Perioral dermatitis is a skin condition that has a presentation similar to that of rosacea. Like rosacea, its cause is unknown. Some dermatologists think it is a form of rosacea; others think of it as a similar but separate type of dermatitis. There are numerous triggers of rosacea.
Discontinuing use of strong topical steroid lotions, or tooth-paste containing fluoride or pyrophosphates, seems to reduce the symptoms of perioral dermatitis. Dr. McCaffery is correct in that, if this is the case, these patients need to be educated about other preventive measures to prevent tooth decay.
Topical metronidazole is one of the drugs used to treat rosacea. Oral antibiotics are the most common treatment for perioral dermatitis. If a patient’s symptoms don’t subside after the discontinued use of toothpaste, then it should be the dermatologist’s decision to start him or her on antibiotic or topical metronidazole therapy.
