perioral dermatitis

Dear Doctor,

I have gone to see my dermatologist for mild acne on my face and red burning sensation around my mouth. He said 'It's irritated'. I did some internet searching and suspect it's perioral dermatitis. He gave me locoid lipocream (hydrocortisone steroid cream) for irritation around my mouth but after 3 days it's more red, burning and now flaky. I had stop using it and the irritation is even worse. I searched the cream and perioral dermatitis is listed as one of its side effects! So I've been applying a cream that gives me the same skin problem I already have!? Also I'm using Benzaderm 10% wash with aloe vera, Tazorac and taking solodyn (minocycline) for acne treatment. Do these products irritate perioral dermatits even more? and what do I do about steroid cream? I can't see my derm until next week and I don't know what to put on my face anymore. Please help!!

[Bhupinder Kaur, MD]

Hello,
Perioral dermatitis is a chronic papulopustular and eczematous facial dermatitis.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.The antibiotics that you are taking can be taken and they wont worsen your condition.Consult your doctor for prescribing you a less potent steroid cream as steroid creams can cause redness and peeling of the skin.
I hope that helps.Take care and please do keep me posted on how you are doing or if you have any additional doubts.Kind regards.

[graceyea]

Hi,
I stopped using the steroid cream and benzaderm wash and switched to a mild soap (manuka honey). So I'm taking Minocin and applying Tazorac for now. Most part of skin is peeled off. It looks alot better. I think the oral antibiotic is working very well!! I heard steroid creams do not cure the condition but just ease the symptoms. Is that true?
Thank you for your concern doctor!

[alarin]

I notice that you have suggested oral antibiotics and anti-inflammatory drugs to combat perioral dermatitis.  I've been suffering from this condition for about 2 years.  I was pregnant when I was diagnosed with it and my doctor was only comfortable prescribing a topical antibiotic.  This did very little to help the condition.  After my son was born and while I was nursing I developed what my doctor thought was a second condition around my eyes, she prescribed a topical steroid for the rash around the eye and said that we woudl have to wait until I stopped nursing to give me an antibiotic for the other rash.  I've just been to see her again, and I think I've finally convinced her that the rash around my eyes is the same as the rash that is now all around my mouth, chin, cheeks, and forehead.  She told me to stop using the steroid cream and prescribed Minocycline.  I've been using the Minocycline for about 4 days now and have not seen any improvement, actually it's much worse around my eyes since I stopped the steroid cream.  My eyelids are red, swollen and painful to the touch.  What type of anti-inflammatory would help?  Just an over-the-counter ibuprofen or is there something topical that I could use to reduce the swelling?  I'm not convinced the antibiotics are working at all, but I will continue to take them for at least the 4 weeks my doctor suggested and possibly longer if by then I have seen improvements.  But I would be grateful for any relief in the meantime.