Is the dryness around my mouth due to active perioral dermatitis?

Question

Hi doctor,

Four years back, I started taking Isotretinoin as I had acne and perioral dermatitis. After six months, everything went away. After eight months, I got redness around my mouth and so the doctor gave Isotretinoin 10 mg for a month with Metrogel. It helped me. After a year, redness around my mouth reappeared and the doctor gave me Tolexine 100 mg for two months with Metrogel. But it did not help me. Now I am taking Isotretinoin 20 mg two times a week. I do not know whether my perioral dermatitis is still active or I have post-inflammatory hyperpigmentation as I still have some dryness around my mouth and it looks yellow or red.

Answer 1

Hi,

Welcome to icliniq.com.

As you have erythema, then you still have active perioral dermatitis. Continue using Metrogel ointment (Metronidazole) once daily afternoon for 15 days. You can apply Tacrolimus cream once daily in small quantity at night for 15 days. Start taking Zinc tablets. It helps with inflammation. Use a mild cleanser to wash your face. Use Cetaphil. Keep the area moisturized and use Ceramide-based moisturizer. Do not use Isotretinoin for now as it seems to be mild dermatitis and it can cause dryness and cheilitis. You will get good results with Tacrolimus.

Answer 2

Hi,

Welcome back to icliniq.com.

Elidel is pemicrolimus. Try to apply in a small quantity with one or two drops on the entire area at night. Use sunscreen in the morning. You can use Cerave moisturizer or Cetaphil moisturizer. Both are Ceramide-based ones. Please mention if you get irritation with Elidel.

Answer 3

Hi,

Welcome back to icliniq.com.

You can use Toleriane and Bioderma. Both are good products. You can continue using both of them. You can start using Tacrolimus cream. Have a follow-up after two weeks.