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Has dark patches on inside of upper lips. What could be the reason for this?

Dec 2013
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Practicing since : 2002
Answered : 4127 Questions
My daughter has dark patches on inside of her upper lip. This has been for some time. What could be the reason or this. We ignored it for almost 1 years thinking this will go away on its own. But this has remained there. It becomes light at times and then become vey dark. Please can you tell us what is the reason for this and what cure or medicines we need for this.
Posted Fri, 24 May 2013 in Sexually Transmitted Diseases
Answered by Dr. Sanjay Kumar Kanodia 37 minutes later
Dear Patwari,

Thanks for posting your query. I am Dr Sanjay K Kanodia and I will try to provide you the best of information regarding your query.

After reading your short history and reviewing the picture the most probable condition that comes to my mind is "Lip Licker's Dermatitis". This is a common condition found in children and adolescent kids where the child has excessive tendency to lick his tongue around the lips. This excessive licking produces an irritation around the lips because of saliva as well as friction by tongue leading to initial redness or small vesicles. The initial symptoms are sometimes not noted and then later on as it heals it leaves behind pigmentation which we call as post inflammatory hyperpigmentation (PIH).

Before I proceed and guide you any further, I would like to ask you few questions directly or indirectly related to the little angel's problem:
1. How many kids you are blessed with?
2. Who is mainly taking care of your daughter ( is she been left in cratch or house maid mainly)?
3. How is she performing in studies and her learning capacities?
4. Is she afraid of something or is she scolded by anyone?
5. Any treatment in form of topical creams or oral medications you gave in this 1 year period?

I hope you will not be bothered by my questions as I want to give you the best of the suggestions and remedy for the problem of your sweet child.

Waiting for your information and further queries.

Dr Sanjay K Kanodia
MD (Dermatology & STD)
Above answer was peer-reviewed by
Follow-up: Has dark patches on inside of upper lips. What could be the reason for this? 3 hours later
Dr kanodia thanks for your help. My reply to your questions are as below.

1. She is the only child we have.
2. My wife is a home maker who takes care of her. Also we have a live-in maid at home.
3. She is a very active child and has a very sharp memory. She is normal at study but does not concentrate on her studies a lot. She is more interested in playing.
4. Typical to any child she is afraid of darkness and at times scared of dogs.
5. We gave no medicine to her and only applied Vaseline.

Thank you
Answered by Dr. Sanjay Kumar Kanodia 1 hour later
Welcome again Sir,

First of all I am so thankful to you for your so precise reply.

Now for the explanations part that why I asked you so many of the questions.

- This lip licker’s dermatitis begins generally in cold weather but other wise also seen in kids who have tendency for constantly licking the lips due to dryness. Now this is one part of documented thing but according to the other part of our experience it is also seen in those kids who are either more pampered or scolded. This brings a sense of fear and as a part of their defense mechanism they start licking the lips. This is same as thumb sucking process. Once they start doing it leads to a vicious cycle of lip licking, dryness, redness, and chapping and ultimately leaves behind pigmentation which I already mentioned as post inflammatory hyper-pigmentation (PIH).

-As your wife is mainly taking care of her so she should make it utmost important that this habit of licking or touching lips by tongue is strictly to be broken and abolished. Let she take special watch at home that she is not doing it. At school also, let you talk to her teacher and explain the situation patiently, so that they also help you out in the same manner ( abolishing licking with tender efforts and also no scolding for this as well as in studies)

-Let she either be not pampered more, and I think you are not at scolding her- so balance your approach also in handling her.

-Let she be made confident about her fears slowly. I can see that the there is more of flaking on left side of mouth, it seems she is sleeping more on left side so the saliva might be drooling on left side – check it out at night, if it is so wipe the saliva with neat cloth and let she not breath by mouth. If there is any nasal blockage then check for this also.

-A simple point of advice is to change your tooth paste also to a milder one with least of fragrance and chemicals.

-As a medicine part the most important thing is moisturization and petroleum jelly is as good as anything but is to be applied for multiple times. I think you can explain our sweet and intelligent kid to apply it by herself at home and in school. If the dryness is not resolved in few weeks of time then we would need mild steroids as last resort under dermatological guidance.

-Don’t worry about the pigmentation no active medication is required, once you follow the suggestions and everything goes on right track it will get resolved in few months.

Lastly as a father of a daughter of same age group I can understand your concern and trying to give you best advice. Even if you have any further questions, I will be happy to help. If you do not have any clarifications, you can close the discussion and rate the answer. Wish good health for your sweet family.

Dr Sanjay K Kanodia
(MD- Dermatology & STD)
Above answer was peer-reviewed by
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