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Suggest Treatment For Peri Oral Dermatitis
Question: I was diagnosed with peri oral dermatitis and have been on Oracea for about 7 months and it completely cleared it up. But now it seems as though the rash is coming back. I have metro gel 1 percent but an scared to use it since I read if you stop it it will come back worse boy question for you is if I do use metro gel 1 percent how many times a day do I use it and can I use it for the next couple of years.
Brief Answer:
Perioral dermatitis can relapse; topical metronidazole can be tried.
Detailed Answer:
Hello. Thank you for writing to us
I have taken note of your query and I have understood it.
Perioral dermatitis can certainly relapse after a seemingly complete cure.
Though Oral Doxycycline (a tetracycline group of drug) as well as other oral drugs like Minocycline, Azithromycin and Erythromycin are more effective in achieving control in perioral dermatitis however, topical treatment is also effective in perioral dermatitis and comprises a lot of options like metronidazole, pimecrolimus, azaleic acid, clindamycin, benzoyl peroxide etc.
Certainly, Metronidazole can be tried. You may use it twice daily.
If it is effective, all by itself, without the need for an Oral tetracycline you may continue with it for a few weeks or months and then gradually taper it down to once daily for next few days or weeks and then try to stop.
Topical metronidazole does not cause any rebound flare.
There is no contraindication even if it is required to be used for a long term Or even if repeatedly.
However, sometimes the rash of perioral dermatitis may not respond as well as is expected to topical treatment alone.
In that case, oral treatment needs to be started again.
The decision whether to use topical Or oral treatment Or both is decided best by the treating doctor after having a look at skin condition
Regards
Perioral dermatitis can relapse; topical metronidazole can be tried.
Detailed Answer:
Hello. Thank you for writing to us
I have taken note of your query and I have understood it.
Perioral dermatitis can certainly relapse after a seemingly complete cure.
Though Oral Doxycycline (a tetracycline group of drug) as well as other oral drugs like Minocycline, Azithromycin and Erythromycin are more effective in achieving control in perioral dermatitis however, topical treatment is also effective in perioral dermatitis and comprises a lot of options like metronidazole, pimecrolimus, azaleic acid, clindamycin, benzoyl peroxide etc.
Certainly, Metronidazole can be tried. You may use it twice daily.
If it is effective, all by itself, without the need for an Oral tetracycline you may continue with it for a few weeks or months and then gradually taper it down to once daily for next few days or weeks and then try to stop.
Topical metronidazole does not cause any rebound flare.
There is no contraindication even if it is required to be used for a long term Or even if repeatedly.
However, sometimes the rash of perioral dermatitis may not respond as well as is expected to topical treatment alone.
In that case, oral treatment needs to be started again.
The decision whether to use topical Or oral treatment Or both is decided best by the treating doctor after having a look at skin condition
Regards
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Thanknyou for your response. When I had my last outbreak last year in September, that was the last bad one then I was ear until now, I used acv to get rid of all the dots. On top of using metro gel morning and night, could i use the acv in between to get rid of further dots. And I do yogurt masks as well , can those be continued. And what is in metro gel that gets rid of perioral dermatitis? Thank you for taking your time to answer
Brief Answer:
Perioral dermatitis has a good prognosis, overall
Detailed Answer:
Hi.
Perioral dermatitis can develop to even the slightest of irritations on face and therefore I would not recommend apple cidar vinegar (acv) on face as it can cause irritation and precipitate a relapse.
I also suggest you to use a gentle cleanser for face wash, twice daily e.g cetaphil cleansing lotion.
Stop everything else like masks, sunscreens, cosmetics, moisturizers etc as these can be factors in precipitating a relapse.
The gel that you have inquired contains metronidazole.
Topical Metronidazole which is an antiinflammatory and thus beneficial in perioral dermatitis.
As I already mentioned, oral doxycycline and other oral antibiotics bring about the most remarkable response in perioral dermatitis, therefore, if your recent flare is severe enough it would be appropriate to combine both topical metronidazole along with Oral doxycycline.
The condition is nevertheless only of cosmetic concern and has a goof prognosis although there may be a few relapses.
I suggest that you talk to your doctor for the needful. Your doctor will assess the exact condition and advice accordingly.
Regards
Perioral dermatitis has a good prognosis, overall
Detailed Answer:
Hi.
Perioral dermatitis can develop to even the slightest of irritations on face and therefore I would not recommend apple cidar vinegar (acv) on face as it can cause irritation and precipitate a relapse.
I also suggest you to use a gentle cleanser for face wash, twice daily e.g cetaphil cleansing lotion.
Stop everything else like masks, sunscreens, cosmetics, moisturizers etc as these can be factors in precipitating a relapse.
The gel that you have inquired contains metronidazole.
Topical Metronidazole which is an antiinflammatory and thus beneficial in perioral dermatitis.
As I already mentioned, oral doxycycline and other oral antibiotics bring about the most remarkable response in perioral dermatitis, therefore, if your recent flare is severe enough it would be appropriate to combine both topical metronidazole along with Oral doxycycline.
The condition is nevertheless only of cosmetic concern and has a goof prognosis although there may be a few relapses.
I suggest that you talk to your doctor for the needful. Your doctor will assess the exact condition and advice accordingly.
Regards
Above answer was peer-reviewed by :
Dr. Raju A.T
So I'm already on the oral doxycycline. Even on the antibiotic and having no relapses since starting it in September, there's still a chance for relapse while being on it? I really do think the relapse was caused my the uv lights in the tanning bed. Really hoping all this will clear up again since I'm leaving for Greece In a week. Also once the rash clears, can I continue the acv and yogurt masks. I just don't understand if that's what I used to clear up the rash last time and have been using it since why would it not work again?
