I had a flaky dry red rash around my lips, what can I do

Dear Doctor,


I had a flaky dry red rash around my lips, the dermatologist diagnosed it as perioral dermatitis, and suggested I to used a tiny bit of  Metronidazole around the edge of my lips each night. But the prescribed medicine failed to take effect, and it worse than that. Now the flaky redness is stick in, It is still itchy, and more dry, flaky and red.

What can I do?  How can I get off it, it is a much vexed problem.

Thank you very much for your help.

[BhumikaMD]

Hi,
This could be perioral dermatitis. Perioral dermatitis, a condition related to acne vulgaris, consists of red papules that may appear microvesicular that typically affect the nasolabial folds, perioral area or perioccular area. It usually affects women between the ages of 20 and 45.
http://en.wikipedia.org/wiki/Perioral_dermatitis
It is commonly caused by the use of fluorinated topical glucocorticoid steroids to this area.
It is treated in a similar manner to acne vulgaris with tetracycline antibiotics or erythromycin but, without the use of topical steroids.
Recently, photodynamic therapy (PDT) has been reported to be helpful, although large studies have not yet been performed.
Roaccutane has been used in patients with severe perioral dermatitis with some benefit. Do consult with a dermatologist regularly.
Let us know if you need any other information.
Regards.