Treating Steroid-Induced Perioral Dermatitis while on Accutane?

Question

Currently in a course of accutane, and I was prescribed a topical steroid to use on and off for 4 months (desonide 0.05%) to help with retinoid dermatitis. I was unaware that it could lead to perioral dermatitis, and now I have steroid-induced perioral dermatitis. I've tried topicals, but they only seem to make it worse (especially due to sensitive, dry skin now). Current provider has me on oral antibiotics (macrolide). How long will they take to clear up the POD?

Anna Chacon, MD, FAAD · Answer

Steroid-induced perioral dermatitis can be a challenging condition to manage, especially when the patient is concurrently on isotretinoin (Accutane), as both conditions can cause similar skin irritation and dryness.
1. Discontinue Topical Steroids: The first step in treating steroid-induced perioral dermatitis is to discontinue the use of topical steroids, if possible. However, this should be done under the supervision of a healthcare provider as sudden discontinuation can sometimes cause a flare-up of symptoms.
2. Topical Antibiotics: Topical antibiotics such as metronidazole or erythromycin can be used to treat perioral dermatitis. They can help reduce inflammation and kill bacteria that may be contributing to the condition.
3. Oral Antibiotics: In more severe cases, oral antibiotics like tetracyclines may be prescribed. However, these are usually not used in conjunction with Accutane due to potential side effects. A healthcare provider may consider other options like erythromycin or azithromycin.
4. Gentle Skincare: Use gentle, fragrance-free cleansers and moisturizers to avoid further irritation. Avoid harsh scrubs, astringents, or other potentially irritating skin care products.
5. Avoid Fluoride and Sodium Lauryl Sulfate: Some studies suggest these ingredients, often found in toothpaste, may exacerbate perioral dermatitis. Consider switching to products without these ingredients.
6. Monitor Accutane Usage: If you're on Accutane, your dermatologist will closely monitor your response to the medication and adjust the dose as necessary. 
Remember, it's crucial to consult with your dermatologist or healthcare provider for personalized advice and treatment options. They can assess your skin's condition and recommend the best course of action based on your specific circumstances and overall health.

Treating Steroid-Induced Perioral Dermatitis while on Accutane?

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Treating Steroid-Induced Perioral Dermatitis while on Accutane?

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Everything you need to know about Accutane

Our mission is to create a world where every investment in modern beauty is Worth It.