Brief Answer:
Yoghurt mask is acceptable but not vinegar
Detailed Answer:
Hi.
Yes, even while on treatment there might be a breakthrough flare up of perioral dermatitis in response to certain exacerbating factors and UV light is one of those.
In general perioral dermatitis patients should avoid anything that can possibly precipitate it.
Sunscreens, moisturizers, cosmetics, UV light, apple cidar vinegar etc are well known factors that may cause it to return.
My advice to avoid everything was a general one because almost anything can precipitate a relapse.
Though I don't see any problem with yoghurt mask. It is a gentle exfoliator and is acceptable for sensitive skin.
Moreover, since you have used yoghurt mask in the past therefore I don't think it would be an issue.
Vinegar is too strong and I would suggest you to avoid it.
Regards
Yoghurt mask is acceptable but not vinegar
Detailed Answer:
Hi.
Yes, even while on treatment there might be a breakthrough flare up of perioral dermatitis in response to certain exacerbating factors and UV light is one of those.
In general perioral dermatitis patients should avoid anything that can possibly precipitate it.
Sunscreens, moisturizers, cosmetics, UV light, apple cidar vinegar etc are well known factors that may cause it to return.
My advice to avoid everything was a general one because almost anything can precipitate a relapse.
Though I don't see any problem with yoghurt mask. It is a gentle exfoliator and is acceptable for sensitive skin.
Moreover, since you have used yoghurt mask in the past therefore I don't think it would be an issue.
Vinegar is too strong and I would suggest you to avoid it.
Regards
Above answer was peer-reviewed by :
Dr. Raju A.T
Ok thank you so much. I am going to for now use metrogel 1 % twice a day and then April start to use it once a day. Is it safe to use for a long period of time. If this helps clear up the little bout that I have now, I'd be comfortable to use it every night before bed. Are there any side effects to have a continued long use of this cream. I have read good reviews so it puts me a bit at ease. I know it's hard to answer but since my flare up is so small compared to when it was really bad, how long will it take for the metro gel to kick in where I can wear powder again and have my skin feeling strong?
Brief Answer:
Metronidazole works fine for mild perioral dermatitis
Detailed Answer:
Hi.
You can safely use metronidazole gel even over long term Or repeatedly, if required. It is absolutely safe.
Initially use it once daily at night for a week and later you may use it twice daily.
Side effects are dryness and occasional irritation.
With metronidazole you should notice improvement in about 2 weeks.
Regards
Metronidazole works fine for mild perioral dermatitis
Detailed Answer:
Hi.
You can safely use metronidazole gel even over long term Or repeatedly, if required. It is absolutely safe.
Initially use it once daily at night for a week and later you may use it twice daily.
Side effects are dryness and occasional irritation.
With metronidazole you should notice improvement in about 2 weeks.
Regards
Above answer was peer-reviewed by :
Dr. Prasad
Perfect thank you so much for your help. I will post a picture before this chat room is ended for me. If I have any other questions I'll contact you. Thank you for your help
Brief Answer:
You are welcome
Detailed Answer:
Hi.
Thank you for writing to us. Sure! you can contact me at your will.
Regards
You are welcome
Detailed Answer:
Hi.
Thank you for writing to us. Sure! you can contact me at your will.
Regards
Above answer was peer-reviewed by :
Dr. Prasad
Hi there. Another quick question. Since I'm using metro gel morning and night, during the in between time after the morning where the gel has been on for a while, am I able to use my soap and cream that I purchased that was designed for pd? I don't exfoliate the area just gently wash it then apply a cream. Then tonight I would do a yogurt mask then apply the gel again. Will using the soap and cream affect the metro gel healing process?
So starting out I should use metro gel twice a day for a few weeks then go to once a day? Also will this cause my face to burn or look addionally red? Thanks for your time
And also if burning goes occur should I try to decrease my application to once a day?
So starting out I should use metro gel twice a day for a few weeks then go to once a day? Also will this cause my face to burn or look addionally red? Thanks for your time
And also if burning goes occur should I try to decrease my application to once a day?
Brief Answer:
Avoid using too many things together on face; the goal is to calm your skin
Detailed Answer:
Hi.
Avoid using too many things simultaneously together. Using too many things together might cause more irritation and a full blown flare.
The goal is calm down your skin. Therefore use only the medication and avoid other things like masks and other creams etc.
Since you have a mild flare up of dermatitis, therefore, the best thing to do would be to just use metronidazole daily, initially once daily for a week and then make it twice daily after a week and finally once everything is clear you may again go back to just once a day application.
I repeat, avoid yoghurt mask or any other cream for the time being and first let the flare up subside. You may use them later.
As I already mentioned, use a gentle cleanser like cetaphil cleansing lotion rather than a soap.
Regards
Avoid using too many things together on face; the goal is to calm your skin
Detailed Answer:
Hi.
Avoid using too many things simultaneously together. Using too many things together might cause more irritation and a full blown flare.
The goal is calm down your skin. Therefore use only the medication and avoid other things like masks and other creams etc.
Since you have a mild flare up of dermatitis, therefore, the best thing to do would be to just use metronidazole daily, initially once daily for a week and then make it twice daily after a week and finally once everything is clear you may again go back to just once a day application.
I repeat, avoid yoghurt mask or any other cream for the time being and first let the flare up subside. You may use them later.
As I already mentioned, use a gentle cleanser like cetaphil cleansing lotion rather than a soap.
Regards
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. Shanthi.E
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