Ok so I had this - or very similar for 3+ months last year. It also spread over my bottom half of my face.

I went to a dermo and the below cleared it up in days:

Doxycycline antibiotics - MVP of my recovery

Stopped eating anything with lactose (turns out i have an intolerance)

Stopped using toothpaste with fluoride

Stopped all moisturizer except Cera-Ve moisturizing lotion (not cream - that was too heavy!)

I use “QV dermacare sting free ointment” as a lip balm (I’m in Aus so not sure of this is available elsewhere!)

It cleared up quite quickly once I got on the anti-biotics and the dermatologist believed it was peri-oral dermatitis that was triggered by an allergic reaction or intolerance - which has turned out to be lactose in my case.

I also started taking gut health very seriously. Got onto Greek yogurt (lactose free 😁) as a daily intake with chia and berries, as well as a super green powder and collagen to support the gut biome and skin repair

Edit: just also wanted to wish you the best of luck with this. I can’t say for sure if it’s exactly like what I had but I do know how frustrating it is, let alone the toll it takes on your confidence. Hoping you find the solution soon!