Question:

For about a year now i have had redness surrounding my lips. None of the topical ointments that the dermatologist perscribed worked at all. I think its from toothpaste but I have tried flouride free toothpaste, no improvement, and have also tried an SLS free toothpaste, also no improvement. Im running out of ideas of what it could be. I wanted to see if you had any thoughts.

Answer:

If you have seen a dermatologist, I would want to be sure that he or she is aware of two conditions: perioral (or circumoral) dermatitis and exfoliative cheilitis.

Perioral dermatitis is often related to things like tartar-control toothpastes, flavored gum or skin products like moisturizers or cosmetics.  Redness around the lips is usually seen together with  small bumps or papules, but these bumps may not be observed in cases due to toothpaste.  Use of topical steroids is not helpful for this condition.  Together with halting the use of possible inciting agents, a prescription of topical antibiotic cream such as metronidazole usually results in improvement over several weeks to months.

Exfoliative cheilitis can be due to similar contact agents as above, but many cases result from chronic wetting of the lips (chronic lip licking).  Besides redness around the lips, the lips themselves are often cracked or scaly in appearance.  Halting the use of cosmetics or lip balms, ceasing any lip wetting habit and use of an antimicrobial cream can be helpful.  Since this condition is often related to infection by both bacterial and yeast bugs, topical iodoquinol cream has been effective in many patients.

Hope this helps.  Good luck!

For more information:

Go to the Mouth Diseases health topic.