A Little Bit of Sugar for Perioral Dermatitis?

A little bit of sugar?

SEPTEMBER 7, 2012

by dawnmarie

This page is what I might consider a diary of my experience with perioral dermatitis.  I first published on another blog on 9/7/2012 and reposted it here.

The original post was updated as I posted flattering new pictures of my progress (scroll down towards end of post) or had an update to add. 

Please note: Powdered sugar and olive oil is not a cure for the underlying cause of perioral dermatitis.  However, in my experience, sugar and olive oil provides symptomatic treatment for burning and itching. It also treats and prevents  bacterial infection, speeds up healing and decreases scarring according to medical literature and that seems to be my experience as well.  

I have had been dermatitis free since the first week of June 2013 until April 7, 2014.  I started using sugar and oil again on April 7th 2014 (updated April 9th, 2014).  I have not had any recurrences since the April treatment (updated 7/23/2014). I first experienced perioral dermatitis July 2011 and had breakouts every 2 to 3 weeks.  The outbreaks became less severe and started to come less often.  One day, it all just stopped…but it came back 10 months later as noted above.    I use sugar and olive oil as a general mask several times a week.  I also use sugar scrubs a few times a week which contain granulated sugar, honey and olive oil.  I wash my face daily using the oil cleansing method using various oils which may or may not include coconut, olive, castor and sunflower oil. This experiment was tried out of desperation and the results were repeatable with each successive outbreak.  I used the sugar and oil paste continuously for 5 to 9 days per outbreak, 24/7 for the most part.  (Update October 28 2017:  i have not used the oil cleansing method in a loooong time.  Still love sugar scrubs though.)  

The original experiment:

Is there a role for sugar or honey in wound healing?

MOST DEFINITELY there is!   I have a few articles at the end of this post about it.  Great information to have for natural wound healing.  I am interested in using sugar right now instead of honey because honey irritates my skin when it’s raw and won’t stay in place. Why do I care?  I am a pharmacist by trade (now a housewife) and I’m interested in what people did before the advent of modern medicine.  Herbs, oils and home remedies.  In addition, I have a pretty bad case of ongoing perioral dermatitis that has been raw and painful lately.  It’s the worst it’s ever been.  I’m in the trial and error phase. Perioral dermatitis is a generic phrase meaning inflammation or disease of the skin around the mouth.  The name of the “disease” says nothing about the cause and there is no “guaranteed” treatment that will work in everyone.  My perioral dermatitis is waxing and waning, cyclic.  I would like to find a natural remedy rather than using synthetic chemicals right now.   I figure God must have put something out there for me to heal a wound like this… I have made this rash into what it is this time around because I can’t keep my hands off my face.  It itches so badly and hurts and peels and weeps!  I’ve tried a few common home remedies that have caused irritation (apple cider vinegar, yogurt, lavender oil, tea tree oil).  I have taken a few little clumps of bumps to a mechanical/chemical burn that never really heals before flaring up again. When the rash is at its worst, I can’t sleep and it hurts to talk and smile.  Everything seems to bother my chin.  Air (ceiling fan, air conditioning), water… my husband’s stubble.  It burns and itches something fierce when it’s this raw.  It stings.  It’s embarrassing.  It’s ugly. Currently, I am putting powdered sugar and olive oil on that nasty little booger…all day long.  I use about a tablespoon of olive oil and enough powdered sugar to make a paste.  Not a thick paste.  It needs to stay on without a bandage.  I would say that my mixture starts out about the consistency of a thicker lotion…but it will thicken up a little bit more in the ointment jar with time…hehe…cake frosting.  It does not matter what kind of oil you use.  See what works.  Trial and error.  Use something your face tolerates… coconut oil, jojoba, olive, sunflower, hemp, grapeseed.  You can make more at a time if you want.  I just make a little bit…no particular reason really.  It’s good for a very long time (years apparently for powdered sugar and cooking oil) but I would think that depends on the kind of oil used. 

