It is a huge blow to self-esteem...I've been living with skin problems since 1985 :(
A doctor recently suggested that I get checked out for lupus...malar rash is common in folks with lupus...and I guess mine has a malar pattern (nose-both sides of face - butterfly shaped).
You may want to work with a dermatologist or naturopath...not sure if a biopsy would be considered overkill..but it might help.
What tends to make it worse? Heat/sun/stress/sugar/that time of the month/avoid foods/etc all make mine worse. I use a gentle handmade soap and no moisturizers. Skin all over my body seems to be shedding constantly, especially on the affected areas of my face. What seems to make it better? Nothing seems to help me in the long run...
Any fluoride treated water, when boiled, becomes more concentrated with fluoride. So using fluoridated water to make coffee/tea/soup/etc...increases your exposure to fluoride. Also, shellfish are high in fluoride.
Fluoride not only gives me perioral dermatitis, but also causes my mouth to burn! And gives me an upset stomach.
Hoping to hear from you!
p.s. I'm disappointed to hear that replacing your fillings didn't help...I was hoping that would help me (and it still might). I go to the doctor's in a few weeks to see if he wants to test me for lupus. By the way, you are beautiful - inside and out - and so am I :-)