Perioral Dermatitis, folliculitis

[pisces12]

About 2 months ago, I was diagnosed with perioral dermatitis after using Nasonex nasal spray. The theory is that a year plus use of the spray may have caused it to get on the area around my nose and cause the perioral dermatitis.  I promptly stopped the spray and have not touched it since.  I know that sometimes people prescribe antiobiotics for perioral dermatitis but I am prone to candida infections so did not want to be placed on antiobiotics unless totally necessary.  I went to an integrative dermatolgist and she prescribed me ketoconazole cream to use on my face and the rash improved although it does wax/wane. It got particularly bad on one weekend around the same time that I also got a vaginal yeast infection.  Could that be connected and is perioral dermatitis a fungal infection?  I went back to the dermatolgist last week and explained the situation to her.  At the same time, I also had a few ingrown hairs on my bikini line from waxing which were causing some itching.  The dermatologist said that I have folliculitis and then upon further examination said that she also saw some in my nose.  She prescribed me bactroban and told me to swab that in my nose and also use it on my face instead of the ketoconazole cream.  I looked in my nose when I got home and saw that I have some little white bumps inside.  I don't know if that's from sinusitis and the discontinuation of the nasonex or is that a staph infection?  I'm sorry for all of the questions but I'm very confused about all of this.  I had beautiful skin before and never had any major problems.  The ketoconazole cream seemed to be helping and I don't want to switch to the bactroban if it's just going to make things worse.  What do you think?    Any information you might have would be greatly appreciated as I don't want to use anything unnecessary that could further damage my health.

Thank you,

Chrissy

[Deanie07]

I was diagnosed with perioral dermatitis a few years ago and rosacea.  I have been keeping a diary of what I eat trying to make some sense of it all.  I have been off wheat and gluten products since July and have been much better.  However, this morning after eating my usual, I started getting red around my mouth and up one cheek.  Then it occured to me that I had used Listerine mouthwash this morning and have been using it off and on with this cold.  Viola!  I think it may be the key!  I would sure look at any products I use in my mouth or on my face.  I can't use fluoride toothpaste either.

Nadine

[Alan Rockoff, MD]

Forgive me, but it really doesn't make a lot of sense to see a dermatologist in person and then to put a series of questions to someone who's never seen you.  Getting perioral dermatitis after a year of nasal steroids certainly makes sense.  In my experience a month or so of oral antibiotics usually ends the problem altogether.  You might want to talk to your dermatologist about compromising your principles a bit on this matter in hopes of getting rid of the issue.  Looking into your nostrils and doing internet research are not, however, likely to help.

Best.

Dr. Rockoff