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Lip inflammation, fungal infection, eczema, itching, drying, peeling, Cortic DS

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Practicing since : 1996
Answered : 988 Questions
Hi Doc,

I have a skin inflammation issue around the edges of my lips (usually the bottom part). I don't know what it is - maybe a fungal infection like eczema or maybe not, but it itches and becomes dry and begins peeling the skin. I went to my doctor and she firstly prescribed me with hydrozole cream. When I apply the cream, the symptoms disappear completely, but when I stop using the cream, it comes back after 1-2 days - firstly by itching, then a day after, the dryness and peeling begins. Sometimes I feel a slight burning sensation, probably from scratching. After 8 months of using the cream, the symptoms didn't go away as it keeps coming back when I stop using the cream so I went to the doctor again. She now gave me Cortic DS cream. I get the same results but this time she tells me to use it for 3-4 days then stop using it. Then use it 3-4 days again when the symptoms come back and repeat the process and eventually it will go away.

However, I do not see it going away like this. I am also aware that it might be the cream that is causing this but I doubt it is. How do I get rid of this forever?

If the creams remove the symptoms of itchiness and dryness, perhaps it is eczema or dermatitis or something like that? Can you please provide me more info on this condition and tell me how to cure it? T

Thank you very much.
Posted Tue, 1 May 2012 in Skin Hair and Nails
Answered by Dr. Bharat Chawda 7 hours later

Thank you for the query,

Before I answer your question ,I would like to know few things here:
1) What is the exact location of this skin lesion.Is it at the angels of mouth ?
2) Do you have any stomach upset along with this?
3) Any history of chronic illness or any deficiency of any vitamins known to you?

I would appreciate if you can send me a close up picture of the lesion which would help me further in suggesting you better. You can send it at YYYY@YYYY and kindly mention "ATTN Dr.Bharat Chawda" as a subject. Also please reply to this mail saying that you have enclosed a picture.

With the above history which you have given there seems to be the possibility of either a fungal infection or a angular cheilitis.

In both these conditions you would respond very partly to the creams which you have been prescribed,in-fact the symptoms would wax n vain.So I would suggest you to completely stop using the above creams as these are steroids and would not help in healing.

Also please improve your diet and water intake .

Please reply back with the above answers and send the pictures if possible, as this will help me in answering you better.

Awaiting your reply.

Dr.Bharat chawda
Above answer was peer-reviewed by
Follow-up: Lip inflammation, fungal infection, eczema, itching, drying, peeling, Cortic DS 9 hours later
Hi Dr XXXXXXX chawda,

What do you mean the symptoms would "wax n vain?"

Answer to your questions:

1. Its on the bottom part of the bottom lip, right on the edge. However, when I leave it for days, it affects all around the lips. It firstly began on the right angle of the mouth but after applying the cream, it stopped there and now is mostly the bottom part only.

2. What do you mean by stomach upsets? I don't feel any stomach pains but sometimes I hear growling in the stomach.


I can't send any photos because the lips look normal since I've been using the cream but I stopped using it today. The cream seems to be effective though... until I stop using it. What should I do if I don't use these creams?

Answered by Dr. Bharat Chawda 3 hours later

Thank you for the reply.

I apologize for my spelling mistake here. Actually it is 'Wax and Wane'.

Wax and Wane means that the lesion which you have would disappear on applying the cream and would reappear once you stop them .This happens when one is using a steroid cream ( both hydrozole and cortic DS are steroid creams). This also happens when one has fungal infection and patient uses a steroid cream instead of anti fungal cream. Steroid being anti-inflammatory drug gives a temporary result. But the lesion reappears once you stop using it. Steroid would never give a permanent cure if one has either fungal infection or Angular cheilitis.

Angular cheilitis is seen mostly at the angles of mouth and is usually due to deficiency of vitamins or due to stomach infection.This is the reason I asked you about stomach upset.

There is also a chance of it being 'Peri-oral Dermatitis', but then usually we see it all round the lips (both upper and lower).

