If you’re grappling with an inflammatory skin condition like acne, acne rosacea, or periorificial dermatitis (aka POD), first of all: we’re sorry. We know, these are tough skin conditions that are no fun to live with! The good news is that we’ve got an ingredient that can help. Metronidazole is FDA-approved for the treatment of acne rosacea, but it’s helpful in most cases of periorificial dermatitis in addition to your ordinary everyday inflammatory acne.

What is metronidazole?

Metronidazole is an antimicrobial, anti-inflammatory, antibacterial agent that is FDA-approved to help reduce the inflammatory papules (bumps) and pustules of rosacea. Our dermatology providers also like to use it to help treat periorificial dermatitis. With POD, you may have red bumps around your mouth, nose, or (less commonly) eyes, along with flaking, stinging, burning, or itching.

When used topically as directed by your dermatology provider, metronidazole can help reduce redness, swelling, and pimples (aka acne-type lesions). Thanks to this research-backed ingredient, the bacteria and inflammation that contribute to flare-ups will be nipped in the bud, helping not only to treat existing breakouts of acne or POD, but also to prevent them in the future. Pretty cool, right?

Are there any side effects of metronidazole?

It’s pretty uncommon, but possible side-effects of topical metronidazole can include stinging, dryness, or itchiness. Let your Curology provider know if you experience any of these side-effects while using your custom mix, and we’ll adjust your formula to suit your (sk)individual needs.

What is periorificial dermatitis?

Periorificial dermatitis, or POD, is a rash that tends to occur around the mouth. Most often, POD shows up as small red bumps that are slightly scaly. It’s a common rash mainly affecting adult women; it can crop up either around the mouth and/or chin (termed perioral dermatitis), around the eyes (periocular dermatitis), or around the nose (perinasal dermatitis). The bumps can feel itchy or tender, and the skin in that area can get dry and flaky, too. It’s certainly not pleasant, but with the right ingredients and a little patience, we can get your skin to recover before you know it!

What causes POD?

Any product that has active ingredients (such as an AHA, BHA, or retinol) or that may be drying (such as an alcohol-based toner) may set off POD in people whose skin is susceptible to this problem. Other potential causes of this rash include strong topical steroids or fluoridated toothpaste (if you get it around your mouth), but the cause is often unknown.

How to heal your skin and get rid of POD

1. Stop using all skincare products on the affected area. Ask your Curology medical provider whether or not to use your Curology medication on the areas affected with POD. (You can continue to use your Curology medication as you normally would on the rest of your face!)

2. Use a gentle cleanser to cleanse your face. You can try the Curology cleanser, which is super-gentle and dermatologist-developed for just such an occasion!

3. If your skin is particularly dry or itchy, use a thin layer of a heavier moisturizer in the morning to help protect your skin, such as pure petrolatum (Vaseline). Apply a thin layer of Vaseline to the affected area prior to applying your Curology cream. This will help protect the affected area from the Curology “migrating” into the area.

4. DO NOT USE an over-the-counter steroid (i.e., hydrocortisone cream). It may temporarily improve your symptoms, but then it will get worse!

5. We sometimes use an oral antibiotic to clear severe cases of POD. If you’ve got a particularly severe or stubborn rash, check in with your Curology medical provider. We may have more tricks to get this under control for you!

Unfortunately, it may take up to 4 weeks (and in some cases longer) to improve, and POD can get worse before it gets better. We know it’s really irritating and annoying, but patience is key in order for your skin to heal!

What’s the difference between acne and rosacea, and can I have both?

Rosacea was once known as acne rosacea, but it is not related to ordinary acne (acne vulgaris). However, you may have an overlap of both acne and rosacea, such as pimples and blackheads and whiteheads with the diffuse redness that is characteristic of rosacea, for example.

Acne and rosacea can happen at the same time — the unpleasant combination of pimples and diffuse redness in the skin, including little red “squiggles” (these are actually tiny blood vessels). Unfortunately, that redness — and those tiny blood vessels beneath the skin’s surface — require in-office treatments using lasers, IPL, or other light-based devices to get rid of. But we can reduce the inflammation and the resulting redness that acne lesions can leave behind with a prescription topical ingredient such as metronidazole (plus other active ingredients combined into one Curology formula)!

How to get metronidazole

Topical metronidazole is available by prescription only, but luckily, Curology makes it easy and affordable to get this proven ingredient in a custom mix — and it’s delivered right to your door.

Get your personalized skincare routine with Curology

Get your personalized skincare routine with Curology

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If you’re dealing with any of those unpleasant symptoms of redness, bumps, flaking and itching, burning or stinging around your mouth or nose, let your Curology provider know. Your provider will prescribe the right stuff for your skin’s unique condition, type, and sensitivity level!

And remember: we’re always here for you. ❤

Written by

Curology Team

Medically reviewed by

Nicole Hangsterfer, PA-C