If colonization or infection has anything  to do with this…I’m doing some killing.  Sugar has an antimicrobial effect because it deprives bugs of water  (osmotic effect).  The little critters shrivel up and die (bactericidal).  Like salt on a snail.  Sugar also lowers wound pH (makes it more acidic) which stops the bacteria from multiplying (bacteriostatic). Oil also functions in a physical way.  Oil coats the bacterial cell wall (outer membrane).  This apparently interferes with the ability of the cell to bring in food and water while preventing the elimination of garbage from the cell. In addition to the above, sugar helps skin to regenerate its barrier to a normal state. “Saccharides at the wound surface encourage the production of hyaluronic acid from glucose, simultaneously suppressing the formation of fibre-forming collagens. The sugar preparations at the wound bed create an environment that enables wound healing proteoglycans to exert their effects without producing excessive quantities of collagens.“ http://pilonidal.org/_assets/pdf/honey_wound.pdf At times, perioral dermatitis  is caused by using topical steroids on the face.  That’s not me.  Other theories involve hormones, sun exposure, chemicals used in personal hygiene and beauty products…even chemicals in our water. I’m a face product addict and  I spend a lot of time in the southwest sun.  I’m doing what I can to limit “risk” factors, whether they be theoretical or not but I also have to be able to stick with things I try as well as live my life without letting this take over.  Nothing has been proven, so I guess it’s all about what works for the individual. I should mention that I have autoimmune thyroid disease.   Another detail that may or may not be important is that I’ve spent many hours compounding and admixing medications over the years.  The last time was in January of 2011 and included compounding medications such as hydrocortisone cream, progesterone capsules, estrogen capsules and testosterone cream.   When you do that kind of stuff, you take precautions, but your skin can be exposed.  I don’t know what the long-term effects of these chemical exposures are as far as my skin is concerned. I couldn’t find information for use of sugar and olive oil in this kind of wound but I am trying it anyway because there is information on treating severe wounds of various types with sugar and oil.  I don’t know that I would call my wound severe, but I can’t think of any reason why I shouldn’t try it anyway.  I’m hoping to speed up healing and decrease scarring.  I started using the powdered sugar and olive oil mixture the morning of September 4th.  I keep the wound covered continuously, as much as possible, night and day, with just a few hours at most without the paste covering the wound.  I am not using anything else at this time.  One thing at a time…except for maybe an NSAID (aspirin or ibuprofen) and an antihistamine if needed. The most acute thing I’ve noticed is that my face doesn’t itch or sting. The first day, I could feel immediate warmth in the area along with relief of itch, elimination of pain BUT increased reddening.  That was a little scary.  Well, alot scary.  It was as if the sugar and oil were exposing “hidden disease” in tissue that was scarred as well as the stuff I knew was there.  The wound seemed to be getting worse!  However, since there was no pain or itching, I attributed the redness to blood flow and sloughing of dead and diseased skin.  There was warmth in the area, but not a painful burning…or even an uncomfortable warmth.  It was actually kind of soothing.  The warmth was definite enough to melt the preparation on the rash area.  The next day, I could not feel the warmth anymore and the mixture dried out sooner. Still no itching or pain and if so, very mild compared to without the preparation.  Topical castor oil helps with itching as well. This is a good thing. It means I can keep my hands away from my face which is most definitely a must.  I can laugh and smile without it hurting.  My face  doesn’t dry out and crack and new skin seems to be forming.  I have hope!  It doesn’t feel like a 1000 paper cuts all being realized at the same time.  I can see texture in a good way, I think?  Every now and again, if the water I splash my face with is too cold, I might get a tinge of sting when I wash the mixture off to reapply.  It’s three days out as I write this.  I am applying the sugar and oil in such a way as to keep the wound continuously moist (oily…however you want to describe it) and covered with paste.  Basically, I just splash water on the wound when the sugar layer gets too thick and starts falling off my face.  Pat dry,  then reapply and start the process all over again.   The rash does not seem to be getting worse.  It seems to be improving.  The texture is changing. 

