Eczema on lips

[debbta]

For the past three weeks or so, I've had a crack in the middle of my upper lip that will not heal.  Just about the time it starts to feel closed, I smile, and - bam - it opens up.  Two or three years ago, I started developing sores that somewhat appear to be cold sores, but don't really run the course of what I know of cold sores.  I never had cold sores before in my life, but, one of my sons suffers horribly with them, so, I was familiar with the what they're like.  When they begin, I feel a tingling, usually on the right edge of my lower lip and within a few hours, several bumps will develop and progress to pustular bumps, they drain and ooze, get crusty and eventually go away.  Periodically, I also get what is best described as chapped skin following the lip line of demarcation - the outer edges of your lips.  Very painful.  At that time, I was a chronic lip balm user.  The dermatologist I saw said it was eczema, since I have eczema on other parts of my body.  He advised against using lip balms.  He prescribed Protopic.  I've used it very sparingly since it has a black box warning.  I believe it warns against using it on open sores, so it seemed counter-intuitive to use it on the cold-sore-like things.  Right now, I'm concerned that since I smoke cigarettes, the crack in my lip could be oral cancer.  Does it sound possible or are these problems typical of eczema on lips?

At the same dermatology appt., I asked about some bumps I get on my nose.  They look like white heads, sort of, except they're raised, they're very hard and transparent.  They are more prominent when my body temp increases and regress when I cool down.  He immediately diagnosed it as Rosacea and prescribed Finacea.  I don't have evidence of what I know of Rosacea anywhere else on my face.  I don't have red flushing or break-outs of any kind on my face.  I have very dry, sensitive skin and a very fair complexion.  The Finacea hasn't seemed to make a difference.  Again, I was concerned it could skin cancer.

I'm sorry this post covers so many issues, but if anyone can answer any or all of my concerns, I'd really appreciate it.  

[Bhupinder Kaur, MD]

Hello,
Since the symptoms have been persisting I suggest you to get a blood test like RAST and a biopsy of the lip scrapings done. I suggest you to get an evaluation done from a dermatologist to confirm the diagnosis.
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.

[debbta]

Thank you for your response.  I have been taking B-Complex for over a year now.  You're right in the Vaseline recommendation.  I had been applying nightly for around one week.  Last night, I tried going without and sure enough, the upper lip was cracked again.

[Bhupinder Kaur, MD]

Hello,
It could be due to cheilitis or eczema. 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 blood test like RAST or biopsy of the skin sample.

Avoid licking the lips as saliva evaporates quickly resulting in them being drier than before. Drink plenty of water and take multivitamin supplements and do not apply lipstick or other cosmetic products for some days. Use a humidifier to moisturize the air in your home and apply shea butter or Vaseline on your lips.

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.