My Journey with Perioral Dermatitis

I was once in your shoes, feeling defeated by my own body and tired of looking the way I did. I felt hopeless about the state of my skin and didn’t like having to use pharmaceutical creams on a long term basis. I missed being able to leave the house without feeling the need to use make up and I missed not having to worry about people thinking “what’s on her face?” when I was out in public. 

I wanted to feel like myself again and to be confident in my own skin. But let’s rewind a little bit to the beginning. 

Early Days

Fresh out of University I jumped straight into work in the financial industry with all of the ambition of a fresh grad. I did it all – I worked late and I was out even later almost every night at work events, building my network and enjoying all of the food and drinks that often come with industry events. It wasn’t until about 3 years later that everything seemed to catch up to me. 

Slowly but surely, I started to struggle with digestive distress including bloat and constipation. I didn’t think much of it until about a year later when my face exploded with what looked like mixture of eczema and acne. I later learned that this was a pretty severe case of perioral dermatitis. I immediately booked in with my doctor who had prescribed an antibacterial cream that is generally used to treat rashes. 

Perioral (periorificial) dermatitis is a red rash that circles your mouth. Your skin can be scaly, dry and flaky with swollen, inflamed bumps called papules...Perioral dermatitis can look like acne and is often mistaken for it.

- Cleveland Clinic

The Worst of It

After a few days of using the prescribed cream, I woke up to find my perioral dermatitis had completely exploded on my chin. It was also now creeping up around my mouth and even to my eyes! I was horrified. I was lucky enough to grow up with generally clear facial skin despite some eczema on my arms and legs. At least with the eczema I could cover it up but it was a completely different story having a very visible rash on my face.

I frantically booked into the first dermatologist appointment that was available that day. It was there that I learned one of the worst things you could do with perioral dermatitis was use an antibacterial cream on it. I was then prescribed a round of antibiotics and a different cream called tacrolimus ointment to help reduce the inflammation.

After a few days, the antibiotics and ointment worked their magic and the severity of the rash settled considerably. After I had finished the antibiotics, I still needed to use the ointment on a daily basis for maintenance. My skin still hadn’t quite returned to normal as there was still redness, uneven skin tone and some small bumps.

Let the Research Begin 

Things were undoubtedly improving, however I missed being able to leave the house without make-up and I was tired of using the ointment everyday. I knew deep down that there had to be a better long-term solution. I began to research perioral dermatitis as much as I could, and it turned out there wasn’t much information available.

Basically, all I could find was generic advice such as “don’t use toothpaste with fluoride or switch your face wash”. All of which I knew weren’t going to get to the root cause of my problem. Those were all topical solutions and I knew that there had to be more going on for my body to be responding this way – I was missing something. 

Expanding my Studies

With this in mind, if something was happening at a deeper level then it likely had to do with my diet. I had always had an interest in food and nutrition but somewhere along the way that got lost. So I decided that I would commit to my interest in nutrition and added to my degree in Honours Economics with a certification from the Canadian School of Natural Nutrition as a Registered Holistic Nutritionist and as a Culinary Nutrition Expert.

Finally Some Answers

Putting all of the pieces together, I took my own knowledge as a certified Nutritionist along with the guidance of a local Naturopath. I began to understand that our bodies often will display symptoms to signal that something is out of balance. Something that needs to be addressed. A few key takeaways that stood out to me were:

  • My detoxification pathways were congested
  • My gut health was a mess and there were serious imbalances in my gut bacteria
  • I needed to address my high levels of daily stress as stress shuts down digestion
  • My hormones (eg. insulin, estrogen) were completely out of balance

In other words, I needed to address what was happening inside my body before I could expect to see any change on the outside. 

Brighter Days

Taking into account what I knew, I then had a game plan to turn things around. As a Holistic Nutritionist, I view the body on a whole and acknowledge that the whole body is intertwined. My first area of focus was on rebuilding a solid foundation and that started with the foods that I was using to fuel my body.  So that’s where I started. I began with whole foods that were minimally processed, prioritized protein, boosted my intake of healthy fats and reduced my sugar intake significantly.

I did this alongside comprehensive gut health tests as well as completely adjusting my lifestyle habits to reduce my stress levels and support healthy hormones. I did also switch my creams and face wash to reduce any potential irritants on the outside to further support all of the changes happening on the inside. 

To put it differently, skin health can be complex and nuanced but by addressing how I was nourishing my body to create an environment that my body could thrive in was one of the biggest factors.

Nowadays, I am extra grateful for my clear skin. I haven’t had a breakout in years, I feel confident in my bare skin and I am glad to say that I’ve thrown out my tacrolimus ointment (!!). I firmly believe that clear skin is possible however it’s not going to start with topical lotions or creams. It needs to start from the inside. 

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Picture of Caroline Chow, R.H.N., C.N.E.

Caroline Chow, R.H.N., C.N.E.

Caroline is a Registered Holistic Nutritionist that was once in your shoes. She has struggled with eczema and a severe case of perioral dermatitis. She used to feel so hopeless and defeated - like her body was working against her.

Until she began learning about nutrition and the importance of viewing food as nourishment in supporting your skin health. She completely turned things around and now she is passionate about helping women find clear skin through diet so that they can swap the topical creams and makeup for a permanent solution to healthy, glowing skin!

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