A picture of the lesion would have helped a lot. Anyways if you see a recurrence of the lesion then please send me a picture so as to guide you further.

I would advise you to stop using both these creams and start with a oral anti-fungal tablet ( either fluconazole or terbinafin ). Please do consult your dermatologist for a prescription of this drug.

Along with this you should also take vitamin B12 or a B-complex tablet for atleast a month once a day after breakfast.

Since anti fungal tablets are not OTC drug ,and a prescription based medicine , I would request you to consult a dermatologist for proper prescription. A clinical look of the lesions makes a difference.

Hope this answers your query. In case of any doubts, I am available for the follow up queries.

“ Wish you Good Health”.

Dr.Bharat chawda
Above answer was peer-reviewed by
Follow-up: Lip inflammation, fungal infection, eczema, itching, drying, peeling, Cortic DS 1 hour later
It might be Peri-oral Dermatitis because it does affect both the bottom and upper lips, just that the bottom lips is much worse at first and develops faster after I stop using the cream. If it is, then what should I do?

Thanks for your help, I want to know how sure you are on angular chelitis or fungal infection. Because my doctor thought it was eczema/dermatitis. If it is, then how would I cure it?

Thank you very much!
Answered by Dr. Bharat Chawda 58 minutes later

Thanks for the follow up.

Angular cheilitis only effects the angles of mouth and not the whole lip. One can see lot of cuts at the angles.

Usually fungal infection too involves angles of mouth. Itching is the main symptom here.

But peri-oral dermatitis involves the periphery of both the lips associated mainly with burning sensation. Licking of lips can exacerbate the problem, so it should be avoided.

At times allergy to tooth paste can also lead to same. Even steroid cream which are very strong and flourinated ones should be avoided in peri-oral dermatitis.

Flourinated tooth pastes should also be avoided (you can try using pepsodent or sensodyne ).

Antibiotic like erythromycin or minocyclin can be tried along with very mild steroid (desonide) for pei-oral dermatitis. Your primary physician / dermatologist should be right person to prescribe you the same.

I am not sure about the diagnosis ,since I've not seen the lesion. Probably if I had seen I would have suggested you better. As I have described you the clinical appearance of the lesions, probably you can guess the exact condition.

My best advise would be stop use of strong steroid and start with antibiotics. I hope your doctor should agree with me. Even if you start a anti-fungal with this and a B-complex, it wont harm you in any way. Sometimes these kind of trials can work if we do not have exact cause.

Hope this helps you in understanding your problem.I would wait for the picture to suggest you further .

Dr.Bharat Chawda

Above answer was peer-reviewed by
Follow-up: Lip inflammation, fungal infection, eczema, itching, drying, peeling, Cortic DS 2 hours later
Hi Dr XXXXXXX Chawda,

I sent you an email containing some photos. Instead of my lips, its also on my arm which I forgot to mention to you. Whenever I apply a cream to the arm, it begins itching and scratching makes it worse so I don't do it. I'm not sure if its the same kind of infection but it itches similar to the mouth and you might have a better idea of what it is with the image.

Also, I have a cream called Sorbolene moisturiser, it says it relieves eczema, should I use it? Will anything happen if I use moisturisers like that? It doesn't contain sodium lauryl sulfate by the way.

Also, I've been reading on peri-oral dermatitis on forums and people say they get "out breaks" which I am not sure of what they are but I don't think I have gotten one. Also they say to wash the mouth with warm water, and some say using lemons / XXXXXXX cidar vinegar helps. Is this information valid and should I start using them?

And is peri-oral dermatitis hard to cure? I would like to know, thank you.

Once again, Thank you. You've been much more helpful than my doctor.
Answered by Dr. Bharat Chawda 4 hours later

Thank you for replying again & posting the pictures.

Peri-oral dermatitis out breaks can happen. The reason is that it gets cured with mild steroids and antibiotics only to recur again. Often it is hard to cure and may take long time to respond.

I am completely against use of any indigenous preparation, so please avoid use of vinegar or lemon. It's not going to help you.