I’ve tried lots of different things during the last year (this started July 2011):  yogurt, ACV, calendula, honey washes, honey “dressings”  (which run down my face and are too sticky), tea tree oil, chamomile compresses, vitamin E oil, salicylic acid, SLS free hygiene products, fluoride free toothpaste, oatmeal compresses, very little makeup to limit parabens and paraffins and no makeup on the area if I can help it, no moisturizer, switched to peppermint hemp castile soap (very dilute), or no soap at all…some diet type stuff-yada, yada, yada. I’m cleaning my house with combinations of things which may or may not include vinegar, essential oils, water, castile soap, olive oil, baking soda and borax . I’m getting more fruit into the ol’ diet.  More vegetables.  I’m reading a book called “Eating Animals” just because I feel like it as I think about triggers.  If this is hormone related, I might need to consider what my meat is being fed.  If it’s a “sensitivity” type thing, is it possible that antibiotic metabolites cause skin sensitivities (photosensitivity?) in people who eat animals fed antibiotic prophylaxis? and more generally, should I care about how the animals I eat are farmed?  Does God care?   In terms of pharmaceuticals, have we thumbed our nose up at everything God has created to be used as medicine, thinking we can do better while making lots of money?  We live in an age of pharmaceutical grade food and drugs.  I’ve been thinking about how all of creation groans, waiting for His return.  Anyhow,  that’s a coffee table conversation for another time, another post.  I’m learning.  I’m not interested in gluten-free diets, dairy free or complete vegetarian stuff.  Not yet anyway, we’ll see.  I’m interested in eating real food.  I’m hoping it will help my face among other things. I have not tried antibiotics yet.  That might be coming.  We do have data on antibiotic therapy for perioral dermatitis but it’s not very good data and the therapy doesn’t always work.  Why does it work for some if this condition isn’t thought to be bacterial?  Some believe it’s due to the anti inflammatory properties of certain antibiotics.  If so, then why the use of antibiotics that don’t have anti inflammatory activity orally or topically?  Ibuprofen has anti inflammatory activity.  Why doesn’t that work?  So, I’ll keep learning and see where it leads me.  I’d rather not try topical antibiotic creams/gels (they have “stuff” in them…possible trigger ingredients).  I’m not interested in vitamin supplements or oral/topical retinoids.    I will get my “supplements” from food.  I’m also thinking I need to switch to a zinc or titanium based sunscreen.  I have not done that yet. Before starting the sugar/oil therapy for this last bout, I had been using a calendula dressing (oil based) while waiting for  “California Baby” calendula cream to arrive.  Some people swear by it.  The cream is advertised as being helpful for conditions such as mine.  When the cream arrived, I stopped the oil based dressing.  I used the baby cream for a few days, but it was making my skin itch and my skin was still cracking and weeping.  It didn’t help with the pain either.  I went back to the calendula skin dressing that contained vitamin E, olive oil,  almond oil and beeswax.  That has been the most helpful topical product in keeping me comfortable pain-wise and itch-wise until now .  For pain and inflammation, I usually take ibuprofen, sometimes aspirin.  They help some.  I get pretty puffy with NSAIDs, so at times I substitute acetaminophen for pain (it does nothing for inflammation).  I take diphenhydramine to help with the itch and cetirizine in addition to diphenhydramine, if it’s really bad.  I don’t know how much of the itch these things help, they might be making things worse by drying out my skin.  These medications do help a little with sleep and anxiety.  Sometimes, a pinched nose and a few shots of vodka in quick succession…with lemon to cover the yuck, work much, much better.  I also like castor oil for itching.  Oatmeal compresses, peppermint teabags and chamomile compresses used sparingly are helpful, but when used too much, I found they dried out and cracked my skin.  Moderation.  I tried sleeping in gloves, but I just took them off in my sleep. I’m a slow learner but during the last year, the most important lessons learned are that I need to keep my hands off my face, limit my time in the sun, stop with all the face junk and find a new sunscreen.  I also need to limit my use of foundation.  By “foundation”,  I mean heavy foundations with full coverage that last all day long.  I’m a little scared to try mineral powder.  I bought some years ago but stopped using it because it made my face itch.  That was Bare Minerals.  Maybe another brand.  Right now I’m sick of trying things.  I’ve also decided that burkas have their place. I say that only half-jokingly because my brother-in-law suggested I get myself one;  and, I was wishing I had a burka at times during this adventure. Some of the other things I have learned this year are that the “natural” industry has got a good thing going and they are proud of some of their products price-wise and claims-wise.  It’s definitely another niche filled with scams and gimmicks.  Just like anything else.  Look up what we require for something to be labeled organic.  Look up what free range and cage free really mean.  Think about all the different dietary supplements with grand claims. Back to what I’ve learned.  Tom’s of Maine toothpaste hasn’t done a lick of good for my skin.  When this tube is gone, I’m switching to sea salt or baking soda…and a little diatomaceous earth.  I’m not fond of the Tom’s line of deodorant either.  When this unit is gone, I’m finding something more “home-made”.  By home-made, I mean that I will mix it myself, though, I want to try one of those mineral deodorant stones first. (update 2/9/2013…the deodorant stone is awesome:  Alum http://en.wikipedia.org/wiki/Alum) Greek and Bavarian yogurt burn the snot out of my face (in the area prone to dermatitis) and I had to say no to avocado masks.   I find I do better when I stick to eating the yogurt and avocado.   Apple cider vinegar burns my chin and sets me back a few weeks healing time during a bad flare-up.  It’s fine on the rest of my face and even dries out the rash if it’s a small outbreak;  but, when there are cracks and weeping like in the pictures below, it makes it worse.  It’s never “cured” it and I hate the smell.  Lavender is iffy.  It is only itchy when used on the area of my skin prone to dermatitis.  It’s fine everywhere else.  (Update October 29 2017:  My face seems to be okay with lavender these days).  Calendula in oils is good.  Calendula cream does not agree with me.  The brand I used has lavender (California Baby).  It’s fine on the rest of my face though.  Chamomile is soothing but drying.  So is oatmeal.  I also like peppermint tea bags.  They are soothing.  If I have to use soap, my skin seems to prefer really dilute peppermint hemp castile soap (which is good for itchy skin unless it’s got cracks and raw spots).   I am trying to stay away from soap of any kind right now because I need to quit stripping my skin.  I try to use just water and oil when possible.  I’m also limiting how much water sits on my face (for example, I limit tea bag frequency and compress time).  Commercial aloe vera gel is irritating to my skin, but the goopy mucus stuff directly from the plant is soothing.  However, the goop dries out quickly if used on its own and apparently my plant is too small to do much good.  I guess the leaves need to be about a foot long before they have fully mature medicinal value?  Sulfur soap seems to soften up the crusts that form on the wound and helps the weeping, but it is drying if I use it every day.  Sulfur mineral springs are awesome, but I don’t live near sulfur springs.  Diluted tea tree oil takes my little clumps of red bumps to a weeping red patch that leads to itching, burning and peeling.  It’s fine everywhere else.  The joy of trial and error.  Keep in mind that when I’ve tried these therapies, I TRY to do one thing at a time, take note of the effects and when I decide it doesn’t work, causes increased pain and itching or makes things worse, I move on to something else.  Doing too many things at once just confuses the issue and makes it so that I don’t know what works and what doesn’t. 

