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dermdoc19
dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 4124
Experience:  30 years practice in general and cosmetic dermatology
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Small blister type rash from corners of mouth down to chin.

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small blister type rash from corners of mouth down to chin. I have not been wearing makeup, I have tried cortisone creams and they reduce the rash sometimes, but it still comes back. The blisters look more like little pimples. Is this a food allergy or something more. I have had it for over three months

From your description, sex and age, this sounds like it might be peri-oral dermatitis. I would be happy to confirm this, if you would be able to forward a picture.

JACUSTOMER-1vde5l1m- :

I did look up the description of peri-oral dermatitis, perhaps I should mention that I am post-menapausal (complete hystirectomy in 2007), I am very light-skinned, and I do react to facial creams and sun screen. I have been avoiding foundations, and skin creams.

dermdoc19 :

I feel this is peri-oral dermatitis, a rather severe case. However, there is a possibility, in light of your use of cortisone creams that there may be some yeast at play, especially in the lateral corners of the mouth.

There are a number of measures to be taken. Brush your teeth at least an hour before bedtime. Continue to not wear skin care products on your face a night.
JACUSTOMER-1vde5l1m- :

I have tried acne medications and washes in the past, they just make it worse. Is there anything I can use to lessen the appearance?

dermdoc19 :

I realize there may be pieces blaming female hormones for this, but that is all speculation. A thorough review of the literature which I did a few years ago, before giving a lecture at the medical school on the topic, failed to find any support for this.

Some anti-acne medications help this, but some make it worse. Benzoyl Peroxides flare this condition up badly so should not be used.
Retin A cream is sometimes OK, but not when it is flared. Topical Clindamycin is an anti-acne medication which is quite beneficial.
Any sort of peel or microdermabrasion worsens the situation.
By far the best treatment for this is oral Tetracycline? Was this tried?
JACUSTOMER-1vde5l1m- :

No, I have not tried any antibiotics.

Would your recommendation be that I see my doctor and ask for a prescription?
dermdoc19 :

Yes, Tetracycline would be the choice. It is safe, cheap and effective. I would scrape the corner for a KOH scraping to rule out a fungus. Cleocin Lotion is very good for this. Some people like Epiceram too. You do not want to use a steroid: you may even have steroid acne, complicating the above...plus it makes you prone to a yeast infection...especially in the corners of the mouth which is moist and provides a good environment for yeast.

JACUSTOMER-1vde5l1m- :

Thank you for your time, I appreciate the attention and detail you have provided for possible treatments.

dermdoc19 :

You're welcome...also make sure you use a simple toothpaste: Arm & Hammer...Tom's of Maine come to mind. Should not have tartar control.

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