Hi, I have had chapped lips and itchy red skin around them for the last 2 months. I live in London so it is cold here, I dont lick them. I have tried using chapsticks, vaseline, castor oil, coconut oil, and a week ago i started using Daktarine (miconazole) because my gp said it might be a fungal infection. but nothing is solving the problem completely. for the last 2 months, i have had about 10 consecutive days of irritation, they disappear for 2 dys and then the whole process starts again. I am not sure what it is its just so disturbing and stressful.Thank you
This is a clear case of ECZEMATOUS CHEILITIS. Eczematous cheilitis is inflammation of the lips presenting as redness with dryness and scaling. It may also be called lip dermatitis.
Careful history and examination may help to narrow down the list of possible causes. Examination should include not only the lips, but inside the mouth and the skin in general.
Patch testing is very useful in eczematous cheilitis as at least one quarter of cases involve an allergic reaction. Testing should include the standard series as well as extended series such as for lipsticks, toothpastes and others as suggested from the history. Testing the patient’s own products ‘as is’ is important. Photopatch testing may also be useful. The relevance of positive reactions must be considered.
If patch testing is negative then prick testing may be positive, indicating a contact urticaria.
Treatment of eczematous cheilitis
Treatment will depend on the cause. Where an exogenous cause has been identified, this should be avoided if possible. If this does not result in improvement, consider another factor such as a second allergen, irritant or endogenous cause.
For atopic cheilitis, moisturisers and topical corticosteroids may be recommended. Please consult your dermatologist for further clarifications.