Hi doctor, I am suffering with some skin disease. I am pretty sure it is perioral dermatitis, but it could be something else. I have tried steroid creams, Cetaphil cleanser and Spectro gel. But, nothing has changed and I think it has only made it worse. I have also tried to leave it alone. I cannot afford to see a dermatologist to get proper diagnosis and treatment plan. But, still I would like to get it treated. The most recent thing I have tried was Nelson's Calendula. It is a cream and on the internet many people said it worked and it went away completely. For me, I have not had any luck still. My issue is that, some days it looks less intense and it is getting better and sometimes it just feels like it is never going away. I have attached photos here for your reference. Is there any product I can use to clear this up or at least most of it? Ever since I got this thing on my skin, I cannot go outside. The corners of my mouth are inflamed, but it does not look red. The bottom of my mouth has bumps, it almost looks like pimples and acne scars. I feel I have only got one shot to do this. I am trying to explain as detail as possible. If you can possibly list something I have not used that you think may work I will even appreciate that. I am just taking a shot in the dark here. Please help. Literally any advice on my skin situation would be great.
Hi. I have read your concern and understand your problem. I have gone through your photos (attachment removed to protect patient identity). 1. Activation of the innate immune (genetically determined) system. 2. Epidermal barrier dysfunction. 3. Altered cutaneous microflora due to the application of multiple medicinal products like topical steroid, steroid inhaler, cosmetics, fluorinated toothpaste. 4. Neglecting to wash the face and hormonal changes. 1. Steroid rosacea. 2. Perioral dermatitis. Perioral dermatitis. 1. Taper the topical steroid cream use. Also, stop using other cosmetics and sunscreens. 2. Do not stop the steroid cream suddenly as it may lead to flare up. So, just replace it with less potent cream. 3. After tapering the topical steroids, I suggest liquid or gel sunscreen like suncross soft gel SPF 50+. 4. Also, I would like to suggest capsule Doxycycline 100 mg once daily for four weeks and apply topical 0.03% Tacrolimus once during the night. 5. Do not use soap. Instead, use face wash with warm water to clean the face while the rash is present. Avoidance of topical steroids and occlusive face creams. Revert back after a month to a dermatologist online.--->