments
Part 3: MetroGel + Doxycycline Review
And for the Acne Peeps: Visit The Acne Experiment MOTHER HUB
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MetroGel + Doxycycline Review :: Perioral Dermatitis Fiesta |
Hey I am fairly new to your blog but I am soooo happy you are doing this! Thank you so much for making me laugh, sharing your experience, and being very thorough.
ReplyDeleteAfter being to the doctor and NOT getting a referral to a dermatologist, (why is this so hard? Are they just NOT to be bothered?) I got prescribed Elidel Topical Cream which is mainly for people with eczema https://www.webmd.com/drugs/2/drug-22383/elidel-topical/details
Needless to say it worked for a week and then it came right back. Not as bad *looking* this time, but still itchy, burn-y, and irritating beyond all belief.
So far, I have switched from Cetiphil to using CeraVe for face wash and moisturizer/spf and after reading your posts I think I am going to switch it up for 2 weeks to some of the items you mentioned...and if all hell breaks loose – back to the doctor to see what else she can pull out of her magic bag. Hopefully something that is working for you so far.
Once again, Thank you so much!
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ReplyDeletethank you, your post is very reassuring. I just started today taking doxycycline and I didn't know I shouldn't take it with dairy. Lol of course there was cheese in my meal. Feeling good so far but I am nervous about getting any side effects.
ReplyDeleteI always wondered if my lipstick was irritating my POD. I guess I should find a lipstick that doesn’t include wax or petroleum. That should be a fun shopping experience! 😉 Thanks for the information!!
ReplyDeleteThank you so much for making me laugh about this shitty condition that keeps me depressed. I am now starting doxycycline and hoping for the best. Metronidazole hasn't done anything at this point :-)
ReplyDeleteAny updates on the PD? Have you had any flare ups since stopping the antibiotic?
ReplyDelete