My daughter has a cluster of bumps on the right side of her face below her lips. What to do?

Hi,

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I have read your query and examined your photograph (attachments removed to protect the person's identity). It seems she has perioral dermatitis. It is a common skin problem with itchy or tender small red bumps. The bumps usually occur around the mouth, nose, eyes, and occasionally in the genital area. The probable causes can be the following: Activation of the innate immune (genetically determined) system, Epidermal barrier dysfunction, Altered cutaneous microflora due to applying multiple medicinal products like topical steroids, steroid inhalers, cosmetics, fluorinated toothpaste, Neglecting to wash the face and hormonal changes. I suggest you the treatment plan. Taper the topical steroid cream use. Also, stop using other cosmetics and sunscreens. Do not stop the steroid cream suddenly as it may lead to flare up. So, just replace it with a less potent cream. After tapering the topical steroids, I suggest liquid or gel sunscreen like Suncros soft gel SPF 50+. Also, I would like to suggest capsule Doxycycline 100 mg once daily for four weeks and apply topical 0.03% Tacrolimus once during the night. Do not use soap. Instead, use a face wash with warm water to clean the face while the rash is present. Get a review after one month.