Perioral dermatitis journey: the wonder drink, the comeback, the staph infection and the clear up

IMPORTANT: I have not been paid to talk about or share my story. I am a journalist and this article is an honest account of my experience. Nothing in this article should be considered medical advice. You do you. 😁 There are NO affiliate sales links on this page. For an ever-updated list of products and tools I use for my skin, read here.

Get comfy - this article spans EIGHT years of my life 🤣

For the most part of three years, my face felt like it was on fire.

From September 2014 until July 2017, I moaned, whined and cried regularly about a dry, scaly and sore rash that persisted on my chin, either side of my nose and the area above my lip.

It looked a bit like goosebumps and although it wasn't even too noticeable to others, for me, it was physically painful, felt hot and as though it was burning to the point where it became difficult to concentrate on anything else.

Early days: Hard to capture on camera, clusters of painful skin-colored bumps that made my face feel like it was burning

As a TV presenter & journalist, I would apply thick foundation to cover the rash before filming.

I felt miserable when I touched my face, and the wonderfully gentle make-up artists at work were phenomenally patient with what had become a rather tricky routine to get me camera-ready.

This random and unexplained rash had quite literally appeared out of nowhere, sparking what would become years of detective work on my part, trying to decipher what had caused it and why it wouldn’t shift.

In the beginning, no theory was too farcical.

Was I having a reaction to some kind of chemical in my make-up? I switched foundations and powders immediately.

Was it something in the tap-water? I bought a filter.

Was it the flouride in my toothpaste? I threw it out and bought a natural one.

What about chemicals in my hairspray? Chucked it and got some organic ones (naively thinking organic must equal less allergenic, and also assuming this was an allergy).

Was I reacting to something I was eating? I eliminated all my favourite foods and began reintroducing them slowly over time to see if i could spot a change in the rash.

Was I allergic to my new boyfriend or something on him? He stopped using his skin products and began close-shaving his face to minimise any stubble irritation when we kissed.

The questions never ended while the rash continued to swing between states of stubborn and angry.

In hospital having allergy tests for different chemicals to try and find the cause of the rash

During those three years, it’s possible to say that I spent more time thinking about what was wrong with my skin than I thought about anything else. 

I visited several doctors, including three top dermatologists and an allergy specialist for comprehensive skin tests. Those patch tests revealed allergies to methylisothiazolinone, methylchloroisothiazolinone, Finacea gel (containing 0.15 gm azelaic acid, which had ironically been prescribed for me as part of treatment for the rash), limonene, linalool, propolis and beeswax. A breakthrough, or so I thought. However, quitting each of those substances made no difference to the rash over time.

The medical consensus was that I had a case of perioral dermatitis.

The cure? There wasn’t one. I could take antibiotics to manage it (sometimes this cleared it up in patients permanently, I was told) and use some creams, but other than that - I was on my own. 

I used a variety of medical creams - ranging from immunosuppressant (Elidel pimecrolimus cream,1%) to anti-inflammatory (Differin adapalene 0.1% retinoid), and I took multiple courses of oral antibiotics (tetracycline and doxycycline) and even oral steroids (prednisolone) in the early stages. But the sore dermatitis always returned.

Meanwhile, that new boyfriend I mentioned earlier had become my fiancé and in the run up to our wedding, I was on yet another course of antibiotics to try and calm the perioral dermatitis before the big day.

I kept imagining how our wedding photos would forever show us on our special day with my face bearing a dry and flaky rash covered by layers of foundation that would surely start crumbling away as the day went on.

It was around this time that I heard about the benefits of a fermented drink called kefir.

It’s choc full of beneficial bacteria understood to help heal the gut and can be helpful if you’ve been on antibiotics like I had.

I hadn’t heard that kefir could be good for the skin at this point. I was just looking to help repair my gut from taking so many antibiotics.

After some research, I found a company in Wales, that produced goat's kefir and spotted that the website also carried testimonials from people saying their skin rashes had improved after drinking kefir daily.

According to the company’s founder, Shann Nix Jones, in her book ‘The Good Skin Solution’:

I drank a glass every morning on an empty stomach

“Our skin is really just a map of our gut. 

“Heal the gut, and eczema, psoriasis, acne and rosacea will diminish.

“It takes time but it will improve.”

Shann warned me that, with a case as chronic as mine, it could be at least nine weeks before I see any kind of improvement.

It was going to be a long game but I had nothing to lose. 

