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Suggest Alternative Medication For Perioral Dermatitis
Question: I have perioral dermatitis. I'm using metro gel now but doesn't seem to be working as fast as I used it last time. I was wondering if I can take flagyl 500 mg to help treat the bacteria that may cause the pd. I'm currently in Greece and they sell it here bits a brownish capsule. What would you recommend for the dosage if I can take it orally on top of using the gel and taking Oracea.
Brief Answer:
If metronidazole gel not working then clindamycin/nadifloxacin can be used.
Detailed Answer:
Hello,
Welcome and thanks for posting your query to the forum.
I can understand your concern for Perioral dermatitis.
Perioral dermatitis is a commonly encountered clinical entity and is quite recurring condition. It is sometimes quite difficult to completely treat this condition.
I can get from your query that you are using metronidazole gel over the affected are and want to use oral metronidazole for the same.
In my patients I prefer to use topical therapy than any oral medications. Over and above there is no direct role of metronidazole orally in cases of Perioral dermatitis. So I am not in favor of using metronidazole orally.
In case if metronidazole gel is not working then I prefer to use certain other antibiotic gels such as clindamycin gel or nadifloxacin cream. In any flare of pimples like eruptions I use benzoyl peroxide 2.5 % gel in dilutions.
If at all these topical medications are not working then I use certain oral antibiotics such as doxycycline or minocycline as per the grade and extent of involvement.
I hope this information will help you.
"Wish you good health"
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)
If metronidazole gel not working then clindamycin/nadifloxacin can be used.
Detailed Answer:
Hello,
Welcome and thanks for posting your query to the forum.
I can understand your concern for Perioral dermatitis.
Perioral dermatitis is a commonly encountered clinical entity and is quite recurring condition. It is sometimes quite difficult to completely treat this condition.
I can get from your query that you are using metronidazole gel over the affected are and want to use oral metronidazole for the same.
In my patients I prefer to use topical therapy than any oral medications. Over and above there is no direct role of metronidazole orally in cases of Perioral dermatitis. So I am not in favor of using metronidazole orally.
In case if metronidazole gel is not working then I prefer to use certain other antibiotic gels such as clindamycin gel or nadifloxacin cream. In any flare of pimples like eruptions I use benzoyl peroxide 2.5 % gel in dilutions.
If at all these topical medications are not working then I use certain oral antibiotics such as doxycycline or minocycline as per the grade and extent of involvement.
I hope this information will help you.
"Wish you good health"
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
So I shouldn't take the flagyl? Will it do any good for me if I go take it?
Brief Answer:
Perioral dermatitis : various sugestions and guidance.
Detailed Answer:
Hello,
Welcome back and thanks for your swift follow up.
As I said earlier in my previous mail that I am not in favor of using metronidazole orally (any tablets by mouth). It is because of the fact that it is not an established therapy for the same. The other of the options are already been describe to you.
Even then I give you certain other tips and important points which I guide to my patients:
-Steroids are implicated to be very important cause of the condition. SO if you are using any steroid based cream then should stop it immediately. The use of inhaled steroids for treating asthma, particularly from nebulizers, may also cause perioral dermatitis. Systemic steroids may be an additional triggering factor. Periocular dermatitis may be caused by steroid eye ointments. So if you are using any of these, then must stop the steroid based medications.
-Toothpaste is also considered to be a primary irritant and allergic contact factor. SO should check it by changing your toothpaste.
-An intimate contact with a partner’s beard stubble is also an irritant factor. I have specifically found in young females of your age having this factor as one of the important cause in aggravating the condition.
-Cosmetic products, especially foundation, may play an important role resulting from an occlusive effect by these products.
- Change of weather superficially causes more flare. SO you should take care of direct contact of cold air specifically and exposure to external environment.
I hope this information will help you.
"Wish you good health and early recovery from the problem"
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)
Perioral dermatitis : various sugestions and guidance.
