Do you know how you know your skin is bad? You get your skincare tips from Reddit. Instagram is for those with blemish-free complexions—god given or paid for—who can share a bare face, unabashed, to a chaotic assortment of coworkers, random high-school classmates, and even (gulp) exes. Reddit, however? That’s the platform for those of us who don’t want our name attached to our face, let alone publicly broadcasting it. Instead, we post under an anonymous username, to a bunch of other anonymous usernames, with all our identifying features cropped out.
I’m using the “royal we” here because – if you couldn’t guess already—I’m talking about myself. About a year ago, a dermatologist diagnosed me with perioral dermatitis. Here’s an official definition from Dr Mary L Stevenson, MD at NYU Langone Health: “Perioral dermatitis is a skin condition which results in dry, flaky red skin as well as red bumps or papules. It can look like acne although it is a distinct diagnosis with some overlap in treatment. In addition it can be itchy, red, dry, and swollen.” Here’s my personal definition: every couple months, ugly, raging patches erupt on the lower half of my face. They are wildly uncomfortable, noticeable through copious amounts of cover-up, and take forever to get rid of.
Perioral dermatitis is most common among women ages 25 to 49, and lasts for weeks or months.
The list of potential causes are wide-ranging, and therefore comically unhelpful: Chewing gum! Fluoridated toothpaste! Birth control! Steroids! UV light! Certain sunscreens! Heavy moisturiser! Stress! The weather! (“Often patients may find flares can happen during times of stress including times of weather changes like changes in the winter with dry, cold air,” says Stevenson.)
I can’t say for sure what caused mine. (Most, if not all, of the reasons above apply to me.) But here’s what I can tell you: Last summer, at age 29, I began to panic that I wasn’t doing enough to “de-age” my skin. I’d spent the whole pandemic incessantly staring at my burgeoning wrinkles on Zoom. When I wasn’t on Zoom, I was on social media, scrolling past influencers dripping delicate oils on their porcelain-doll skin, or I was FaceTiming friends to pass the time. In college, we tanned for hours on the beach in Cabo San Lucas chugging margaritas. Now, we were sitting on couches, suddenly spouting stuff about retinoids and “baby botox”. The final straw arrived when, as lockdown eased, my group chat erupted that the Acme basement—my nightclub of choice when I was still on my parent’s health insurance!—had finally reopened. “I’m going out!” I remember thinking—and I was hellbent on making sure my eye bags didn’t come with me.
I went into a vanity spiral. I booked a fancy facial with a fancy facialist in a fancy loft downtown where various serums and lotions were massaged into my face over 90 minutes. “This is placenta cream—for anti-aging,” she said, her soothing voice like a lullaby in the all-white room. Afterwards, during check out, she laid out all the skincare products she used. I bought every single one, grimacing when she read the total cost out loud. Then I went to the beauty boutique next door, grabbing two different yet equally expensive sunscreens off the shelf. In the days to come, I lathered on copious amounts of them all.
Weeks later, my dermatologist peered at me through a computer screen as I tried not to bury my burning, scaly-red face in my hands.“Perioral dermatitis,” she said matter-of-factly. “Have you been using any new creams or sunscreens lately?”
I shook my head yes.
“To be safe, I’d remove them from your routine,” she said. Then she prescribed me a hefty course of doxycycline.
I walked over to my bathroom cabinet and opened it. All my shiny new bottles stared back at me. “Goddamnit,” I muttered. I swept them all into the trash.
I wish I could say that was it, that I had a bad reaction to some skincare product. That I finished the antibiotics and it never happened again. But that’s not how perioral dermatitis works. It resurfaces unexpectedly. Sometimes it’s a small flare-up. Sometimes, it feels like the entire area from my nose to chin is flaking and inflamed. (“Is that… powder on your nose?” a coworker asked while pointing at my nostril during a particularly bad episode.) My current episode started in March and is still lingering in May. I get frustrated. I feel insecure. Sometimes, as silly as it sounds, I even cry – despite knowing that, at the end of the day, it’s a benign aesthetic issue. And while I often hope my perioral dermatitis will go away on its own, it only recedes when antibiotics are involved.
Since I don’t want to be popping those pills all my life, I’ve tried my best to take preventative measures. I cut down on alcohol. I swapped fluoride toothpaste for charcoal. I only wear make-up if I’m going out on the town. I cut dairy from my diet. (There’s no scientific proof dairy is linked to perioral dermatitis, but there are theories it’s not great for your complexion as a whole. Also, one of my fellow Redditors said it worked for them, and at this point I’m down to experiment.)
Finally, I use barely any skincare products at all.
That’s right. In an age where “get ready with me” content dominates TikTok and influencers spout 30-step make-up routines, I’m down to using three products a day. Fewer, if my perioral dermatitis is particularly bad: CeraVe cleanser, moisturiser, and sunscreen. (“Gentle cleansers and/or a gentle glycolic or sulfur wash and gentle moisture from products with ceramides in them are great simple and gentle skincare regimens,” Stevenson says.) Each costs 12 to 15 dollars at CVS. So far, it’s the only routine that’s kept my face in a reasonably clear state. Most people my age have a bathroom cabinet that rivals those seen in a Top Shelf. Mine, however, resembles that of a cosmetically clueless seventh grader.
I did actually use CeraVe from middle school into my early years of high school. Hormonal, awkward, and knowing nothing about beauty, I got it because my cool friend swore it was the best way to prevent breakouts. Little did I know, she was more insecure about her looks than I was. She’d recently started on Accutane—CeraVe and Cetaphil, as it turns out, are safe choices for those suffering with acne, too. In fact, its gentle reputation is the main reason that in 2020, the brand went viral on TikTok and flew off the shelves of stores across the country.
As an adult user, I feel a newfound appreciation for those no-frills brands that are accessible, affordable, and a saviour for those of us with messed-up skin. Yet it’s odd, opting out of the high-end skincare craze when it’s continuously marketed to you. As a 30-year-old woman, my browser is dotted with targeted ads for 300-dollar miracle creams. Suggested Instagram posts for buzzy beauty start-ups with pastel interiors fill my feed. A sign that reads “Getting old is getting old,” stares at me on the subway.
I’d be lying to you if I didn’t admit to feeling anxious when I read something about how skincare ingredients should be organic and all-natural, or how someone my age should be on retinoids. I still feel strange not participating in an industry that society tells me, both subtly and overtly, I very much should be.
But then I remember Ponce de Leon, the Spanish explorer who became obsessed with finding the Fountain of Youth. The waters, he believed, would restore the youth of anyone who drank or bathed in it. He searched his entire life but never found it. The fountain, as it turns out, was nothing more than a myth.
So maybe I’ll be fine with CeraVe after all.
This story originally appeared on British Vogue