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Vitamin Deficiency? Perioral Dermatitis?

Dr Rockoff,

Three and a half months ago I went to the doctor because of a sharp pain in my left eye and burning sensation in both eyes. I had a red dot in my left eye where the burning was, but the doc had no idea and perscribed plain eye drops to help lubricate. (I also noticed my face look really broken out and I had been going through a lot of stress at the time so it made sense)

Three months ago I started getting a burning sensation just above my upper-lip [mustache area] and some slight pinkish coloration as well... My lips were also extremely chapped [chapped stick did not work at all]. I also noticed dry skin on my penis... so I drank a ton of water for a few weeks and it seemed to go away on it's own after a trip to a more humid climate (had record low humidity (7%) here) ...I assumed it was dry weather because the burning seemed to go away as well.

I mostly forgot about this and was trying to lose a little weight I guess [mostly caffeine and carbohydrates] and was going through a lot of stress) -- also wasn't drinking much water... Late at night after not eating I would eat a bunch of sugar take some vitamin C and go to sleep (i guess my body needed glucose).. Also, a few times late at night while using the computer I felt some numbness/tingling in my fingers on the right hand and also felt like I had a problem with muscle control in my left hand.  (this went away after I slept) ..I was also getting really easily stressed-out  [found these are all symptoms of b vitamin deficiency, and the way to get it matches my diet and stress level perfectly)

I used an abrasive cleanser to try to smooth my skin out and got a little too rough. within a few days of that I began to notice a burning in my mustache area and also dry cheeks to the point where my normal cleanser [clinique for men] started to burn my face.  I switched to cetaphil facewash and started putting cetaphil lotion on and that seemed to help with the dry cheek feeling. Also, thinking it could be acne related I tried a diet that was mostly vegetables with some chicken, and absolutely no sugar, etc.

I had already made an appt. with the derma so I went ahead and went in thinking she would suggest it was just dry skin. (at this point I was not aware the symptoms pointed to vitamin def.)

(this was a month ago)  

I was diagnosed with perioral dermatitis and given 100mg doxy. once a day for a month and Klaron.  Over the course of treatment I felt as though the klaron was irritating my cheeks (where I didn't really have any issues until I started treatment, but was putting the lotion there anyway thinking it would kepe it form spreading).  One evening I put hylira, Mimyx cream, and then put Klaron on my skin and almost immediately my face swelled a bit and turned red in those areas (also felt some burning).

After a month of treatment I went to a second dermatologist who suggested she still thought it was bacterial and switched me to Noritate 1% after the incident with Klaron and wanted me to go on minocyclin 75mg/noritate for a month then return to check my progress. Two weeks into taking the antibiotics I started to notice the burning in my eyes was becoming worse as well.

In the meantime I visited the first derma and asked her about the potential for a tinea infection (i had a farm dog scratch my face before this started) because I was experiencing some itching and had read tinea barbea looks like a bacterial infection.  She thought it was worth a shot although I think she was placating me, and perscribed lotrimin pills/ciclopirox cream --

I had also started using the clinique for men because it was the only thing that seemed to make my face feel clean, as well as "born to be mild," a face-wash for sebhorreic dermatitis that I read may help with peri-oral. ...a week into combining the noritate with ciclopiroxolamine and putting that on twice a day, I noticed the areas where I had been putting these creams looked very red and when I got to work i felt burning (just like with the klaron)

...came home, washed it off, called first derma. and this time pointed out a few spots that felt bumpy but I assumed were acne from using creams..  (didn't have any of this before I went in for treatment)   (they look like white scabs)

This time she says she still thinks it's perioral dermatitis or possibly rosacea and I should baby my skin and perscribes doxy. 100mg TWICE a day (instead of once) and only mimyx cream on the face and a mild cleanser...

...It has been 1 1/2 weeks of taking a b 100 complex vitamin twice a day [the first two days i noticed a huge improvement] and no doxycycline.  my lips are no longer cracked and the sides of my mouth healed up in the first two days. What are the odds that I have dermatitis from a dietary issue and the treatment has simply worsened my condiditon? I know that tricycline derivatives deplete vitamin B. I have lost 24 lbs over the last month probably due to the anti-acne diet and maybe the b vit. def. ?


Should I be wary of starting on 100mg doxy 2x a day?

Also, I cried when I came home from the dermatologist and the places where my tears were on my cheeks actually feel really good right now [twice i've noticed this] -- Does that mean anything?

How can you know if this is sebhorreic derma. from vitamin deficiency and getting rough with a face scrub?  or the onset of perioral dermatitis/rosacea?  I'm scared that what I do next will effect the rest of my life...
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Avatar universal
1) yes
2) yes
3) intimate, but not sexual
4) I probably did, it was clinique face wash for men
5) antibiotics of all types for about 6 months made it worse if they did anything
6) Tried 100% natural for awhile, just got worse

Eventually treated it myself by washing in the morning with all natural Tea Tree (2%) face soap (Thursday Plantation) followed by a topical application of 75% moisturizer (Hylira 0.2%), 15-25% Ketaconozole (2%) foam and 0%-10% Benzoyl Peroxide (2%) Proactiv Lotion when needed.   (Daily) -- I should point out the successful regimen suggests Seborrheic Dermatitis with [some] abnormal symptoms.  If you are male I would urge you to try an over-the-counter anti-dandruff shampoo daily as a face-wash for a week and talk to your dermatologist about a more aggressive treatment if you notice an improvement.  There may be subtle symptoms on other parts of your body that you weren't aware of such as: Your back, chest, belly-button, genital-area and area just above your tail-bone may be red, itch, or burn.


In the beginning, I had to wash with the same face-wash at night, which I followed with a very light application of Klaron and Hylira 2%, but eventually phased nightly-washing out as it seemed to be overly-irritating once the initial outbreak had been controlled.

Burning is 98% better, sometimes noticeable during stress.  Dryness is only noticeable a few times a month.  Bumps are completely gone, but do appear on my nose a bit more now that I don't wash at night.

I suspect it was a combination of hormones, the dry climate where I live, stress and possibly returning from an extended vacation in a more humid climate...  
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Avatar universal
I have similar symptoms as you and have tried tons of products and here are my questions and suggestions:

1)  Were you getting less sun (winter?) when you noticed the symptoms?
2)  Were you going through any unusual or difficult stress prior to the dermatitis?
3)  Had you engaged in any sexual exchange that could have transferred bacteria or yeast prior to the symptoms?
4)  Do you use a soapy shampoo or face wash with Sodium Lauryl Sulfate?
5)  Tetracycline may help you temporarily until you find the cause.  --REMEMBER all universal laws operate with cause and effect.

6)  visit:  http://www0.epinions.com/content_966500484

Mahalo.
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Avatar universal
P.S. the white scabs are on my nose -- where I was never having any symptoms
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Avatar universal
I also ate an absolute ton of Tums-Tablets [10 or so] one evening after not eating throughout the day (probably tasted the sugar in them).  Low stomach acid was related to rosacea in a study I read.
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