Detailed Answer:
Hello,
Welcome back and thanks for your swift follow up.
As I said earlier in my previous mail that I am not in favor of using metronidazole orally (any tablets by mouth). It is because of the fact that it is not an established therapy for the same. The other of the options are already been describe to you.
Even then I give you certain other tips and important points which I guide to my patients:
-Steroids are implicated to be very important cause of the condition. SO if you are using any steroid based cream then should stop it immediately. The use of inhaled steroids for treating asthma, particularly from nebulizers, may also cause perioral dermatitis. Systemic steroids may be an additional triggering factor. Periocular dermatitis may be caused by steroid eye ointments. So if you are using any of these, then must stop the steroid based medications.
-Toothpaste is also considered to be a primary irritant and allergic contact factor. SO should check it by changing your toothpaste.
-An intimate contact with a partner’s beard stubble is also an irritant factor. I have specifically found in young females of your age having this factor as one of the important cause in aggravating the condition.
-Cosmetic products, especially foundation, may play an important role resulting from an occlusive effect by these products.
- Change of weather superficially causes more flare. SO you should take care of direct contact of cold air specifically and exposure to external environment.
I hope this information will help you.
"Wish you good health and early recovery from the problem"
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
So I think the metro gel might be making my chin more red since I've been using it for about a week and a half and I haven't seen my chin or face completely clear yet. My chin has remained red and I think it's from the metro gel. Is it ok to just stop metro gel? Will I have a bad flare up or anything?
Brief Answer:
Topical application such as clindamycin gel or nadifloxacin cream.
Detailed Answer:
Dear young lady,
Welcome back and thanks for your further follow up.
Metronidazole gel can be used for perioral dermatitis of mild grade. In case fo the grade of dermatitis is higher or the eruptions or the redness is more then other topical application such as clindamycin gel or nadifloxacin cream or benzoyl peroxide 2.5 % gel can be used.
Still if despite doing all the measures as suggested in previous mail you feel more eruptions then oral antibiotics such as doxycycline or minocycline can be used.
Do not try to touch the area as can cause furtehr flare. Follow the suggestions as given in the previous mail.
I hope this information will help you.
"Wish you good health and early recovery from the problem"
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)
Topical application such as clindamycin gel or nadifloxacin cream.
Detailed Answer:
Dear young lady,
Welcome back and thanks for your further follow up.
Metronidazole gel can be used for perioral dermatitis of mild grade. In case fo the grade of dermatitis is higher or the eruptions or the redness is more then other topical application such as clindamycin gel or nadifloxacin cream or benzoyl peroxide 2.5 % gel can be used.
Still if despite doing all the measures as suggested in previous mail you feel more eruptions then oral antibiotics such as doxycycline or minocycline can be used.
Do not try to touch the area as can cause furtehr flare. Follow the suggestions as given in the previous mail.
I hope this information will help you.
"Wish you good health and early recovery from the problem"
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
That's the thing.. When I had my last bad flare up it was in September. I began taking Oracea and using Osmia organic products which transformed my skin ba k to what I love!! It has been six months now with no flare up and no signs of the pd coming back. February I stupidly did a bed XXXXXXX and exposed my face to the uv Rays and noticed a small flare up. I used metro gel once at night for five days and boom flare up gone, back to normal. Then seven days later noticed my face looking a little stressed, by this time I'm in Greece and started using metro gel. It has been about two weeks now and no improvement. The area looks s little red but nothing to worry about. I used acv and yogurt and my cream and soap to get rid if it last time. And with excellent success. Since I'm in Greece don't really have the tools to do the acv but why would it come back if everything's been going well? I just don't get this. And will the same tools like the acv work again to cure it.
Brief Answer:
Application of Apple Cider Vinegar or yoghurt is not a good idea.
Detailed Answer:
Dear young lady,
Welcome back and thanks for your swift follow up.
