Peri-Oral Dermatitis

Clinical features:

• Papular and pustular, acne-like dermatitis of lower face

• Usually young women 20–50 yrs

• Around mouth and on chin, sparing adjacent peri-oral area (see Fig. P2)—the ‘muzzle’ area

• Frequently begins at the nasolabial folds

Treatment

• Systemic antibiotics (first choice):

  • – doxycycline 100 mg (o) daily reducing to 50 mg/d for 8 wks—takes 10–14 d to respond; erythromycin if tetracyclines contraindicated

• Topical agents (consider if tolerated):

  • – metronidazole 0.75% gel bd or clindamycin 1% lotion bd

• Discontinue any topical corticosteroids and avoid all creamy preparations incl. moisturisers and make-up.