From the FDA Drug Label
To use AZELEX® Cream for the full prescribed treatment period. If it does come in contact with the eyes, they should wash their eyes with large amounts of water and consult a physician if eye irritation persists. Due in part to the low pH of azelaic acid, temporary skin irritation (pruritus, burning, or stinging) may occur when AZELEX® Cream is applied to broken or inflamed skin, usually at the start of treatment.
The diagnosis of perioral dermatitis is not directly mentioned in the provided drug label. Treatment for perioral dermatitis is not explicitly stated in the label, but azelaic acid cream is used to treat certain skin conditions. The label provides precautions and instructions for the use of azelaic acid cream, including avoiding contact with the eyes and mucous membranes, and discontinuing treatment if severe irritation develops 1.
From the Research
Perioral dermatitis is best treated with a combination of oral antibiotics and topical treatments, with abrocitinib emerging as a potential therapy for resistant cases, as evidenced by a recent 2023 study 2. The diagnosis of perioral dermatitis involves identifying the characteristic papulovesicular eruption in the perioral region, with a typical narrow spared zone around the edge of the lips. The etiology of perioral dermatitis remains unclear, but it is often associated with the use of topical corticosteroids, skin irritants, and other physical and hormonal factors. Some key points to consider in the treatment of perioral dermatitis include:
- Avoiding the use of topical corticosteroids, as they can worsen the condition
- Using gentle, fragrance-free cleansers and moisturizers
- Discontinuing the use of heavy facial creams or fluorinated toothpaste
- Considering oral antibiotics, such as doxycycline, for their anti-inflammatory and antibacterial properties
- Using topical metronidazole to reduce skin irritation and redness
- Maintaining a simple skincare routine and avoiding potential triggers to prevent recurrence The most recent and highest quality study, published in 2023, suggests that abrocitinib, a Janus kinase (JAK) inhibitor, may be a promising therapy for cases of perioral dermatitis that are resistant to conventional therapies 2. In terms of treatment outcomes, improvement should be noticeable within 2-4 weeks, but complete resolution may take several months. After the initial antibiotic course, continuing with topical metronidazole for maintenance can help prevent recurrence. It is essential to note that the treatment approach should be individually addressed, depending on the severity of the clinical presentation and the patient's age, with special attention to patient education and continuous psychological support, as highlighted in a 2015 study 3. Overall, a comprehensive treatment plan that addresses the underlying inflammation, potential bacterial involvement, and triggers of perioral dermatitis is crucial for effective management and prevention of recurrence.