Hi! I am 56 y.o female, generally healthy, who noticed for the last month dry scaly skin on the perioral region of the chin, on my medial eyebrows, and perinasal area.  I have not changed my cosmetic use, use a cream cleanser, and no blisters.  I was told not to use any makeup and to clean only with warm water.  Should I also try oxytetracycline or topical steroids?
Hello. Thanks for writing to us at Chat Doctor I will keep a possibility of facial seborrhea dermatitis. Facial seborrhea dermatitis classically presents with scaly patches on face particularly sides of nose, medial eyebrows or glabella, chin and upper lip etc. The patches are usually dull red and scaly. Seborrheic dermatitis is a steroid responsive dermatomes. I usually treat my patients of facial seborrhea dermatitis with a moderately potent topical steroid e.g. fluticasone propionate 0.05% cream, twice daily. This usually brings about remarkable improvement in my patients in about 10 days to 2 weeks. However, since seborrhea dermatitis is a recurrent condition and because steroids can be used forever on face therefore once significant improvement has been achieved topical steroids may be discontinued. Subsequent treatment with a topical immunomodulator like pimecrolimus is sufficient to maintain the improvement. The cream that you have been using contains pimecrolimus, and it would be more useful as a maintenance cream rather than for treating a flare up of seborrhea dermatitis. Regards