Perioral dermatitis won't go away

I've had perioral dermatitis for several months now that hasn't gone away with various different types of treatment.

It started as fairly mild but still annoying. I saw a dermatologist who prescribed protopic, which worked decently, and then desonide cream. The rash was about 75% gone after several weeks with desonide, but then suddenly got worse again.

I went back to the dermatologist, who said the dermatitis had likely become resistant to desonide and told me to discontinue that as well as protopic. He has now prescribed tetracyline, specifically 250mg pills twice a day for a month.

I've used it for about a week and a half now with no results. Does this seem like a week dosage? From what I've read online, tetracyline is usually prescribed at 500mg for 6 weeks.

[Bhupinder Kaur, MD]

Hello,
Perioral dermatitis like acne is a chronic papulopustular and eczematous facial dermatitis. It mostly effects women and appear around the nose, mouth and eyes. Treatment consists of oral antibiotics and anti-inflammatory drugs. A mild soap or soap substitute, such as Dove or Cetaphil should be used for washing. Scrubbing should be avoided.
Antibiotics like Doxy or Tetracycline are the treatment of choice and the dose is usually 500 mg PO three times during wk 1; 500 mg PO bid during wk 2; 250-500 mg PO qd for as long as 6 wk. You should consult your dermatologist and get it done.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.