Rash below bottom lip

[Stefan1]

Hello Doctor..my name is Stefan Walsh, I am 19 years old and am having a rash problem.  Right below my bottom lip is this rash which I connot seem to get rid of.  If I curl my bottom lip around my bottom teeth a bunch of little white dots are visible which can be squeezed out like pimples, yet they are very very tiny like blackheads..only white.  Also from itching parts of my skin has broken open, this is where the most reddness is.  It gets very irritable sometimes, mostly when one of my cats comes near me or happens to touch this part of my skin, it becomes so itchy they I find myself scraping the rash with my upper teeth, which only makes it worse.  Ive been to the dermatologist once and he gave me a medicine which didnt work, i have also been using aquaphor on it which is what I use for my chapped lips.  Another problem is my chapped lips.  I have had extremely chapped lips for almost 2 years now, they are so bad that I apply chapstick, or aquaphor now, about 15 or more times a day, everyday, for the past 2 or more years. This may have something to do with the rash under my lip which is only getting worse by the day.  This rash has become a social disorder now, I feel like when im talking to someone they are always looking at this blotchy reddness under my lip, and especially when I am walking around with some sort of shiny cream on it.  I tried using Cortizone-10 maximum strength with 1% hydrpcortisone ointment but nothing seems to be working! Please tell me what I can do.  Thank you for your help.

[Stefan1]

Okay, I'll do my best to leave it alone, but do you know what could be the problem with my lips always begin chapped and dry. I get flakey dry skin on and around the lips all the time, which also makes a red outlining around my lips, no chapstick seems to help this.  Any idea what the problem could be here?

[Alan Rockoff, MD]

I can't say for sure, of course, without seeing you, but what I think is going on is this:  You have small, white cysts under the skin below your lower lip.  These are normal.  You don't need to get rid of them, and basically you can't.  But because you're trying, you keep rubbing your lower lip with your teeth, which is why you get redness below your lip, and thats making you self-conscious, which makes you bite your lips, and around the circle goes.  This is hard advice to follow, but what I think you need to do is to leave your lip alone and just let the ski heal for a few weeks.   Then show your lip to a dermatologist for a definitive diagnosis.  Do the best you can to achieve this.

Take care.

Dr. Rockoff