I began an experiment to see if this sour drink could, as I understood it, boost the diversity of good bugs in my tum to crowd out the bad bugs that may have been the underlying cause of the stubborn rash on my face.

As advised, I drank it first thing every morning so that those clever little bugs could cling to my gut wall before I ate anything else. 

Our wedding day in 2017, after yet another course of antibiotics to suppress the perioral dermatitis

At the start, I was still on antibiotics to rid my skin of its worst bumps in time for my wedding. Thankfully, the drugs temporarily suppressed the inflammation enough for me to stop thinking about my skin for that one day.

After the wedding, I threw myself into my new kefir regime.

I was so committed, I even sourced a brand of goats kefir while on honeymoon in Hawaii so I could keep up the protocol (special thanks to my husband for bearing with me while I got an Uber to the other side of Honolulu and back). The kefir didn’t taste the same, likely not the same potency, but I wanted to keep doing what I could to help my gut bugs.

Applying make-up is a stress-free experience now

Here’s what happened next:

Results

• By week 11: the dermatitis had improved.

• By week 14: it had totally disappeared.

• At about 18 weeks: there was a relapse in inflammation. I also quit nutritional ketosis, drank slightly more kefir and maintained a low-sugar lifestyle.

• At six months (approx 24 weeks) skin felt better again.

• **Skin stayed clear from then on**

It's now been 14 months since I began drinking the kefir and I can only say my skin has got better and better, with no trace of the old perioral dermatitis.

Needless to say, I continue to drink this stuff every day.

Psychobiotics?

Skincare aside, Shann's book, ‘The Kefir Solution,’ puts forward a case for the potential effect of kefir on mental health and digestive issues too.

She explains that IBS, depression and anxiety are all connected.

"You may go to the doctor and be told that you have a lot of different problems: IBS and depression and eczema and allergies.

"You don’t. You have one issue: microbiome damage.

My very unscientific skin experiment may have been one of the best things I ever did

"Heal your gut, and these symptoms will all resolve together."

In this way, according to Shann, kefir is a ‘psychobiotic’ - a new term for a "combination of live organisms that, when ingested in adequate amounts, produce mental health benefits."

Hear Shann talk all about this fascinating subject in healthHackers™ episode 14. 

Conclusion

My very unscientific skin experiment may have been one of the best things I ever did. I still wonder if it was all a big coincidence. It seems unlikely though.

It’s worth mentioning that during the rash years and the recovery stages, I experimented with red-light therapy and hyperbaric oxygen therapy, although not to the same degree of persistence as the kefir drinking.

I was also in nutritional ketosis (a very low carbohydrate and super high fat lifestyle) for the most part, which some experts suggest could contribute to a less diverse gut microbiome.

Could this way of eating have caused an imbalance within my microbiome, triggering the rash on my face? I can never know.

At the same time, it's said that kefir works best when you reduce sugars in your diet (you don’t need to be in ketosis though) and at the time of writing this, I haven't eaten sweets since an anxiety wake-up call and some hypnotherapy in 1998 - true story!

I’d love to see some major clinical studies carried out on fermented foods like kefir and learn more about their potential for skin healing. 

I wish I had known about this drink a year before my wedding. But never mind, I'm happy I was able to enjoy our one-year anniversary without perioral dermatitis.

And, to be clear, I have not been paid to talk about or share this. I am a journalist and this article is an honest account of my experience. 

Have you had success with probiotics for skin complaints? Tell me, I want to hear!

Update, Sept 2020 - I moved to America (where I cannot access my ‘magic’ kefir)

It’s been nearly three years since the dreaded perioral dermatitis vanished during my kefir protocol. I have had so many moments of sheer gratitude in that time; feeling so happy to no longer be living with burning discomfort on my face. I became such a fan of Chuckling Goat kefir, the company even sponsored an episode of my video and podcast series; healthHackers®.

However, there have been a couple of significant developments since I published this original article - which is why I am writing this update.

Firstly, I relocated to the USA from England in 2019 (one year ago), and unfortunately that meant I could no longer purchase Chuckling Goat kefir as the UK-based company cannot ship internationally. As you can imagine, I was very concerned that without this seemingly magical drink, my rash might return.

I relocated to California from England in 2019

I suspected that opting for a regular American store-bought kefir would not be an exact match for the sour-tasting straight-from-the-farm one I’d been drinking daily in the UK. So, Shann suggested I make my own. I’m pleased to say, I’ve been doing so for nearly a year now here in California and I’m very proud of my kefir batches! I use goats milk and live kefir grains for the fermentation process. It still doesn’t taste as potent as Chuckling Goat kefir, but hey - I just have to make do.

