A Single-Center Pilot Study to Evaluate the Efficacy, Safety, and Tolerability of Sarecycline for Treating Periorificial Dermatitis

Periorificial dermatitis (POD) is a facial skin rash often found in the oral commissures and nasolabial folds, and around the eyes. Treatment options include topical metronidazole and azelaic acid, and oral tetracycline-class antibiotics. While the broad-spectrum antibiotics are efficacious, they can lead to adverse gastro-intestinal (GI) symptoms, negatively impact gut flora, and lead to antibiotic resistance. Narrow-spectrum tetracyclines, such as sarecycline, have a low potential for promoting bacterial resistance and GI issues. The main objective of this study is to demonstrate sarecycline’s efficacy and safety in treating POD. It was hypothesized that subjects with POD given a 4-week course of sarecycline would have improvement in their POD and tolerate the medication well. This was a single-center, prospective, pilot study to evaluate the efficacy, safety, and tolerability of sarecycline for the treatment of POD with once-daily dosing over 4 consecutive weeks. Subjects were evaluated using the PODSI score at weeks 0, 2, and 4. All 9 subjects who completed the study had shown improvement in POD with no reported drug-related adverse events. All subjects were female, and the mean age was 41 years old. Sarecycline may be an appropriate novel treatment option for POD and should be explored further in a larger population study capturing this data. Furthermore, there is a need for more large-scale clinical studies evaluating treatment options for POD, with a focus on the impacts of antibiotic resistance and its implications on public health. Swenson K, Graber E. A single-center pilot study to evaluate the efficacy, safety, and tolerability of sarecycline for treating periorificial dermatitis. J Drugs Dermatol. 2025;24(6):617-620. doi:10.36849/JDD.8590.