Persistent Lip Itching in Children: Seeking Solutions for Relief

Itchy lips?

Dear Dr.
Zhong,
My young son has been experiencing itching and swelling of the lips for about three to four years.
We have consulted many dermatologists, but there has been no improvement or resolution.
For a long time, we have been using lip balm to alleviate the itching.
Some people have suggested that I give him more B vitamins and reduce his intake of dairy products, but the situation remains unchanged.
I am at a loss as to what to do.
I appreciate your time and would be grateful for any advice you can provide.
Thank you very much! I am truly grateful.

Chen, 40~49 year old female. Ask Date: 2003/12/24

Dr. Zhong Yitun reply Dermatology

Based on your description, the young man is suffering from cheilitis.
It can indeed be somewhat challenging to treat, but it's not very difficult; bringing him in for evaluation should suffice, as there are some medications that can be quite helpful.
Additionally, proper care measures are crucial, such as avoiding strong-flavored foods (very salty or spicy) and large pieces of fried food.
It's also important to correct his habit of licking his lips; while it may provide temporary "moisture," the cycle of wetting and drying can lead to more severe cracking and peeling of the lips.
Applying lip balm should be beneficial, but using flavored or lanolin-containing lip balms may sometimes worsen the condition, so it's best to use plain petroleum jelly.
Furthermore, while the lips are not healed, it's advisable to temporarily stop using toothpaste (just use a toothbrush and water without adding salt, and try to brush after meals).
Avoid citrus fruits like oranges, grapefruits, and pineapples while the lips are healing, as they can irritate the wounds.
With appropriate treatment and the aforementioned care measures (maintenance and prevention of worsening), healing can be achieved.
Taking B vitamins does not have a definitive effect (though it may provide some minor benefit given the current nutritional status in Taiwan; cheilitis is not caused by malnutrition).
Dairy products are not contraindicated unless they are extremely acidic.

Reply Date: 2003/12/24

More Info

Persistent lip itching and redness in children can be a frustrating and distressing issue for both the child and the parents. Given that your son has been experiencing these symptoms for three to four years without significant improvement, it is essential to take a comprehensive approach to identify the underlying cause and find effective solutions for relief.

First, it is important to consider the potential causes of persistent lip itching and redness. Common reasons for these symptoms in children include:
1. Allergic Reactions: Allergies to certain foods, environmental allergens (like pollen or dust mites), or contact allergens (such as certain lip balms, toothpaste, or soaps) can lead to lip irritation. It may be beneficial to keep a food diary to track any correlations between food intake and the onset of symptoms.

2. Eczema or Dermatitis: Atopic dermatitis (eczema) can affect the lips and surrounding areas, leading to dryness, itching, and redness. If your son has a history of eczema, this could be a contributing factor.

3. Irritant Contact Dermatitis: This occurs when the skin reacts to irritants, which can include saliva, certain foods, or even the ingredients in lip care products. If your son frequently licks his lips, this could exacerbate the problem.

4. Infections: Fungal or bacterial infections can also cause lip irritation. If there are any signs of infection, such as crusting or oozing, a visit to a healthcare provider is warranted.

5. Nutritional Deficiencies: While you mentioned that someone suggested B vitamins and reducing dairy intake, it is crucial to ensure that your son is receiving a balanced diet. Deficiencies in certain vitamins, such as riboflavin (B2) or niacin (B3), can lead to skin issues.

Given the chronic nature of your son's symptoms, here are some steps you can take to seek relief:
1. Consult a Dermatologist: If you haven't already, consider seeking a second opinion from a pediatric dermatologist who specializes in skin conditions in children. They may conduct patch testing to identify any allergies or sensitivities.

2. Topical Treatments: In addition to lip balm, consider using a hypoallergenic moisturizer or ointment that is free from fragrances and irritants. Products containing ceramides or hyaluronic acid can help restore the skin barrier.

3. Avoid Triggers: Identify and avoid any known triggers, such as specific foods, products, or environmental factors. Keeping a symptom diary can help pinpoint what exacerbates the condition.

4. Oral Supplements: While B vitamins may help, it is essential to consult with a healthcare provider before starting any new supplements. They can assess your son's nutritional status and recommend appropriate supplementation if necessary.

5. Behavioral Modifications: Encourage your son to avoid licking his lips, as this can worsen dryness and irritation. You might consider using a non-irritating lip balm to help keep his lips moisturized.

6. Regular Follow-ups: Since this has been a long-standing issue, regular follow-ups with healthcare providers are crucial to monitor progress and adjust treatment plans as necessary.

7. Consider Allergy Testing: If allergies are suspected, an allergist can perform tests to determine if specific allergens are contributing to your son's symptoms.

In conclusion, persistent lip itching and redness in children can stem from various causes, and a multifaceted approach is often necessary to find relief. By working closely with healthcare professionals, you can identify the underlying issues and implement effective strategies to help your son manage his symptoms. It is essential to remain patient and persistent in seeking solutions, as chronic conditions can take time to resolve.

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