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dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 2779
Experience:  30 years practice in general and cosmetic dermatology
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I have dermatitis perioral past 6 months

Customer Question

I have dermatitis perioral for the past 6 months around my mouth and chin. My dermatologist prescribed Tetracycline but before I start taking this antibiotic, would there be any other solution you could recommend such as a topical cream?
I dont like taking this broad spectrum antibiotic. This condition can be stressful because it doesn't seem to go away. My other worry is the potential for scarring, what do you think? Ideally, if you could suggest another topical medicine which will help the rash to disappear I would be grateful.
Submitted: 2 years ago.
Category: Dermatology
Expert:  dermdoc19 replied 2 years ago.
That is a pretty standard treatment for perioral dermatitis. If you are concerned about taking Tetracycline, topical Clindamycin or Avar cream are decent alternatives.
Expert:  dermdoc19 replied 2 years ago.
I have also used Aczone with some success. If you are afraid of the antibiotic effect on your gut flora, your dermatologist might consider Oracea. Although this is an antibiotic, it works for its anti-inflammatory effect rather than killing bacteria. The dosage is considered too low to kill bacteria.
Expert:  dermdoc19 replied 2 years ago.
I would be happy to answer further questions.
Expert:  dermdoc19 replied 2 years ago.
As far as a cleanser I would recommend Cerave Moisturizing Wash. This helps restore the skin barrier function.
Customer: replied 2 years ago.
thanks for your response, do you think the topical Avar cream or Clindamymin you recommended will be as effective as the oral antibiotics, especially as the infection is still there after 6 months?
Expert:  dermdoc19 replied 2 years ago.
It is not really an infection. It is felt to be an overreaction to normal bacteria. Changing the bacterial flora of the skin may be the reason the above mentioned medications work. Either that or they work because of their anti-inflammatory properties. I usually use both a topical medication and an oral medicTION. I HAVE TENDED TO USE MORE ORACEA ( PERIOSTAT, generic) for concerns of what we call antibiotic stewardship ( prescribing less antibiotics to prevent bacterial resistance in the community). I personally think the oral antibiotic helps the most. Avar is a good product. If a woman ( nearly all cases of perioral dermatitis are in women) has redness as part of her symptoms, Avar has a variety called Avar green. The green tint masquerades the redness.
Expert:  dermdoc19 replied 2 years ago.
I would be happy to answer further questions.