Eczema of the lips

[kris082668]

When I was about 12, I developed HSV-1 on my lips (I also have eczema on my hands).  While that did heal, over the years I did have problems with my lips from time to time.  And then in the summer of 2003, I sun burned my lips – and they have never been the same since.  My lips will break out in welts, develop yellow crusty lesions, swell, burn and itch (the edges of the lips as well).  Sometimes at the same time! I cannot put anything on them except Vaseline.  These are the Rx. that I have been prescribed over the past 3 1/2 years, with minimal success:

Protopic Ointment 0.1 %
Elidel Cream1%
Alclometasone Dipropionate 0.05%
Desonide Ointment 0.05%
Locoid 0.1%
Denavir 1%
Valtrex 1GM

Benadryl Cream 2%
Cortaid

The combination of Denevir, Cortaid and the occasional dosage of Valtrex have somewhat calmed down my symptoms.  I’ve had an E.N.T look at my lips, he didn’t want to take a biopsy and he had no answers.  I’ve had allergy tests done: indoor / outdoor stuff and the TRUE test (which revealed that I am severely allergic to thimerosal).  Even with all of these tests and information, my dermatologist could never pin down the actual condition of my lips.  Would you give me your opinion on my condition and how to properly treat it?

In addition, as a result of the condition, I cannot wear lipstick of any kind.  I’ve tried non-comedogenic, natural, vegan, you name it – I have a reaction from all of it (even Burt’s Bees products) with the exception of food coloring.  When I put liquid red food coloring mashed into Vaseline on my lips, it gives me a nice color that lasts all day, and doesn’t irritate my skin.  Next I’m going to try dry food coloring mixed w/ Vaseline (there is a larger range of colors: burgundy, pink, purple, other reds).  Are there any health risks of using food coloring to dye my lips?  And do you have any suggestions on how my make my lips healthy again?

Any suggestions would be greatly appreciated!  I do not have much faith in the dermatologists that I am currently dealing with.

Thank you so much

[Alan Rockoff, MD]

Most chronic cheilitis (eczema of the lips) in young women is triggered by some irritation, followed by repeated lip-licking.  Trying to heal lips that constantly licked is like trying to heal hands that are washed twenty times a day.  On the other hand, telling yourself not to lick your lips is like trying to tell yourself not to smile.  So it's tough.  I recommend that a culture or biopsy be considered to look for yeast, though that's uncommon.  I doubt very much that you have an infection or relevant allergy.  My advice is to use nothing other than a bland over-the-counter moisturizer like Aquaphor ointment at bedtime, and a lighter one like Lubriderm during the day.  You may find that occasional use of a mild steroid can help, at least for short periods.  But if you're looking for a "cause" or a "cure," you're likely to be disappointed.  Get yourself as comfortable as you can, and over time, if you're able to stop thinking about your lips, their sensitivity may well subside.  That's been my experience with other patients I've seen with similar conditions.

Good luck.

Dr. Rockoff

[kris082668]

Dr. Rockoff,

I had also asked about the affects of using food coloring directly on the lips.

Any thoughts?

[Alan Rockoff, MD]

Not familiar with any such effects, one way or another.  It sounds innocuous, though.

Dr. Rockoff

[kris082668]

One final thing Dr.: I am allergic to lanolin.  That seems to only leave vasoline.  Any further ideas?

[Alan Rockoff, MD]

Not really.  Vaseline is a good moisturizer.  How do you know you're allergic to lanolin?  Besides, the lanolin in creams like Eucerin is bound to the other ingredients and not available to cause reactions on the skin, even in people who are allergic...

Dr. Rockoff

[kris082668]

For many years, I used Carmex.  Then it irritated my lips.  Then my dermatologist had me use Aquaphor.  Used it for a long time, then it irritated my lips.  So my dermatologist figured that I was most likely allergic to lanolin and that I should try vaseline.  So this keeps things pretty limited.  Any thoughts?

[Alan Rockoff, MD]

Not realy, beyond the ones I already shared.

Dr. Rockoff

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[JessieArch]

Hello Kris.  Wow, your description of the oozing and crusting blisters on your lips, particularly the edges of the lips, is exactly what I have been looking for from someone else, as I also suffer from this and eczema on my wrists and fingers.  And more interestingly is the Dr.'s comment about testing for yeast.  I have recently been doing lots of research for my chronic symtoms including this mouth eczema, eczema on my hands, athelete's foot and vaginal yeast infections.  Everything I have read points to an overgrowth of candida yeast in my body.  I've looked into treatments and just today I have purchased what is called ThreeLac.  It is a combination of three probiotic bacteria which will (hopefully) attack the yeast and begin to kill it.  I suggest you read about candida yeast and see if you find some symtom matches, it has really helped me identify my problem.