Lip Dermatitis: Causes, Symptoms, and Treatment Options

Lips

Hello Doctor,
I would like to ask for your advice.
When I was around 17 years old, I suddenly experienced swelling around my lips, accompanied by a burning sensation and small blister-like rashes on my lips, which sometimes produced a watery discharge.
At that time, I was working in a restaurant and used a friend's unknown lipstick, which seemed to exacerbate the condition.
Due to my family's financial situation, I was reluctant to seek medical help, fearing it would add to my parents' burdens, so I only purchased over-the-counter medications and ointments, but they were ineffective, and the issue has persisted for many years.
Two years ago, while on my honeymoon in Bali, the dry and extremely hot weather caused my old condition to flare up again.
Earlier this year, I visited a dermatologist and was prescribed both oral and topical medications, but as soon as I stop the treatment, I experience pain again—burning and swelling, with a rough sensation when my lips touch each other—regardless of the season, whether summer or winter.
The doctor I saw was rather dismissive and did not provide thorough care, which left me feeling disappointed.
I hope the doctors at your clinic can help clarify my concerns or suggest other methods for treatment.
Thank you.

chi, 20~29 year old female. Ask Date: 2003/12/25

Dr. Zhong Yitun reply Dermatology

At the age of 17, one day my lips suddenly swelled, and there were small blisters that burned intensely, which was likely herpes.
If the topical medication you applied contains steroids, it may delay healing at best, or worsen the condition at worst.
The herpes virus can be defeated by the immune system or specific medications under ideal conditions (with adequate rest) within a few days (the exact duration depends on physical condition).
However, a portion of the virus can become "latent," hiding within the nerves, which cannot be affected by medications or the immune system.
When one is frequently fatigued, weakened, or exposed to sunlight, the virus can easily "reactivate" into an active form, causing new outbreaks of herpes at the original site.
This is known as "recurrent" herpes.
For simple herpes, Acyclovir cream can be used for treatment (not covered by health insurance), applied every 4 hours, along with sufficient rest.
It’s important to be cautious and not overexert oneself when feeling too busy or tired.

Reply Date: 2003/12/25

More Info

Lip dermatitis, also known as cheilitis, can be a frustrating and uncomfortable condition. It often manifests as swelling, burning sensations, and the formation of small blisters around the lips. The symptoms you described, including the burning sensation and the appearance of blisters, are common indicators of this condition.

Causes of Lip Dermatitis
Lip dermatitis can arise from various factors, including:
1. Allergic Reactions: Many individuals experience lip dermatitis due to an allergic reaction to certain ingredients in cosmetics, such as lipsticks, lip balms, or even toothpaste. In your case, using an unknown lipstick could have triggered an allergic response.

2. Irritants: Environmental factors, such as dry weather, wind, or exposure to irritants like certain foods (spicy or acidic), can exacerbate the condition. You mentioned that your symptoms worsened during your honeymoon in Bali, which could be attributed to the hot and dry climate.

3. Infections: Fungal or bacterial infections can also lead to dermatitis around the lips. This is particularly true if there is a break in the skin barrier.

4. Underlying Skin Conditions: Conditions like eczema or psoriasis can also manifest on the lips, leading to chronic symptoms.

Symptoms
The symptoms of lip dermatitis can include:
- Redness and swelling of the lips
- Burning or itching sensations
- Formation of blisters or crusting
- Dryness and peeling of the skin around the lips

Treatment Options
1. Avoidance of Triggers: The first step in managing lip dermatitis is to identify and avoid any known triggers. This includes avoiding certain cosmetics, foods, or environmental factors that may exacerbate your symptoms.

2. Topical Treatments: Over-the-counter hydrocortisone creams may help reduce inflammation and itching. However, it is essential to use these under the guidance of a healthcare professional to avoid potential side effects, such as skin thinning.

3. Moisturizers: Regularly applying a fragrance-free moisturizer or lip balm can help maintain hydration and protect the skin barrier. Look for products that are hypoallergenic and free from potential irritants.

4. Antihistamines: If your symptoms are related to an allergic reaction, oral antihistamines may help alleviate itching and swelling.

5. Prescription Medications: If over-the-counter treatments are ineffective, a dermatologist may prescribe stronger topical steroids or other medications, such as calcineurin inhibitors, to help manage inflammation.

6. Lifestyle Modifications: Staying hydrated and using a humidifier in dry environments can help maintain moisture levels in the skin. Additionally, avoiding licking your lips can prevent further irritation.

When to Seek Professional Help
Given your history of persistent symptoms and the ineffectiveness of over-the-counter treatments, it may be beneficial to seek a second opinion from a dermatologist. A thorough examination and possibly patch testing can help identify specific allergens or irritants contributing to your condition.
In summary, lip dermatitis can be a challenging condition to manage, especially when it is triggered by external factors or allergens. By identifying and avoiding triggers, using appropriate topical treatments, and consulting with a healthcare professional, you can work towards alleviating your symptoms and improving your quality of life.

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