Flake This Kiss Upon The Brow: Eczema on The Lips

Curated by Claudia Shannon / Research Scientist / ishonest

It’s the kiss of death for any planned macking sessions, in addition to being unsightly and painful. Plus, it makes a mockery of your feeble attempts to attack it with Chapstick.

We peel off the truth about lip eczema.

Types and symptoms

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There are seven types of eczema, and some of the names are quite the mouthful:

  • atopic dermatitis
  • contact dermatitis
  • dyshidrotic eczema
  • nummular eczema
  • seborrheic dermatitis
  • stasis dermatitis

Contact dermatitis most often affects the lips, but atopic dermatitis can occur here, too. When it hits your kisser, it’s called lip dermatitis, or eczematous cheilitis. (Seriously, just call it lip dermatitis though, it’s annoying enough as it is.)

Common symptoms of lip eczema are:

  • red, gray, purple, or dark brown patches, depending on your skin tone
  • dry and flaky skin
  • itching
  • skin splitting or scaling

These symptoms are more likely to occur on the skin of your lips than on the mucous membranes inside your mouth.

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The three types of lip eczema include:

  • Irritant contact dermatitis. This occurs when you put something irritating on your lips or — in the case of chronic lip-licking — doing something irritating to your lips.
  • Allergic contact dermatitis. This happens when an allergen touches your lips. This type of lip eczema is more common among females, possibly due to the use of cosmetics.
  • Atopic dermatitis. This type of eczema is chronic. It causes skin to have problems containing moisture, leading to an increased risk of dryness, oozing, and infection.

And there are three types of cheilitis to match the three eczema types, like a matching hat and booties on a chihuahua, but more flaky and irritating.

  • Allergic contact cheilitis. This causes patchy reddening and peeling of the skin on the lips, which may spread to nearby skin as well. Burning, tenderness, and itching may also occur.
  • Irritant contact cheilitis. This type tends to be itchier than others, but also can cause burning and blistering.
  • Atopic cheilitis. This more commonly features dryness, scaling, and cracking in addition to possible redness.

Causes of lip eczema

Cheilitis is the cheerless term for inflammation of the lips, including lip eczema.

Eczematous cheilitis typically occurs after contact with allergens and irritants, while other types of cheilitis can be the result of anything from drug use and infections to immune or vitamin deficiencies. Even exposure to cold or biting or picking at your lips can cause lip eczema.

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Allergens and irritants that can trigger eczema on the lips, aka eczematous cheilitis, include:

  • lipstick
  • oral hygiene products, like toothpaste
  • food, like eggs and shellfish
  • topical ingredients
  • fragrances
  • preservatives
  • antioxidants
  • dyes
  • dental materials
  • putting musical or occupational instruments in your mouth
  • frequently putting other objects in your mouth, like nails and pens

Risk factors for lip eczema

Surprise — if you already have atopic dermatitis elsewhere on your body, you’re far more likely to develop lip eczema, too.

If you have a history of allergies, you’re also more at risk of having an allergic reaction that can trigger lip eczema.

Triggers

Since lip eczema is often an allergic form of cheilitis, it’s obviously best to avoid putting anything you know you’re allergic to in or around your mouth.

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Also, just avoid habitually putting odd things, like pencils or nails (!), in your mouth in general.

Cosmetic ingredients known to trigger lip eczema include:

  • cosmetic sensitizers (fragrances, Balsam of Peru, and nickel)
  • lipstick ingredients, like ricinoleic acid (castor oil)
  • resins like rosin and shellac
  • dyes
  • preservatives
  • copolymers
  • ozonated olive oil
  • propolis

Treatment

If there’s one reason to smile about lip eczema through your cracked lips, there’s this: Unlike some other types of cheilitis, eczematous cheilitis tends to be acute, not chronic.

Plus, it’s treatable. Not only that, but lip eczema often clears up without treatment once you remove the triggering allergen or irritant.

OTC treatments
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Combining a low-to-medium-intensity topical steroid like hydrocortisone cream with medical emollients can help treat lip eczema. Antihistamine drugs can relieve the symptoms of allergic or contact eczema on the lips.

Natural remedies

Some common natural remedies for eczema, like taking an oatmeal bath, may be impractical when the rash is on your lips. But others might help, like applying coconut or sunflower oil to your lips.

Avoid scratching, picking at, or licking your lips. If your lips feel dry, try some petroleum jelly or lip balm. Just make sure it’s not one that you’re allergic to — even some “natural” products, like those containing beeswax, have been known to trigger lip eczema in some people.

Prescribed treatments

Your doctor may prescribe stronger topical steroids to treat lip eczema, or drugs called topical calcineurin inhibitors (TCIs) that can relieve redness and itching.

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A prescribed topical steroid, crisaborole (Eucrisa), has been available since 2016. This helps reduce redness, itching, and inflammation if atopic dermatitis is behind your lip eczema. However, doctors only prescribe it for people with mild to moderate atopic eczema.

In extreme cases, a potent oral steroid may be necessary to treat lip eczema.

Biologic drugs, immunosuppressants, and light therapy need a prescription as well.

Diagnosis

The three types of lip eczema have pretty similar symptoms.

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A skin examination by a dermatologist or allergy specialist, along with an allergic patch test, is necessary to diagnose which particular nasties have your lips in an uproar.

Metals, fragrances, antioxidants, and preservatives tend to be the most common culprits causing lip eczema.

Commonly confused conditions

It’s easy to confuse chapped lips and other forms of cheilitis with lip eczema.

Takeaway

Lip eczema can be caused by irritation or an allergic reaction to something you put on your lips or in your mouth, as well as coming into contact with these substances in other parts of your body.

Common symptoms include redness or rash and dry, itchy, flaky, and cracked skin. Lip eczema often clears up once the offending substance is removed, but also can be treated with medication or even home remedies.

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