Mysterious unresponsive "scrape"

[LetaB]

  Two years ago I got a small red spot on my upper lip. It appeared and felt like the top epidermis was just missing. For instance sunblock would sting on it and the edges of it peel away a little. I went to my GP twice - once she prescribed an antbiotic and once she prescribed an antfungal but nothing worked. It has been growing ever so slowly larger so that now it's an eighth of an inch and you can feel it's gotten deeper too. Then around a year ago I developed another on the other side of my upper lip! We have no dermatologist where I live and I don't know what else to try. Any ideas?

[BhumikaMD]

Hi,

It could be eczema, sweat dermatitis, allergic reactions or folliculitis. This could most definitely be secondary to shaving / waxing/ threading.

You need to wash the areas several times with fresh water. Do not use any cosmetic products at the sites.

Apply calamine lotion at the site of the lesions and see if it helps. You could take some oral antihistamine medications like cetrizine or loratadine. You need to maintain a good personal hygiene .

Anti-itch drugs, often antihistamine, may reduce the itch during a flare up of eczema, and the reduced scratching in turn reduces damage and irritation to the skin.

For mild-moderate eczema a weak steroid may be used (e.g. hydrocortisone or desonide), whilst more severe cases require a higher-potency steroid (e.g. clobetasol propionate, fluocinonide).

Eczema can be exacerbated by dryness of the skin. Moisturizing is one of the most important self-care treatments for sufferers of eczema. Keeping the affected area moistened can promote skin healing and relief of symptoms.

Folliculitis is infection and inflammation of the hair follicles. The condition may be superficial (i.e., on the surface of the skin) or deep within the follicles.The most common cause of folliculitis is infection by the bacteria Staphylococcus aureus.

Folliculitis symptoms can appear independent of infection. Exposure of the skin to certain chemicals, especially oils and tars, can trigger an outbreak. People with depressed immune systems, diabetes, or obesity have a greater risk of contracting folliculitis than the general population.

Be extremely careful about personal hygiene. Application of antiseptic washes may help prevent recurrences. A topical antibiotic cream, mupirocin (Bactroban®), has been effective at reducing bacterial colonization in the nostrils. It is applied twice daily for a week and is repeated every 6 months.

Let us know if you need any further information.

Regards.

[LetaB]

  I am so fortunate that you chose to write a response to my question. Unfortunately when I said "upper lip" I guess I'm using an obsolete definition. That is I mean the area of skin inbetween the nose and the actual upper lip. I don't know what else it's called. You see how this is more unusual than severe chapped lips? And the surrounding skin is healthy.

[BhumikaMD]

Hi,

This could be a part of Cheilitis, which is a medical condition involving inflammation of the lip. Or a bad case of Chapped lips , a condition whereby the lips become dry and possibly cracked. It may be caused by the evaporation of moisture.

Lip balm can often provide temporary relief, though it should not be used extensively.  One should avoid licking their lips as saliva contains the enzyme amylase, which can damage the already compromised lip tissue.
Honey can be used on the lips as a natural remedy.


Cheilitis is associated with many conditions from Vitamin B12 deficiency, iron deficiency anemia, be a symptom of allergies.can also be caused by taking the (retinoid) drug Isotretinoin (brand name Roaccutane).

Applying protective paraffin-based ointment (such as Vaseline) or lip balms to the lips is normally very effective. Also take Vitamin B supplements.

If nothing works you can have a biopsy done to find out the cause.
ref:http://en.wikipedia.org/wiki/Chapped_lips

Some causes of the symptoms you mention, could be lip biting, lip licking, Vit.B2 deficiency, smoking, overexposure to sun and ill fitting dentures. In extreme cases, this could be due to bacterial or fungal skin infection.

You need to drink plenty of water daily – around 1.5 – 3 litres per day and eat a balanced diet. Do not keep your lips dry; apply lip balm which contains sunscreen – preferably a medicated one.

If the symptoms still persist, consult your skin specialist or dermatologist.

Let us know about how you are doing and if you have any other doubts.

Regards.