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Treatment for perioral dermatitis
by finkobx, Dec 10, 2008 04:22PM
Dr. Rockoff,
I was diagnosed with perioral dermatitis about a month ago. I got it while on vacation. I used a hot tub at a beach rental home and wound up with red bumps on my arms. I used OTC hydrocortisone cream and they went away. I also had a small patch of dry skin at the corner of my mouth, so for about 2 weeks, I used the cortisone cream on my face. It was then that all around my mouth I got red bumps and it was extremely dry and rough textured. I went to my family doc and she prescribed me 7 days of Bactrim DS. It went completely away by the end of the 7 days. However, one week later, it came back with in a 24 hour time period. So, I went to the dermatologist and he prescribed the Bactrim to me again and told me to take it for 3 months. I have been on the Bactrim the second time for about 25 days and it seems to have cleared almost all of the bumps, however there is residual redness. I guess my biggest concern is....what in the world is Perioral dermatitis??? My dermatologist had no answers for me. I get that it can be caused by using steroid creams on the face, which I did do for 2 weeks, but why does it then stay for so long? And is 3 months of Bactrim really going to treat it to make it go away or will it come right back after stopping the antibiotics?? I am trying to be positive in my thinking, but I am definitely concerned. Is POD a bacterial infection or is a fungus? Is it a yeast infection of the skin? Is it a deficiency in my body of some type of vitamin? I would be so grateful for anything that can help me better understand this and deal with it. It is unsightly and definitely makes me want to shy away from normal social activities. What type of success rates do you usually see with people who have this? Do most of the patients seem to treat well with antibiotics or does it seem to always come back?? Thanks very much for your reply.
I was diagnosed with perioral dermatitis about a month ago. I got it while on vacation. I used a hot tub at a beach rental home and wound up with red bumps on my arms. I used OTC hydrocortisone cream and they went away. I also had a small patch of dry skin at the corner of my mouth, so for about 2 weeks, I used the cortisone cream on my face. It was then that all around my mouth I got red bumps and it was extremely dry and rough textured. I went to my family doc and she prescribed me 7 days of Bactrim DS. It went completely away by the end of the 7 days. However, one week later, it came back with in a 24 hour time period. So, I went to the dermatologist and he prescribed the Bactrim to me again and told me to take it for 3 months. I have been on the Bactrim the second time for about 25 days and it seems to have cleared almost all of the bumps, however there is residual redness. I guess my biggest concern is....what in the world is Perioral dermatitis??? My dermatologist had no answers for me. I get that it can be caused by using steroid creams on the face, which I did do for 2 weeks, but why does it then stay for so long? And is 3 months of Bactrim really going to treat it to make it go away or will it come right back after stopping the antibiotics?? I am trying to be positive in my thinking, but I am definitely concerned. Is POD a bacterial infection or is a fungus? Is it a yeast infection of the skin? Is it a deficiency in my body of some type of vitamin? I would be so grateful for anything that can help me better understand this and deal with it. It is unsightly and definitely makes me want to shy away from normal social activities. What type of success rates do you usually see with people who have this? Do most of the patients seem to treat well with antibiotics or does it seem to always come back?? Thanks very much for your reply.
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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.