Below is a picture of my chin at the end of August.  It was having a good day,  relatively speaking.  That means that foundation would stick to my face.  You can see the changes in my skin texture and the scarring present after all the bouts of dermatitis flares since  July 2011.  It doesn’t look normal and never completely heals before flaring up again.  On August 27th, I put on makeup and sunscreen to cover up as best I could that day.  It’s also important to note that I played golf the day before.  I didn’t wear makeup, but I did wear sunscreen and a visor (I should have worn a big floppy hat).   Shortly after  putting on foundation and sunscreen on August 27th, my face started burning and itching.  I used Olay (sensitive skin sunscreen) and some Merle Norman foundation (which I’ve since changed to their lighter, more “plant based” HC formula.

8/25

August 27th.  I put on makeup and sunscreen shortly after this picture was taken.  Very scarred skin.  This is not a great picture, but you get the idea.  It pretty much looks like the picture from 8/25 but it’s hard to see in this photo.

August 27th with makeup (it covers okay with makeup)

September 1st

(itchy, bumpy, burning, weepy skin that can’t be covered with makeup)

SO… I took my literature seach in a different direction the morning of September 4th based on an article my mom had read about using sugar and oil to heal various types of wounds.  Right now I’m in the phase of just trying to heal THIS wound.   I figure if I can get a nice healthy dermal barrier back, maybe the dermatitis will be easier to get rid of or will go away once and for all.  I am drilling into my thick skull…Hands off!  No makeup on the rash and limit it on the rest of my face or don’t wear it at all.  No sunscreen right now and try titanium or zinc based product in the future.  Limit the sun exposure and wear hats.  Eat good food.  Everything in moderation.    

In conclusion, below are pictures of my chin before starting sugar/oil, and X hours after starting therapy.  After starting the sugar/oil, the pain and itch went away…72 hours out, the benefits of the therapy are quite visible.  After the pictures are some links and blurbs about healing with honey or sugar.

Treatment of Perioral Dermatitis Wound with Powdered Sugar/Olive Oil Paste Progressive Photo Documentation

Before starting sugar and olive oil 9/4/2012

30 hours after start of sugar and olive oil 9/5/2012 (Looking worse, but feeling better…the wound seems to be growing.)

