Hormonal link to perioral dermatitis?

[flounder]

I wrote in about a month ago with a question about a rash around my mouth - perioral dermatitis. I've been on erythromycin for about 3 weeks now and have seen some improvement. However I've also noticed a distinct hormonal pattern. For 3 months now the rash has got much much worse around the time I ovulate. Even on the antibiotics there's a distinct worsening - very red and painful again. The area involved has decreased each month.There are also severe mood swings - crying for no reason, depression etc. at the same time. I was taking contraceptives for hormonal mood swings etc - Logynon for about two years and Femiane for about 5 or 6 months. I stopped all contraceptives in October. Is it possible that this is related to progesterone levels or a combination of estrogen and progesterone? The rash improves between ovulation and my period and then begins to worsen slowly getting really bad mid-cycle.As i said it does seem to be improving over time - each month it seems a bit better. Could this be a residual effect of the contraceptive? And if so, how long should I stay on the antibiotics? Is it normal to have flareups like this on the antibiotic or should there be steady improvement?
Should I be looking into getting hormone levels checked?
I'm trying not to get discouraged but its a bit difficult sometimes.

Thanks

[Alan Rockoff, MD]

As far as I know, perioral dermatitis has no hormonal components.  I usually treat it with topical antibiotics like metronidazole and one of the oral cyclines, though erythromyin does work for some people.

I therefore have no explanation for the apparent hormonal correlation. and also none for the mood swings, etc.  For those I would consult a gybecologist or hormone specialist, but the perioral dermatitis condition should be treatable even without changing your hormones one way or another.

Best.

Dr. Rockoff