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To evaluate the effectiveness of topically applied metronidazole (Elyzol) for treating perioral dermatitis (a skin disorder characterized by small, persistent eruptions near the mouth), 108 patients were studied. Patients were treated with either metronidazole cream or with oral tetracycline (the accepted therapy) plus a placebo (inactive) cream. The extent of the redness of the lesions (erythema score) and the number of papules (small pimples) in each eruption were evaluated at the study's start, and again four and eight weeks after treatment began. Patients and physicians independently classified the outbreaks as improved, unchanged, or aggravated. Before the study began, patients in the metronidazole group had an average of 25 papules, while those in the tetracycline group had 21, on average. Metronidazole led to a reduction in average papule number, to 33 percent of the original number after four weeks and to 8 percent of the initial number after 8 weeks. For tetracycline, the corresponding figures were 4 and zero percent. No differences were found between the groups in physician- or patient-determined erythema scores, or in overall evaluations. Slightly more patients in the tetracycline than the metronidazole group complained of adverse reactions (most commonly abdominal discomfort). It is concluded that metronidazole was effective, but worked more slowly than tetracycline against perioral dermatitis, and tetracycline was significantly more effective than metronidazole overall. (Consumer Summary produced by Reliance Medical Information, Inc.)