48 hours after starting sugar and olive oil 9/6/2012

72 hours out 9/7/2012 (Very exciting change!)

91 hours out:  picture taken and added to post 9/8/2012

118 hours out:   picture taken and added to post 9/9/2012

138 hours out:  Picture taken and added 9/10/2012

“spot” therapy started, full area therapy discontinued

162 hours out:  Picture taken and added 9/11/2012

All therapy discontinued

9/13/2012 final picture

 “Use of Sugar on the Healing of Diabetic Ulcers: A Review”

Sugar as a Wound-Healing Modality

Methods to heal wounds have been studied for the past four or five millennia. Surgery’s earliest known document on the care of wounds is The Edwin Smith Surgical Papyrus, dated around 1700 BC, which describes the treatment of a number of difficult wounds encountered on the battlefields of Egypt.⁹ Since then, our knowledge of the physiology of wound healing has been elucidated, but timely and efficient wound healing has remained somewhat elusive, especially in areas where technology and modern wound care supplies are limited. However, natural resources have been used extensively for wound care with acceptable results. The use of sugar for wound healing is one of the earliest known methods. In premodern times, the idea that sugar can facilitate the healing of wounds has been documented.^10,11 Mesopotamians were known to wash wounds with water or milk and subsequently dress them with honey or resin. Mesopotamians also documented the severity of wounds and which conditions were optimal for facilitating the rate at which the wounds would heal. Other substances, in conjunction with sugar, such as plant derivatives, wine, and vinegar were explored and implemented to determine their efficacy in wound healing.¹⁰ In 1679, Scultetus made use of finely powdered sugar to clean wounds.¹² Zoinin, in 1714, promoted the value of sugar for promoting wound and ulcer healing.¹³ In modern times, the use of sugar as a general treatment for the healing of wounds has received much attention in Latin America, Europe, and Asia.^14–24 Currently, Brazil is the world’s leading producer of sugar, with 566 million tons cultivated in the 2008–2009 market year. Brazil is projected to increase production to 605 million tons for the 2009–2010 market year.²⁵ This vast production makes sugar readily available and cheap. These attributes make the use of sugar an attractive candidate for the healing of wounds, especially in economically challenged areas. Moreover, certain types of wounds such as chronic wounds may benefit from a more cost-effective method of wound healing. The use of sugar to heal diabetic ulcers is such an example. Although Latin America, Europe, and Asia have held an interest in using sugar for wound healing, its use has not been widely practiced in the United States.^26,27 The use of sugar in a wound appears counterintuitive since there is evidence that systemic hyperglycemia impairs host defenses and may inhibit healing.^28,29 There is counterevidence, however, that systemic hyperglycemia and local hyperglycemia do not promote impaired wound healing by themselves.^30–32 Direct instillation of sugar in the wound apparently exerts a local osmotic effect that promotes granulation tissue formation, reduces edema in wounds, lowers wound pH thereby enhancing the bacteriostatic effect, promotes dilation of small blood vessels, promotes bacterial lysis, and inhibits bacterial growth by lowering the water activity available that is required for the growth of most bacterial organisms.^{15,16,27,33–35} This technique has been employed in the treatment of burns, postoperative wounds, mediastinitis, diabetic ulcers, and a variety of other wounds.^32,36,37 Since sucrose is not metabolized outside the intestinal tract, local application of sugar would not be expected to lead to systemic absorption; however, this treatment, when used in large open wounds, has been associated with one case of acute renal failure and severe hyponatremia.³⁸ Debure and colleagues³⁸ reported a case of a 64-year-old male who was being treated with granulated sugar for an infected pneumonectomy cavity. The patient developed severe hyponatremia (129 mmol/liter) and acute renal failure with an osmolar gap and elevated sucrose levels in the urine and blood. Once the sugar was removed from the infected cavity, the patient resumed urine flow, and a diagnosis of sucrose-induced osmotic nephrosis was concluded. The authors do note that topical use of sugar has not been associated with toxic events and that the patient had mild renal insufficiency prior to sugar therapy. With this caveat, the use of sugar for treatment of wounds is safe, easy to teach, cost-effective, and worthy as an alternative modality for the treatment of refractory wounds.  Read More Here “Use of Sugar on the Healing of Diabetic Ulcers: A Review”

WHAT IS SUGARDYNE? “Sugardyne is a specially-formulated dressing composition suitable for use on a great variety and number of wounds, burns and ulcers.  It was developed in its earliest form by the battlefield surgeons of ancient Egypt some 4,000 years ago as honey and grease.  In more recent times, povidone-iodine was included in the formulation and the commercial product was called “Sugardyne”—sugar for its most abundant component and dyne for power (as in dynamite, dynamo and dynamic).  That additional chemical, povidone-iodine proved superfluous and it was dropped from the formulation.