The Redwin Sorbolene moisturizer is nothing but a moisturizer containing glycerin and vit E. It can help you give a soothing effect and should not harm you in any way. You may use it.

Now as far as the lesion on the arm is concerned, it shows a good amount of inflammation. When one uses a steroid cream over a supposedly fungal infection, it changes its actual picture only to become incognito. In such a lesions I would first like to use a plain anti-fungal over it for at-least 2 weeks. If it doesn't respond then go for a steroid cream. I would advise you to use a anti-fungal cream like terbinafin or clotrimazole cream first to see the response.

Since you don't have any lesion on the lips right now, then try maintain this condition by using a moisturizer, avoid licking of lips & use non-fluorinated tooth paste. Also start with vitamin B-complex for about a month. Also avoid use of strong steroid creams.

I hope this advise would be helpful to you.

Wish you good health,

Dr.Bharat chawda
Above answer was peer-reviewed by
Follow-up: Lip inflammation, fungal infection, eczema, itching, drying, peeling, Cortic DS 7 days later
Hi Doc,

The Redwin Sorbolene moisturiser has the same effect as the steroid creams on my lips so I'm going to keep using it. However, when I apply creams like clotrimazole and cortic-DS to the arm, it itches like hell 3 minutes later and forces me to scratch for ages (the itching doesn't stop for like 1-2 hours). It makes things much worse. What should I do there? Applying the moisturiser to the arm has soothing but it still occassionally itches. I have new images of my arm sent to the email you gave me, it has gotten worse. See if that helps in any way.

Also, whenever I wake up in the morning, occassionally I cough up phlegm (especially when I eat lots of sweets). Not sure if that has anything to do with this, maybe a weak immune system?

Also, what should I eat to help this condition? And what should I do about the lips? Thanks!
Answered by Dr. Bharat Chawda 9 hours later

Thank you for replying again & posting the pictures.

If Redwin Sorbolene moisturizer is helping you for the lips then there is nothing like it. Kindly continue using it for lips and prevent any recurrence. Also do avoid things which we had discussed earlier.

I have looked at the pictures and your arm lesion looks like a fungal infection. As discussed earlier you should use a anti fungal cream over it first for at-least 2 weeks and observe. Since you are using a steroid cream at present, there persistent and increased itching over it. You can use any anti-fungal cream like terbinafin,clotrimazole,ketaconazole cream etc. For itching you can take any oral anti histaminic like cetrizine tablet.
If these are not OTCs at your place then kindly visit a dermatologist for proper prescription and advise.

Regarding diet, there aren't any diet restriction. A healthy diet containing lots of vegetables and fruits are useful in such conditions.

Hope I've answered your query and that you recover soon.

Wish you good health.

Dr.Bharat chawda
Above answer was peer-reviewed by
Follow-up: Lip inflammation, fungal infection, eczema, itching, drying, peeling, Cortic DS 3 days later
Hi Doc,

After using Sorbolene moisturiser on my lips, it has improved a lot, however, a problem arises... I am starting to get pimples in that area - so far 2. They disappear after like 2-3 days but should I continue to use the cream??

Also, should I continue using clotrimazole on the arm? It gets very itchy everytime I use it.

Thank you!
Answered by Dr. Bharat Chawda 1 hour later

Thank you for the follow up,

Sorbolene moisturizer can lead to pimples. I would suggest you to start with a oral antibiotic like Azithromycin. This would help suppress the lesion. Also reduce your application of sorbolene to twice a week.

As for the arm lesion, I would like to observe it for at-least 2 weeks with a anti-fungal and then decide to change the cream. If you don't show any response with the anti-fungal cream you are using, then that would mean it is not a fungal infection, and you should switch over to a topical steroid cream.

If there is any itching over the arm, then you can take a oral antihistaminic tablet like Cetrizine for few days.

You can post me any time and let me know the progress of the lesion. I'll be happy to answer your any query.

Wish you good health.

Dr.Bharat Chawda.
Above answer was peer-reviewed by
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