How can I treat persistent perioral dermatitis??

Dr Irwin I'm 52 and have had acne and peri oral dermatitis on and off since I was 25. I was on desocort cream for 20 years, I've exausted antibiotic use, I can put cream on my face but if I put it around my mouth and chin my skin breaks out terribly. I've used benzol peroxide, retinol,metrogel. My skin is very sensitive to many cleansers even Cetephil makes my skin itch. I've been to many Dermatologists who have run out of options...I continue my quest!!! Thanks for any options

This does not sound like fun!   You didn’t tell me if you still use the Desonide 0.05% cream – even occasionally.  There is some fairly substantial data now that ANY topical steroid, used on the face over time, can make rosacea or perioral dermatitis worse.  This may be why you are still having problems.  I strongly recommend to my patients that they get off any topical steroids on the face (this often takes a long weaning process to avoid rebound flares). Can you consult a different dermatologist yet again?  There has to be someone in your community who might be able to help you.

Also, if Cetaphil makes you itch, have you tried the Free and Clear line (try their Vanicream cream or lotion).  You can buy this online.  Also, a culture should definately be done to rule out any bacterial colonization or infection issues.   I hope this helps!.  Dr. I

Dr. Brandith Irwin, MD

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