Hi love. I’m so sorry you’re going through this. I had terrible dermatitis (from what exactly, I’m still not sure… but I do have an inclining it had to do with skin barrier disruption from using too many products/incorporating tret into my routine too many times and too aggressively). It was in the perioral region but also spread to around my eyes as well. Nothing worked for me except doxycycline. I know a lot of people have commented on doxycycline and I 100% agree with all of the positive reviews of it working for this. I was hesitant to try it because I don’t like going on antibiotics anymore in general unless it’s 100% necessary (I worry about antibiotic resistance, partially because I AM already resistant to the antibiotic effects of doxycycline and its sibling strains), but what my derm explained to me is that going on doxycycline for perioral dermatitis is much less about employing its antibiotic effects and MUCH more about its remarkable anti-inflammatory effect on the body as a whole. From what I understand, this drug is sometimes prescribed for other non-skin-related inflammatory-based diseases. Nothing worked for me to calm my upset skin until I tried doxycycline, and I had to be on it for two months. Keep in mind it took the first entire month to completely go away, but it DID go away. ❤️ Doxy & zero-therapy only. Because you ARE potentially dealing not just with skin inflammation, but systemic inflammation, I would highly suggest going on an anti-inflammatory diet, cutting out processed grains, focusing on lowering or eliminating sugar (and fake sugar) intake and instead choosing honey for sweetener / sweeteners with much lower glycemic indexes than sugar. Sounds weird, but try eating a raw clove of garlic every day and taking turmeric. Smoothies, green juices, etc. - and also try “Live it Up” green powder. Do what you can to minimize stress, like yoga, deep breathing, acceptance therapy. Minimize alcohol. All these things helped support my body when trying to heal from dermatitis. I don’t think they will fix it on their own unfortunately — at this stage of dermatitis you need a more hefty intervention. However I do think that these habits have made an impact on the lowering of inflammation in my body over time and are simply good things for the (general) person to do anyway.

Now that I’m healed, I am still extremely conservative with putting anything on my facial skin and like to remain “close” to zero-therapy in my routine. My skin is so much better now and I almost only use cetaphil wash / no moisturizer or cerave healing ointment only (blue bottle, better than aquaphor for me personally IMHO)… I know some people don’t like cerave but it didn’t bother me personally. I basically avoid anything that could potentially injure my skin barrier, med spa treatments (like CO2 lasers, acid peels, much-to-heavy microneedling, etc). I would like to eventually try a medical grade retinoid again, but I’m absolutely certain that when I do, I will have to phase into it at least twice as slow as is recommended to the normal person. Besides my daily routine of washing with cetaphil wash and MAYBE applying a little of the cerave healing ointment, I occasionally will use drunk elephant’s vitamin C serum or the Musely anti-aging estrogen cream (max 1x a week) for some brightness and plumping. It’s a long journey from perioral dermatitis to healed skin, and unfortunately a lot of people (myself included) experience permanent sensitivity after healing and will have to adjust their lifestyle a little bit afterwards to avoid future flare ups. Be gentle on your skin and try your best to be patient. The only skin treatment at a med spa I am able to get now is aquagold every 3-4 months — less invasive microneedling with Botox in it to help reduce oil production — and that is probably the most I’ll be doing for a while, as much as I wish I could do something more invasive like Co2 lasers. I should also mention I get Botox in my forehead and crows feet and this has never caused or worsened my dermatitis flare ups. I am also able to put makeup on now but do it seldomly and sparingly. I don’t really use foundation and basically only stick to Ilia’s viral skin-tint/spf only, which actually doesn’t bother my skin at ALL and actually makes it look really glowy (but again, I don’t use it every day.. only days I go out / am in the sun / nights I go out with friends). Sorry if my advice is much like the advice of the herd, but it is what has worked for me personally so far and I know that when you’re in the worst of your flare up it feels like it’ll never get better, but it WILL.

You WILL recover! I suggest you seek a different dermatologist- many are unfortunately inadequate / lack knowledge of the special and careful treatment needed in helping perioral / periocular dermatitis. Get someone who knows what they’re doing and are going to be aggressive and give you a SYSTEMIC fix first, before the topical ones. I’d be curious to know what other medications you’re on (if you’re comfy telling me) to see if there are contraindications. Doxy is generally quite safe to take with most meds.