More recently, the composition has evolved to include only two substances….powdered sugar, substituted for the Egyptian’s honey, and cooking oil for their grease. These two materials have proven to be powerful anti-bacterials and have been shown to be superior to all antibiotics in staving off infection; they have out-shined many of the much more expensive materials and products in not only fighting infection but in contributing to unparalleled healing as well. They not only help eliminate infections, but substantially contribute to cost savings, reduction in necessity for skin grafting and overall cost of wound and burn care.”…”Afflictions such as allergies, poison ivy, poison oak and poison sumac will not improve with use of Sugardyne unless there is an infection secondary to scratching.  It is also true that viral afflictions (such as shingles except when similarly infected) will not respond favorably to the use of Sugardyne.”  Read more here:  http://www.sugardyne.com/

…………………………………………………………………………………………………… Wound Management Using Sugar:  http://www.scribd.com/doc/36882278/Wound-Management-Using-Sugar-2002 Honey Dressings:  Why do some cavity wounds heal without scarring? http://pilonidal.org/_assets/pdf/honey_wound.pdf Case report:  granulated sugar to treat pressure ulcers: http://www.woundsinternational.com/case-reports/the-use-of-granulated-sugar-to-treat-two-pressure-ulcers Systemic review of honey as a wound dressing:  http://www.biomedcentral.com/1472-6882/1/2/ Honey as a topical antibacterial agent for treatment of infected wounds: http://www.worldwidewounds.com/2001/november/Molan/honey-as-topical-agent.html Effects of honey and sugar dressings on wound healing: http://www.ncbi.nlm.nih.gov/pubmed/17708384 Honey: a reservoir for microorganisms and an inhibitory agent for microbes : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2269714/ US Patent Application No: 2012/0225,105 SUGAR-BASED DISPERSION: http://www.patentbuddy.com/Patent/20120225105 Comedogenecy of Carrier Oils:  See full article including chart at:  http://illumineat.wordpress.com/2011/06/11/comedogenic-and-non-comedogenic-oils/ Oils are rated between 1 and 5. The first column rates their comedogenecy and the second, their likeliness to irritate skin. A level of 5/5 would means that an oil is likely to be highly comedogenic and highly irritating.

OIL	LEVEL OF COMEDOGENECY	LIKELINESS TO IRRITATE
Almond oil	2	0
Apricot oil	2	2
Avocado oil	2	2
Camphor oil	2	2
Calendula oil	1	0
Castor oil	1	0
Coconut oil	3	1
Corn oil	3	0
Emu oil	1	0
Grapeseed oil	1	0
Hazelnut oil	2	0
Hydrogenated castor oil	1	0
Hydrogenated Vegetable oil	3	1
Jojoba oil	1	0
Mineral oil	0	0
Olive oil	2	0
Peanut oil	2	1
Pomegranate oil	1	0
Rosehip oil	1	1
Safflower Oil (high linoleic acid variety only*)	0	0
Sesame	2	0
Soybean oil	3	0
Squalane	1	0
Sunflower	2	1
Tamanu oil	2	0
Wheat germ oil	5	2

  12/5/2012 update:  I failed a course of doxycycline (October 4 through December 4, 2012).  No change in severity or number of outbreaks during use.  Severe mood changes. 4/29/2013 update: Try adding NEEM OIL to your treatment if you can handle the smell. It might help.  Put a few drops of neem on the rash, let it sit for an hour then cover the rash with powdered sugar and olive oil. I first tried this twice a day for 3 days during the middle of the an oubreak that started March of 2013 and then finished the therapy with just powdered sugar and olive oil. The area does not seem to be as sensitive after the neem treatment.  I really hate the smell though. DISCLAIMER: The statements made here have not been approved by the Food and Drug Administration. These statements are not intended to diagnose, treat or cure or prevent any disease.