From the Research
The most effective treatment for perioral dermatitis is oral tetracycline, as it has been shown to significantly shorten the time to papule resolution 1, 2, 3. When considering treatment options, it's essential to prioritize the patient's age, as oral tetracycline may not be suitable for children under 8 years old 1. In such cases, topical metronidazole, erythromycin, or pimecrolimus may be effective alternatives 1, 2, 4. Some key points to consider when treating perioral dermatitis include:
- Discontinuing all topical steroids, as they can worsen or cause the condition 1, 5
- Simplifying the patient's skincare routine by avoiding heavy moisturizers, fluorinated toothpastes, and facial products containing SLS (sodium lauryl sulfate)
- Using a gentle, fragrance-free cleanser and keeping the affected area moisturizer-free if possible
- Advising patients that the condition may temporarily worsen when topical steroids are discontinued, a phenomenon known as steroid rebound, before improving with appropriate treatment 1, 2. It's also important to note that the etiology of perioral dermatitis is not completely understood, but topical corticosteroid misuse is considered a principal causative factor in its pathogenesis 5. Overall, the treatment of perioral dermatitis requires a comprehensive approach that takes into account the patient's individual needs and circumstances.