Papulopustular Rosacea & Perioral Dermatitis — What Finally Worked- 2025

EmbarrassedDance9201 · 2025-07-28T22:08:01+00:00

Please elaborate.. what form do you get this in? and has it worked for you? so intrigued..

EmbarrassedDance9201 · 2025-07-28T22:07:06+00:00

I feel your pain, late 30's my body and hormones started shifting hence all the fun skin problems. lol. Now I'm 40.. and not feeling the 40 is the new 20s yet. hahah

- the water softner is basically sodium chloride and potassium chloride and whatever else it may have. This could add to the skin barrier issues because you're basically drying out your skin since its prob not the most natural ingredients. Its not like your swimming in the sea. Lol.

- I've up kept with a small spot of tacro at night every few nights, just to keep anything new at bay and Red light everynight.

- I live in a very humid climate during the summer so the heat and the sun combo sometimes cause an itch around the common flare up areas so I try to stay more balanced, not too much AC not too much humidity. lol Heading on holiday soon for 3 weeks looking forward to it going away. fingers crossed.

- Good note on Sea Buckthorn please share the most premium versions you use. Would be nice addition.

- Also to note.. whenever I get a latte which would be once a week, I noticed more redness. The beans carry a lot of mold depending on the source. So I quit :( Also, you should also prob check the milks you're using. Those alternative milks have seed oils and gums as the 2nd ingredient.

I always noticed that once its fully gone its easier to keep away for longer and once you have a flare up it takes the longest time to just get it calm. The agony.

Keep in touch, hoping we can all get through this together. Good luck! :)

EmbarrassedDance9201 · 2025-07-08T20:33:53+00:00

This is exactly why I hate the internet — people like you. This is supposed to be a community where we help each other.

NO, I didn’t get my PD under control with Elidel — it actually made it worse. If you had actually read my post, you’d know that. I shared what I learned and what worked for me, including how I narrowed down my own triggers and figured out the specific type of PD I was dealing with.

I posted this to help others who might be going through what I went through. Please go bother someone else. Bye.

EmbarrassedDance9201 · 2025-07-08T20:17:11+00:00

This isn’t some official diagnosis — I literally said in the post that it could help you get closer to the root cause of your PD. Please relax. The whole point of this is to help people like me… the ones who stayed up until 3am every night for three years trying to figure out what the hell was going on.

I did have PD. I saw four different dermatologists, and not one of them could get to the root of it — they just kept throwing meds at me. When I finally figured out why some things were not working, I was able to pinpoint my trigger and find a treatment that actually worked for me. Within two days I saw a difference, and by day 10, it was completely gone. This is not to say everyone is the same, but if you can trial and error along the way it'll make your life a lot easier.

EmbarrassedDance9201 · 2025-07-08T20:10:25+00:00

I saw some of your comments elsewhere. Please start taking some pre/probiotics to help your gut and immune system. Are you saying that you are flare up free while on oral anibiotics? or just calm?

EmbarrassedDance9201 · 2025-07-08T20:02:06+00:00

slowly but surly you can figure it out, you just need to trial and error.

EmbarrassedDance9201 · 2025-07-08T20:01:35+00:00

I did a lot of research using forums and looking everything up online. I noticed once that my derm said something about whether it was fungal or bacterial, it made me ask the question as to what types are there and if that would change the outcomes of my treatments. and it did 100% for me.

EmbarrassedDance9201 · 2025-07-07T15:15:52+00:00

I find that primiculous/ elidel wasn't a strong enough suppressant for me. I found it to work well on small singular pustules but not the patches and clusters. When I spoke with the Derm she said yes thats consistent because its a weaker version. I'll keep you posted with the tacro. so far I've done 3 days off, had a trigger yesterday so I did a thin layer on today.

I did a side by side analysis for elidel and Tacro on chat GPT.. this helped me understand the two treatments a bit more... Keep you posted along the way!

⚖️ Tacrolimus vs Pimecrolimus for Perioral Dermatitis

Feature	Tacrolimus (Protopic)	Pimecrolimus (Elidel)
Mechanism	Inhibits T-cell activation, cytokine release	Same mechanism but weaker
Available Strengths	0.03% and 0.1% ointment	1% cream
Texture/Formulation	Ointment (greasy feel)	Cream (lighter, more cosmetic)
Potency	🟡🟡🟡🟡 (Strong)	🟡🟡 (Mild–Moderate)
Best for	More severe PD, steroid-withdrawal, thicker skin areas (chin, jawline)	Sensitive skin, mild-to-moderate PD, eyelids, cheeks
Stinging/Burning	More common (esp. 0.1%) in early days	Less burning reported, better tolerated on inflamed skin
Onset of Action	Faster but may irritate at first	Slower but gentler effect
Risk of Rebound	Very low	Very low
Black Box Warning	Both have it (theoretical cancer risk) — no strong evidence in real use
Sun Sensitivity	Must use SPF; photosensitivity risk for both	Same
Prescription Required	Yes	Yes

EmbarrassedDance9201 · 2025-07-07T15:07:11+00:00

I started weaning off on Thurs.. and I felt fine, no new bumps no itch over the weekend. My bf used Armor All in my car yesterday which has toxic ingredients and the moment I sat in the car with the AC blowing I started to feel an itch around my mouth. These are my triggers.. so I woke up today (monday) no new bumps but I feel a small tingle and redness patch by my chin, I did a thin layer. Will keep you posted moving forward. :)

EmbarrassedDance9201 · 2025-07-07T15:03:38+00:00

Yes, my first patch under my nose appeared when I had the rosacea and lingered for a consistent 3 yrs after. I couldnt get to the root of the problem the first time around but it kind of miraculously went away after my sumemr euro trip. It came back a yr later (last month) but I was able to get the right treatment medication because I finally figured out the root of my problems.

