Perioral dermatitis

[kristi13]

Hello, my question relates to perioral dermatitis. I have just been diagnosed, and my POD is at a medium level intensity because I abruptly quit my topical steroid cream (which im positive is the cause of all this).
I have been prescribed 21 days of doxycycline at 100mg and metronidazole 0.75%. I'm wondering if this will be enough to clear my POD? I know it usually takes quite a while to clear and this seems like not enough?
My doctor told me to take my oral anti-biotics for a couple of weeks first than start the topical anti-biotics. Is this the best way to go about, or should I be using them together??
Thank you for any help!

[dave580]

I was diagnosed with the same thing and mine wasn't all that noticeable.  I had about 6-8 little dots/zits around my mouth and lips.  Most people said it looked like I just had a couple zits, but I knew it was something more since I don't get zits like this, especially on my lips.  My dermatologist had me put an oitment in my nostrils twice a day for 7 days (which sucked) and I'm on Doryx or doxycycline at 150mg for 30 days.  I'm two weeks in and it's almost undetectable.  She told me to still take the full month to make sure that I really get the infetion out of my skin.  The ointment in the nose was to prevent the spreading.  Apparently POD is caused by a certain kind of staph in the nose perhaps?  Don't quote me on that, but she said that it's not a staph infection, and there is no risk of mrsa or anything.  It's not contagious.  I wonder what caused mine though, I read that 90% of the cases are in women, and guys don't get this very often at all.  I was using a topical steroid, but that was many months prior to getting POD.  Hope this helps.

[kristi13]

Thank you for your response - is 21 days of doxycycline enough? Will I see improvements?
Also - any insight into how long the rebound effect will last as I have abruptly stopped steroid creams.
Thanks!

[Bhupinder Kaur, MD]

Hello,
Tetracyclines are the standard treatment for perioral dermatitis and you have been prescribed the correct treatment. 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.

Doxycycline is the preferred antibiotic for perioral dermatitis but minocycline can also be used. In unresponsive and granulomatous forms, oral isoterinoin may also be considered.

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.