Lip Problem

[jcjrrecords]

I burned my top lip on a cigarette. At that time, there was a white mark about 1 cm or less. I applied balms, and things were going well.  I didn't want to leave marks behind so I went to a doctor to find out if he could give something that would help it clear up.  He gave me Silvadene cream, which I applied. The next day, the burn was almost completely absent but my skin began to flake and a dark discoloration appeared on my lip in the same places where I placed the cream. The discoloration is about an inch in diameter on my top lip. Flaking stopped but discoloration has persisted. I called the doctor, but was blown off. An assistant said discoloration was normal. Today the doctor answered and denied that he told me to use Silvadene on my lips when it really was the first thing he mentioned after I mentioned to him I had a burn there. After denying Silvadene has side effects, he then told me it may be an "allergic reaction." Then, he told me I should go see a plastic surgeon who is a friend of his in Beverly Hills and is also an eye-ear-nose-throat specialist. He then said it might be a "scar" even though part of my lip is discolored in places the burn did not cover. I called both USC and UCLA Medical Centers, and they seemed to think it might be dermatological, and obviously, I cannot get any *free* medical help, but I do not know which direction to turn and I do not want to spend thousands of dollars going to the wrong places and people and getting runarounds.  Do you think this will clear up on its own?   What do you think I should do? Do you think it is dermatological or medical, or just an allergic reaction to the medicine? Is it worse? Rare? A serious condition?

[Alan Rockoff, MD]

I don't understand the distinction you're drawing between "dermatological" and "medical."  This discoloration could be from the injury itself, or it could possibly be from the deposit of silver in the Silvadene into the skin.  I don't know how common such silver deposition is.  But in either case the best approach is just to leave the lip alone, avoid rubbing or trauma or excessively close observation of the spot, and just let things ride for 6 months or so.  If there's still a spit then that's noticeable enough to bother you, then you might want to look into laser treatment to lighten it.  But that can and should wait.  Let nature take its course.

Best.

Dr. Rockoff

[jcjrrecords]

Thanks for writing.  Would you be willing to take a look at a photo?  One thing: what does argyria look like, and is it treatable via laser surgery?  I've read online that that condition is permanent.