lips peeling

My name is Steve, 22years old , man, having upper and lower lip peeling off for 3 years associated with lip hyperpigmentation.

   The lip was started to be drying out and hyperpigmented 3 years ago and this is follow by peeling off of my upper lip. Initially was peeling a bit but the condition worsen over the time and the peeling is more prominent in the middle part of lip. The peeling lip worsen during brushing teeth when the lip contact with water. Then i went to see so many dermatologist. The first dermatologist give me some whitening cream to depigmented my lip. however i discontinue the cream as it is not useful. The i went to consult another dermatologist. He prescribed me erythromycin 2/52  to me but i stop taking it after after 3 days as it make my stomach disconfort, subsequently i went to University hospital to consult doctor there and she prescibe me elomet steroid cream. This drug is effective but just for temporarily period as the peeling skin return as i discontinue.   Many types of vaseline has been used but was not effective.
For the pigmentation, the upper lip is very special as it have a well demarcated lined divided the lip into external and internal. The external part are hyperpigmented and never peel off , while the internal part keep on peeling off but was not pigmented. I think it more likely to be post inflammatory pigmentation of  the lip.
3 month ago, my lower lip started to have same problem. it started to peeling off, but the condition is milder then upper lip.
The peeling off normally begin with burning sensation then follow by crackin and peeling off. The peeling off accelerated when i use my lip to lick the lip. I was thinking weather the lip is allegic to my saliva.

  As i am having anterior open bite class 2, it affect my lip causing it to be incompetent. My lip naturally will open by it sleep when i not using the muscle to occlude it. These resulting in my lip to be open during sleep and feel very dry mouth in the morning. I am not sure whether the incompetent and dry lip have contribute to my lip condition.

Recently i buy a lip gel from pharmacy(Mentholatum lip gel) which has improve my lip a bit but still will felt burning and dry sometime even the gel has been applied.

Indeed, my main concern is the pigmented lip as it turn my lip unattractive. What drugs can i use to depigment my lip?
I really hope doctor can guide me what  drug or treatment can i get to remove my pigmented lip and also peeling off problem as i have no more idea.
thk doctor.

[Bhupinder Kaur, MD]

Hello,
Firstly, It can be due to vit B deficiency. Take some vitamin B complex for some days and see if your symptoms improve.
Secondly, it can be due to atopic dermatitis or eczema("Atopic" refers to a group of diseases where there is often an inherited tendency to develop other allergic conditions, such as asthma and hay fever). Cheilitis(Inflammation of the skin on and around the lips)is often seen in atopic dermatitis. Diagnosed by bld test like RAST. Treatment is by topical steroids or oral therapy of corticosteroids in severe cases.Topical creams like tacrolimus ointment  and pimecrolimus cream are also useful.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.