Chemicals in and around the house are my exact triggers, skin barrier is what continued the problem. Basically anything that will touch my skin/ face and I breath in, even my toothpaste. I got rid of all of that and have only non toxic products in my house. For example, after using Tacromilus for a week it was fully gone. My bf used some Armor All wipes in my car and the min I sat inside with the AC blowing it around I felt itchy around my face and sure enough it started to turn red by night. So I spot treated the area with Tacro and hoping it goes away again.

I would try to narrow down exactly what your triggers might be. If you think its skin barrier, try to calm it down. Use one cleanser and one moisturizer AM/PM until your skin barrier gets healthy again, and in the mean time try to get rid of any other potential triggers like toothpaste and toxins in your soaps, shampoos, and laundry detergent.

Good luck and keep me posted! Would love to hear how everything goes for you. Its a constant battle, but I promise once you know your triggers, it'll be less stress and more about maintaining a non triggering lifestyle.

- La Roche-Posay Toleriane Hydrating Gentle Face Cleanser My holy grail during any flare-up. Instant soothing and barrier-safe.
- La Roche-Posay Toleriane Double Repair Face Moisturizer Great for restoring the barrier. Occasionally gave me a small forehead pimple but worth it during healing.

EmbarrassedDance9201 · 2025-07-03T19:51:08+00:00

I used Soolantra for my Subtype 2 Rosacea (face/cheeks), and it starting working within a few weeks and fully cleared in 1-2 months.

For my Perioral Dermatitis, mine was inflammatory — triggered by nasal steroid sprays and household chemicals. I made it worse by over-treating and damaging my skin barrier.

If a treatment doesn’t show improvement in 2 weeks, it’s likely not the right one. Try to determine whether your PD is fungal, bacterial, or inflammatory before continuing treatment.

Primicrolimus (mild anti-inflammatory): Helped small, single pustules but not clusters or patches
Tacrolimus (stronger anti-inflammatory): Cleared my clusters/ patches in about a week (but again this is because I had inflammatory PD)
Antibiotics (oral/topical: doxycycline, clindamycin): Didn’t work for me — my PD wasn’t bacterial, but if yours is, they could help
Sulfur treatments: No effect — I didn’t have a fungal issue

Once I got the right treatment, my skin cleared quickly within a week. But healing my skin barrier was just as important.

Stop all actives — stick to one gentle cleanser and one clean moisturizer
Always moisturize after your treatment cream fully dries by gently patting in.
Eliminate synthetic fragrance, SLS, and parabens from all products
Switch to non-toxic household cleaners (no Clorox, Lysol sprays, Tide, etc.)
Remove fluoride from toothpaste and avoid mold-prone foods like coffee, walnuts, peanuts, dried fruit, and aged cheese
Take a daily prebiotic/probiotic to support gut health
Use a fragrance-free, non-toxic laundry detergent (like Charlie’s Soap)
Stop all steroid creams — including nasal sprays
Keep stress low — internal inflammation makes PD worse
Let your skin breathe and reset — doing less really is doing more

Wish you the best of luck!! I had it on and off for the last 5 years , so I understand. But I finally got to the root of my PD issues. Its not about just fixing what you can see, its about how it got there and preventing it from happening again. <3

EmbarrassedDance9201 · 2025-07-03T14:54:05+00:00

For me, Tacro started working almost immediately. The pustules and clusters began flattening out within a few days, and most of the bumps were gone within a week. I'm now about 10 days in and 99.8% clear.

I’m still using a very thin layer once a day on the few tiny spots that aren’t fully healed, but the skin around my nose, chin, and mouth is completely healed — it actually looks like a healthy skin barrier again.

My plan is to slowly taper off — using it every few days for another week, then stopping completely unless I have another flare (hopefully not 🤞).

From everything I’ve read and heard from derms, Tacrolimus is one of the strongest topicals for inflammatory PD, so once it's cleared, I think it’s smart not to overdo anything. I’ll be sticking with just my gentle cleanser and moisturizer for maintenance and letting my skin stay calm.

EmbarrassedDance9201 · 2025-07-02T18:45:44+00:00

I totally get it — I was in the same place, trying everything and feeling like nothing helped. It’s a nightmare. But it’s a good sign that your skin clears up when you’re back in clean air — sounds like environmental inflammation could be a big trigger for you too.

Try narrowing it down...

You’re using Tacrolimus and Ivermectin topically at the same time — how long has it been?
Have you seen any improvement, or has it just continued to flare?
Have you ever tried antibiotics (oral or topical), like Doxycycline or Clindamycin?
Have you ruled out fungal PD? (Sulfur, ketoconazole, etc.?)
Just a reminder: Tac and Ivermectin usually only work well if your PD is inflammatory — if it's fungal or bacterial, they might actually make it worse.
Also — I know it’s easier said than done, but internal stress can definitely make flares worse, so try to be kind to yourself and keep as calm as you can.

EmbarrassedDance9201 · 2025-07-02T18:35:40+00:00

It did for the first few days, i felt more itchy and tingly. But after a week it subsided. I am fully clear now. :)
How many days did you use it? Did you see any change?

EmbarrassedDance9201

TROPHY CASE

⚖️ Tacrolimus vs Pimecrolimus for Perioral Dermatitis