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Ask A Skin Doctor: Lip Contact Dermatitis and Perioral Dermatitis

Dear Doctor

I am having allergic around my lips at the vermillion border for the past 1 year. Initially I had skin peeling on my lips n extend to around lips at the border and then extend to philtrum region..

I was applying Vaseline for sometimes but it got worst.. my lips start turning black and redness arou8nd lips border seen..

My lips gt swollen.. I consulted an MO. he gave me prednisolone n hydrocortisone cream to apply..its gone for a while.. and it came back..after that another pharmacist advised me to use Elomate cream around lips and it completely cured..but when I stop applying elomate cream for a few days its starting back..

But now the skin peeling has stopped but small papules start appearing at one corner of lip at vermillion border and a cheilitis at corner of mouth..unilateral..

As I went again ..another MO said its Herpes labialis and he prescribed me acyclovir topical.cream for 5 days..the papules all gone..

But now my lips are swollen and red around the lips..start to bleed slightly.. its really painful.

Can you tell me what is it actually. I am so blur.. I don’t eat seafood too..i am a vegan..and his is jz for 1 year..i used to wear cosmetics for the past 10 years and nothing happened..

contact dermatitis perioral dermatitis

Dear Patient

It seems that your initial condition was lip contact dermatitis which developed as a result of a reaction something that you were applying to your lips or the area around them.

This was relieved by the use us the corticosteroids Hydrocortisone and Elomate. But unfortunately you have now developed perioral dermatitis.

The treatment of perioral dermatitis is as follows:

1. Stop applying strong steroid creams to your face but since it seems that you may have developed cutaneous steroid addiction you may need to apply hydrocortisone for steroid weaning. Pimecrolimus 0.1% can also be used for steroid weaning.

2. Apply antibiotics like Metronidazole, Clindamycin and Erythromycin to the face because of their anti-inflammatory properties.

3. Take a course of antibiotics like Minocycline 100 mg twice a day for 3 weeks and then reduced to 100 once a day for 3 weeks if the skin is already very sensitive and you cannot apply the antibiotics on it.

4. Stop applying makeup and using cosmetics and other skin care products on the face. Clean the face with plain water.

5. Avoid fluoride toothpastes since they can aggravate the condition in some patients.

6. Make a cold compress by soaking a clean piece of cloth in cold tap water and applying it to the lips to reduce the inflammation.

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