From the Guidelines
The treatment of perioral dermatitis should involve avoiding greasy creams, topical acne medications, and topical steroids, as they can exacerbate the condition or cause unwanted side-effects 1. When managing perioral dermatitis, it is essential to consider the potential irritants and allergens that can worsen the condition.
- Avoiding greasy creams for basic care is crucial, as they can facilitate the development of folliculitis due to their occlusive properties 1.
- Topical acne medications, including retinoids, should be used with caution, as they can irritate and worsen the condition 1.
- Topical steroids should also be avoided, as they can cause perioral dermatitis and skin atrophy if used inadequately 1. In terms of treatment, the focus should be on gentle, non-irritating products and lifestyle modifications.
- A gentle, fragrance-free cleanser should be used, and the face should be rinsed with lukewarm water.
- Topical antibiotics, such as metronidazole or clindamycin, may be effective in reducing the characteristic papules and pustules of perioral dermatitis.
- Oral antibiotics, such as doxycycline or minocycline, may be necessary for moderate to severe cases. It is essential to note that the treatment of perioral dermatitis should be individualized, and patients should be advised to discontinue all topical steroids, cosmetics, and heavy moisturizers on the affected area during treatment 1.
From the Research
Treatment Options for Perioral Dermatitis
- Oral tetracycline is considered a first-line treatment for perioral dermatitis, as it significantly shortens the time to papule resolution 2, 3, 4
- Topical metronidazole, erythromycin, and pimecrolimus are also effective treatment choices with good evidence 2, 3, 5, 6
- "Zero therapy" (discontinuation of cosmetics and topical corticosteroids) can be an effective treatment for mild cases of perioral dermatitis 3, 5
- Systemic isotretinoin may be considered for patients refractory to standard therapies 5
- Azelaic acid cream, benzyl peroxide preparations, and topical clindamycin or tetracycline may also be used in the treatment of perioral dermatitis 6
Considerations for Treatment
- The treatment approach should be individually addressed, depending on the severity of clinical presentation and patient's age 5
- Patients with steroid-induced perioral dermatitis should be closely followed up due to the risk of rebound phenomenon after cessation of previous topical treatment 5
- Topical corticosteroid use is common in perioral dermatitis cases, but its role as a cause or treatment remains unclear 2