Secondly, about a month ago, something unexpected happened. I began to feel small bumps of congestion around my nose and mouth. No burning, itching or flaking - just bumps. I was pretty alarmed (bear in mind that this was how the perioral dermatitis began all those years ago).

I’m flummoxed as to the cause. Is something up with my gut microbiome? Is my homemade kefir not good enough at the job of maintaining ‘good’ bacteria in my gut? Are the bumps because of my new face products, increased use of sunblock (California sunshine now!), wildfire smoke (it’s the season), an over-sanitized lifestyle and mask-wearing in the COVID-19 world? If you think of anything else, email me and I’ll add it to my rumination list… ;)

When I think back to the miserable era of the rash years ago, I remember being told - by one of a number of dermatologists that I visited for help - that I might just have to “manage” the perioral dermatitis going forwards… so potentially, for the rest of my life. I feel hugely thankful that I unexpectedly found a solution by way of a sour-tasting fermented drink that appeared to work for me. I don’t take this for granted and I appreciate that the same course of action might not work for others.

Clinical nutritionist, Jennifer Fugo, who specializes in skin conditions such as eczema, psoriasis, dandruff, rosacea and chronic hives, told me:

“It's unfortunately not always so simple of a solution for people, and perioral dermatitis is particularly a pain and hard to deal with.”

If the perioral dermatitis returns with its full, painful, burning, itching, miserable wrath - I will add another update to this article.

Update, October 2020: It’s back.

The POD came back approximately ten months after I stopped drinking Chuckling Goat kefir

I have a couple of investigations underway with my new USA doctors, including gut microbiome stool testing and anti-demodex mites prescription skin cream.

In a few months time, I shall log my progress and findings within this article (to keep it all in one place) in case my experience is helpful to any of you, even if just for the sake of comfort in knowing that someone else can relate to how you’re feeling right now if you’re reading this during a flare-up. I’ve been posting updates on my Instagram Stories and Highlights, if you want to know more in the meantime.

Nov 2020: During the Thanksgiving break - I was hiding at home with a red raw face

Another update (already!), November 2020: This article is turning into my skin diary!

My dermatologist prescribed me a skin cream that is meant to kill demodex mites. Read why demodex mites may be a cause of PD and rosacea here.

The cream was called Soolantra (Ivermectin). Unfortunately, it seemed to make my rash worse and new patches of red skin popped up on my cheeks. I assumed that was demodex ‘die-off’ having read many user reviews.

However, after 15 days, the itching was almost unbearable.

This was just before Thanksgiving and I managed to get a short-notice appointment with a different dermatologist (mine was on leave).

She took one look at my face and told me I’d likely had an allergic reaction to the Soolantra cream. And that’s not all. Sadly, the reaction had developed into a staph infection and impetigo - on top of existing dermatitis. A quadruple whammy!

I lost a lot of sleep (it’s impossible to lay still with a face that feels like it’s on fire with a thousand bugs crawling all over it).

The rash itched like nothing I’ve ever known

I cried, probably daily (and was unable to comfortably hug my husband in these emotional moments because his chest might accidentally touch my irritated cheeks covered in greasy prescription ointments).

I hardly left the house because the idea of wearing a scratchy mask on top of such inflamed skin made me want to vomit from sheer discomfort.

However, the infection and rash did heal after taking oral antibiotics (Cefalexin) and using a steroid cream, along with anti-inflammatory supplements and a focus on good nutrition.

I didn’t want to take oral antibiotics for the infection at first (who does?). I’d just begun seeing an integrative doctor here in San Francisco to try to repair existing damage to my gut microbiome after a gut analysis stool test revealed work to be done - so I didn’t want to cause even more dysbiosis.

But, needs must. That’s what emergency medicine is for. Thank God we have it.

Update, December 2020: I am typing this with calm and comfortable skin!

After medication cleared the random staph infection, a sore redness returned to my cheeks and the dermatologist suspected that I now had rosacea - a life-long skin disease, she told me. I wondered if I would now have to learn to live with both perioral dermatitis and rosacea. Ugh.

I continued working on optimizing my gut microbiome with an integrative doctor here in San Francisco, was blood tested for nutrient levels that could potentially impact the skin (I was found to have low serum vitamin A, for example), maintained healthy eating, took certain supplements to correct or optimize nutrient levels, and started new pre and probiotics - shoutout to Skinesa, Megaspore and Klaire Labs. Reminder: I earn nothing from naming these brands within this article.

