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To the Editor.—
The cause of perioral dermatitis remains obscure. Some cases appear to be related to fluorinated corticosteroids used to treat other disorders. The conditions of these patients will ordinarily clear with cessation of the corticosteroids and the short-term administration of tetracycline.I believe that the intensive use of "moisturizing creams" is another precipitating factor. In the past year, the conditions of approximately 20 patients with this disease have cleared following discontinuance of moisturizing creams. All but one of the patients were women. On discontinuance of the moisturizers, many patients noticed a period of moderate to severe worsening that was characterized by erythema, small papulopustules, dryness, and peeling of the face. This "rebound" lasted for several weeks to several months, and it was often difficult to get patients through this period. I allow the use of lotion ointment base (Cetaphil) for cleansing the face one time daily and tetracycline
Abele DC. `Moisturizers' and Perioral Dermatitis. Arch Dermatol. 1977;113(1):110. doi:10.1001/archderm.1977.01640010112025