Chelitis? Lip Hypopig. Worsens

[jfan01]

Hi, this problem showed up 11 months ago.  The left corner of my lower lip started whitening from its vermillion border.  I have had oral herpes in that area for 20 years and have treated it with zovirax, and in sometimes in recent years, abreva.  I went to a derm and he thought it was chelitis that was drying out my lips and causing hypopigmentation.  He wasn't completely confident and told me that.  I didn't think my lips were very dry at the time, so this was a surprise.  He prescribed Aclovate ointment, and I followed his directions.  The pigment would come back to my lip for about ten minutes if it ever did, and then would disappear.  He told me to wean off of it when it "started to work," but it never did, and I weaned of it anyway.  Now, six months after discontinuing Aclovate, the problem has worsened by about 20%.  The whiteness has moved closer to my lip's medial area.  I use Aquaphor day and night to keep my lips moistened and have used SPF chapstick daily since this problem started.
Please help.  Here is a picture.

http://www.medhelp.org/posts/Dermatology/Lip-Pigment-Loss-Worsening/show/1038983?personal_page_id=738936

Thanks!

[jfan01]

Thank you very much for your prompt response.  That was definitely not what I wanted to hear.  I have been prematurely graying since the age of 20 (now 22) and exceptionally stressed at the the point of symptom's first appearance and now, it makes some sense.  I will go to a dermatologist soon.  Thanks again.

[Alan Rockoff, MD]

It's probably early vitiligo.  This has nothing to do with herpes.  I suggest that you ask your dermatologist to examine your lip under a Woods light.  If that highlights the whitening, he might consider treating it with a topical steroid cream or Protopic ointment.  Your dermatologist can elaborate on this when you speak to or see him.

Take care.

Dr. Rockoff