Dec 2020: My skin is finally calm! Not wearing any foundation on my lower face in this picture, just a lightweight tinted SPF and a bit of powder bronzer

Thankfully, I found a cream that finally calmed the red, itchy and dry skin on my cheeks. It was a baby lotion with aloe vera and colloidal oatmeal called Live Clean Baby Eczema Cream. I discovered it while shopping in Whole Foods one day. It made a huge difference for me. I make no money from mentioning this cream either.

Additionally, I listened to a lot of Dr Joe Dispenza (on the neuroscience of rewiring your mind) after a tip-off from a doctor friend in the UK. I spent time everyday trying my best to get the hang of meditation and positive visualization (I’m still working on this), plus praying. 🙏

So, here we are a month on and I feel incredibly grateful for this improvement. 🤗 Everything is a work in progress.

It’s remarkable how significantly skin issues can affect your psychological well-being, even with my familiarity with previous allergies, rashes, and chronic perioral dermatitis.

I found the @healthhackers Instagram community to be wonderfully supportive though. To all of you who followed my skin updates and sent messages, suggestions, and shared experiences - THANK YOU. It meant a lot. ❤️

Photo taken July 2021 when pregnancy vomiting and nausea settled down enough for me to be able to make an effort for the camera with makeup and a smile 🤣

Update, September 2021- another life development!

My skin kept getting even better over time! I’m absolutely thrilled with it. I also became pregnant (!) a few months ago and have been experiencing the softest skin I’ve ever known. It must be something to do with pregnancy hormones. 🤷‍♀️

I stopped using the Live Clean Baby Eczema Cream that I found in Whole Foods previously mentioned in this article. I opted for a couple of moisturizers by Vanicream instead. I’d begun pH testing my skin products after discovering that a higher pH level can lead to changes in the skin’s microbiome and potentially worsen some skin conditions and infections (like staph), so I wanted to make sure I didn’t use products with too high a pH. Here’s an article I put together with expert quotes from multiple dermatologists who gave me their input on the topic of skincare pH values.

Additionally, I reviewed a new skin laser device on the healthHackers® channel, which I still use on my face (although not daily). See my video review of the LYMA laser here.

And, from February to around mid-May of 2021, I was reviewing the ZOE personalized nutrition app with an emphasis on gut microbiome health and blood sugar balance, so I was eating foods that were hopefully helping improve my microbiome health and ‘good gut bug’ diversity. See my two-part review of the ZOE experience here - and then here.

Last update (I promise), August 2022

Nearly a year on from my last entry in this article. And EIGHT years since the journey started. My skin is still great - hooray! Plus, I had my baby!

Aug 2022: My baby, Beatrix, and me. I’m not wearing foundation on my skin in this pic. Just a tinted SPF cream and some blusher/bronzer.😊

It’s time to end this article for good. My skin journey was an epic one. At the start, I assumed it was all about what I was putting on my skin. Now I’ve come to believe in the importance of what was going on inside my body much more - my gut microbiome health, blood nutrient levels and hormones, for example. I still don’t have total clarity on what exactly caused my past issues. I likely never will.

The way in which gut health is connected to symptoms that show up on our skin (a.k.a the gut-skin axis) is an area of scientific research that’s growing. I have an app (mentioned earlier) that I have used to help optimize my gut microbiome health from a dietary perspective. I reviewed it on healthHackers® last year and interviewed one of the scientists behind it. I have linked to that app on this page, along with a list of some of the skincare products I currently get on well with, plus explanations of why I use them with some links to Amazon and other purchasing platforms that I have affiliate arrangements with (you’ll see a disclaimer explanation when you click through). I’ll keep that page updated with my products over time. I wanted to keep this original article free of any direct affiliate sales links. It’s about my story and my experience.

If you’re still reading this, it probably means you’ve been suffering with your own skin story. I’m sorry. I truly hope yours is short-lived.

Thank you for your time in reading right to the very end! 🙏 Here’s wishing you healthy skin and happiness in your own journey. I really do mean that.

To follow on Instagram, tap here 👉 @healthhackers

For my YouTube channel (to see reviews, interviews and my trials with various wellness products, including some for skin and hair), tap here 👉 @healthhackers

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Read: Why I’ve Been pH Testing My Skincare Products

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