Perioral dermatitis is really bothersome. The basic thing is sudden flare of the condition. I have found in my patients there are certain aggravating things which causes the problem. Like in your case it started with sun exposure. The direct contact of air also cause the problem.
Application of Apple Cider Vinegar (as you mentioned acv) is not a good idea. The same is true for yoghurt too. On one side these can cause irritation over the area and on the other side can cause blockage of the pore. Both of these things can cause more aggravation of the condition.
As a dermatologist I do not recommend you to use Apple Cider Vinegar or yoghurt.
As I can get that your present location is in Greece. I also can get that you have redness of the skin so application of a plane antibiotic cream would be better idea which you can get as an over the counter medication. You can continue to apply metronidazole gel till you get an antibiotic cream. If at all you find more of eruptions or sudden flare then can get tablet doxycycline or minocycline prescribed by a doctor.
I hope this information will help you.
"Wish you good health and early recovery from the problem"
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)
Application of Apple Cider Vinegar or yoghurt is not a good idea.
Detailed Answer:
Dear young lady,
Welcome back and thanks for your swift follow up.
Perioral dermatitis is really bothersome. The basic thing is sudden flare of the condition. I have found in my patients there are certain aggravating things which causes the problem. Like in your case it started with sun exposure. The direct contact of air also cause the problem.
Application of Apple Cider Vinegar (as you mentioned acv) is not a good idea. The same is true for yoghurt too. On one side these can cause irritation over the area and on the other side can cause blockage of the pore. Both of these things can cause more aggravation of the condition.
As a dermatologist I do not recommend you to use Apple Cider Vinegar or yoghurt.
As I can get that your present location is in Greece. I also can get that you have redness of the skin so application of a plane antibiotic cream would be better idea which you can get as an over the counter medication. You can continue to apply metronidazole gel till you get an antibiotic cream. If at all you find more of eruptions or sudden flare then can get tablet doxycycline or minocycline prescribed by a doctor.
I hope this information will help you.
"Wish you good health and early recovery from the problem"
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
So I'm sorry, I just don't understand why I should not use acv and yogurt if those were the two things that got rid of the flare up in the first place? You say they are bad for me but they did such an amazing job at clearing up the first flare and keeping my face good so how can it be bad to do again?
Brief Answer:
A better & safer option is to apply clindamycin gel or nadifloxacin cream.
Detailed Answer:
Dear young lady,
Welcome back and thanks for your further follow up.
As a dermatologist I do not recommend you to use Apple Cider Vinegar and yogurt. I have already guided that these can cause further irritation and blockage. You were lucky enough last time that you got improvement of the flare by its use last time.
We quite very often see severe flare by Apple Cider Vinegar and use of similar things. These are not the recommended things for perioral dermatitis. There is no exact concentration of the contents been written on Apple Cider Vinegar. There are variety and different brands of Apple Cider Vinegar available in market and any of these can have high or low concentration. So in case if the concentration is high then it can cause more irritation and then further flare.
A better and safer option is to apply clindamycin gel or nadifloxacin cream.
I hope this information will help you.
"Wish you good health and early recovery from the problem"
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)
A better & safer option is to apply clindamycin gel or nadifloxacin cream.
Detailed Answer:
Dear young lady,
Welcome back and thanks for your further follow up.
As a dermatologist I do not recommend you to use Apple Cider Vinegar and yogurt. I have already guided that these can cause further irritation and blockage. You were lucky enough last time that you got improvement of the flare by its use last time.
We quite very often see severe flare by Apple Cider Vinegar and use of similar things. These are not the recommended things for perioral dermatitis. There is no exact concentration of the contents been written on Apple Cider Vinegar. There are variety and different brands of Apple Cider Vinegar available in market and any of these can have high or low concentration. So in case if the concentration is high then it can cause more irritation and then further flare.
A better and safer option is to apply clindamycin gel or nadifloxacin cream.
I hope this information will help you.
"Wish you good health and early recovery from the problem"
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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