Perioral Dermatitis

I am a 20 year old white male and have been seeing a dermatologist three months for a slightly bumpy fairly red area on my chin.  She diagnosed this case as POD and put me on Dynacin 100mg twice a day, and both Metrolotion and DesOwen lotion twice a day.  Previous to my seeing the dermatologist I was treating acne for a year with Benzamycin and Minocycline 100mg twice a day prescribed by my family doctor.  I stopped the Benzamycin on my own a month previous to seeing my dermatologist due to the irritation and redness it caused my skin, especially around my chin.  Since I started my treatment givin by my dermatologist, and doing the usual changing of toothpase and such, I have seen a slight improvement in the color on my chin but not really on the bumps.  The area of redness seems to flare up a little for a short period when disturbed, even by chewing food.  I believe that perhaps, since I have been using an oral antibiotic 100mg for so long that the Dynacin 100mg I am currently using has very little effect on the 'POD', if it even is that.  Could it even be that I simply need to stop topical treatment all together? It has been three months and that is why I am questioning the treatment and or the diagnosis. I also find it ironic how many reports link POD with exposure to Sodium Lauryl Sulfate, and Cetaphil non-soap cleanser is reccomended for POD when it actually contains Sodium Lauryl Sulfate. I am seeing my Dermatologist again in two days and have these same questions however I was looking to see if my asumptions could be correct.
Thank you
-Chris

[Alan Rockoff, MD]

I am skpetical of the diagnosis.  Perioral dermatitis is much more common in women.  Steroid creams can induce it in men, though, and one of the creams you are using is DesOwen, a mild steroid, but a steroid.

But I'm not sure the bumps are pimples at all.  Maybe they once were, and have left behind redness which is best ignored and left to fade on its own.  Certainly, all the lengthy and aggressive treatment you've used hasn't done the job.

Chewing food makes redness redder just by increasing blood flow to the skin nearby.  These fluctuations are not important.

Changing soaps and toothpastes rarely helps, in my experience.  I am skeptical as well of the validity of the "link" with sodium lauryl sulfate, certainly as it pertains to Cetaphil which in this context is innocuous though unhelpful.

"Could it even be that I simply need to stop topical treatment all together?"  you ask.

Indeed it could.  I see little to lose.  Ask your doctor.

Best.

Dr. Rockoff

[aliciariot]

I was diagnosed with Perioral dermatitis 2 years ago.
After being told the topical steroid I was using should be stopped, another M.d. gave me a scipt for doxy cyclene. The antibiotic did clear up the iritation, but now it is less effective, and I am hesitent to always be on antibiotics.
I stopped using them after my last refill was done because they are not working for me any more anyway.
I have tried another topical cream, but my skin is dry, peeling, and sore especially around my upper lip.
I am increasingly frustrated and my face literally hurts. What now?