How do you manage patients with recurrent periorificial dermatitis?

I typically use oral doxycycline, whenever possible, and often the low subantimicrobial doses work as well as higher doses and are much more tolerable for patients. If they can't take antibiotics or prefer to avoid oral ones, I will use some combination of topical metronidazole, clindamycin, and topical calcineurin inhibitors, depending on the patient.

I always make sure that they aren't intentionally or inadvertently using topical steroids on the face. Sometimes they aren't doing it themselves,...