From the Research
Metronidazole is not the first-line treatment for perioral dermatitis, but it can be used as an alternative option, especially in cases where other treatments are not effective or suitable. The most recent and highest quality study, 1, published in 2021, evaluated the clinical efficacy of topical calcineurin inhibitors and topical/oral metronidazole in 24 Korean patients with pediatric periorificial dermatitis, and found that the majority of the patients showed a complete response to treatment. However, another study, 2, published in 2010, found that the evidence supporting topical metronidazole is relatively weak and supported only by case series and a trial showing it to be inferior to tetracycline. Key points to consider when using metronidazole for perioral dermatitis include:
- Topical metronidazole is available as a 0.75% or 1% cream or gel and is usually applied to the affected areas twice daily for 8-12 weeks.
- Oral metronidazole may be prescribed at doses of 500-750 mg daily for 4-8 weeks in more severe cases.
- Metronidazole has both anti-inflammatory and antimicrobial properties that help reduce redness, bumps, and irritation characteristic of perioral dermatitis.
- Patients should apply topical metronidazole to clean, dry skin and avoid the eyes, mouth, and mucous membranes.
- It's essential to continue the full course of treatment even if symptoms improve quickly, as premature discontinuation may lead to relapse.
- During treatment, patients should also avoid potential triggers like topical steroids, heavy moisturizers, and fluorinated toothpastes, which can worsen the condition.