LIP DERMATITIS HANDOUT

Lip dermatitis may have several causes. The most common are:

• Lip licking, especially common in children. The skin about the mouth is typically inflamed as well.
• Excessive sun exposure. This typically affects only the lower lip.
• Atopic dermatitis: This tends to occur in patients with a history of allergies, eczema, hay fever, asthma in them or their families.
• Allergic contact dermatitis to any of a variety of materials that come in contact with the lips, e.g. Drinking from a metal container (nickel allergy), playing a musical instrument (nickel allergy), lipstick (allergy to some ingredient in the lipstick), etc.

Let your doctor know if you

• can think of anything unusual that contacts your lips, especially metals.
• play a musical instrument with a reed (e.g., the saxophone).
• use any anti-wrinkle type rejuvenation cream around your mouth.
• routinely hold any objects in your mouth, e.g. pens, pencils, eyeglasses.
• smoke.

For 2 weeks avoid the following oral agents:

• Lipstick, Chapstick, Carmex etc.
• All mouthwashes
• Avoid toothpastes especially those that contain a whitener or bleach. You can brush your teeth with baking soda.
• All cinnamon flavorings (e.g., cinnamon Altoids, cinnamon gum, cinnamon lattes * Earl gray tea (contains a fragrance that may be allergenic)
• Eating mangos (the rind contains oils similar to poison oak that can cause rash)

You may use:

• Vaseline or Aquaphor ointment as a lip lubricant as often as needed.
• If you are going to be in the sun, the only sunscreen okay to use on your lips would be zinc oxide (yes the white stuff!).

Other Recommendations

• Try not to lick, bite, chew, or rub your lips. Saliva contains an enzyme that digests food and can irritate the skin. Additionally, the constant wet to dry effect of licking your lips repeatedly will cause chapping of the lips (just like licking your lips on a windy day will). It is called lipsmacker's dermatitis and it is a very common cause of lip problems. It can be a nervous habit. If you breathe through your mouth at night or drool, coat your lips with Vaseline to protect them from your saliva.

• Apply any topical steroid prescribed by your doctor to your lips 2-3 times per day for 2 weeks:

• Once you are better, you can add back one of the above products you have been avoiding each week. Add back one product at a time, one week at a time. Obviously the toothpaste will probably be first!

• If you do not clear or relapse quickly after stopping your treatment in 2 weeks, your doctor may want to arrange for allergy testing, e.g., patch testing. It can, at times, elucidate the allergen causing the problem. However, patch testing is quite involved. It requires 3 separate visits and is only done on those that fail empiric treatment per above.

• Let your doctor know of any worsening or epiphanies as to the cause of the rash!

RegionalDerm

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