Proper treatment of perioral dermatitis

[jennag]

Eight years ago I had a rash around my lip that I treated with a steroid cream, which then caused Perioral Dermatitis.  My dermatologist gave my minocyline for 1 month and metro cream which completely cleared it up.  Three months ago the dermatitis came back, I was not using any steriod cream at the time, but I believe it flared because of a new concealer I was using to cover a little redness around my nose. So now it is back worst than I can remember with the first outbreak, it has spread to my forehead and cheeks.  It is leaving alot of brown spots where the large cysts have appeared.  I have frantically searched the internet about this condition and have found numerous cases of people who have had this for years.  This is causing me a great deal of anxiety, I really don't think I can live with this for years, I have bareley left my house since it came back.  I have stopped using my birth control (ortho-tryclen), florinated toothpaste, soap, shampoo with SLS and makeup and moisterizers.  I have been on the minocylcine 100mg per day for about five weeks now and there is noticeable improvement.  I am still getting a few whiteheads appearing and blackheads on my chin, I can't tell anymore if its perioral dermatitis or just a pimple.

My questions for you are:
In your experience with this condition, is it long term and untreatable?
How long does the minocylcine take to work?
Can I stay on it long term for POD treatment?
Would it help to go back on the orthotryclen?  My skin was great while taking it.

I greatly appreciate any information you can provide to ease my mind.

Thank you.

[Alan Rockoff, MD]

You went without the rash for 8 years--why would you suddenly worry that it will never go away?

Steroids aggravate perioral dermatitis, but the condition usually comes for no cause.  If you go back on Minocycline or some similar antibiotic, you should clear up in a month.  That should clear you up within a month.  No need to go back on the pill.  Also no need for chronic oral therapy.  If the condition comes back at all, it probably won;t do so for years.

Take care.

Dr. Rockoff

[jennag]

Thank you for your prompt and reasuring response.  My only concern is that I have been taking the minocycline for five weeks and although much better the dermatitis is still there.  Every dermatology site I checked said anitbiotics are needed for a 12 week period.  Is this the case with your experience of POD.

[summerluvr]

i have had PD for over 3 years and it never goes away.   I also have rosacea on my nose and cheeks that doesn't go away.  I took doxycycline for three months, and have used metro for the rest of the time.  If i stop the cream it gets worse over night, but the cream never gets rid of it.  so annoying.  There must be something that works

[erinmasse]

I too have been on minocycline for 5 weeks now and just yesterday noticed two tiny bumps returning.  It is definitely frustrating.  We would like to have another baby and unfortunately this problem is putting that off....hopefully 12 weeks will do the trick.

[loiloi]

Going back on the contraceptive pill will help. The brand you were using is known to clear hormonal acne around the mouth, as will Diane35. I have acne and peri-oral dermatitis and use Diane35 (called Dianette in the UK) oxytetracycline and Differin gel.
Eloise x

[jennag]

Hey everyone,

Its not POD, its hormonal acne.  I did have POD but from using cheap *** makeup, but it cleared quickly after I started using Grapefruit Seed Extract and water on it. You can get it at a health food store.  Just mix about 15 drops in an ounce of water in a little sealable container.  Shake it till its bubbly and apply it with your finger 3 times a day.
Works great for lots of skin conditions.  I will never use antibiotics again, I'm sure they are what jump started my oil glands into overdrive.  Back on the pill, hope it clears me up.

PS - If you use the GSE make sure you dilute it, very strong stuff, but all natural.

Jenna