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    Suggest treatment for dry lips and eczema

Posted on Tue, 16 May 2017 in Skin Hair and Nails
Question: I've attached a couple pictures of my lips for your reference.
As you can see the top lip is discolored, My bottom lip is slightly off tint also. I've been experiencing dry lips for a period of 2-3 years now. They use to peel however they don't anymore but continue to remain dry. I also have tiny bumps in little patches around the top lip. My lips generally feel raw. At the moment the only thing I use to treat the dryness is aquaphor, I drink plenty of water and limit alcohol and caffeine,
I've seen a dermatologist who suggested that this was lip eczema and said there was nothing that can be done.
At this point I am fed up as this has been ongoing for awhile and it has made me self conscious. I would like to really find a legitimate course of action to help diagnose what the issue is. From my readings, it can be fungal, bacterial infection and thus treatable. The first time I ever started feeling any discomfort on my lips was after I had given oral sex to a female which was 3 years ago. This leads to me believe that I could have been infected with a fungal infection and I'm currently using clotrimazole to see if there is any improvement, I'm on day 2 and don't know how long I should be applying this for. In the case that this is lip eczema I have read that Benadryl cream may be effective also.
At this point I just need someone to examine the pictures and tell me what this is If it is impossible to diagnose through pictures then I'm ready to have a lip biopsy done,
Thank you.
Answered by Dr. Prof. Kunal Saha 2 hours later
Brief Answer:
Apply aloe vera gel.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone carefully through your query and understand your concerns. I have also checked the attached images. There are a couple of whitish discolorations which could be either due to fungal or some autoimmune cause as in eczema. Irrespective of the cause you should apply some aloe vera gel or some suitable gel that hydrates your lips. This is very important and the mainstay of treatment. Benadryl cream can help in reducing itchiness, if present, but not otherwise. Rather than applying benadryl cream, I would prefer some antiallergic tablet like cetirizine once daily when needed.

I would need to ask you if you have dandruff on your scalp. Dandruff is indicative of seborrheic dermatitis which can also have affected your lips. If that is the case I would insist you to apply ketoconazole shampoo twice or thrice a week. Also apply the foam to your lips during those occasions. I do not think that you need to apply clotrimazole to your lips although you can if you wish.

Let me know if I could help further.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Prof. Kunal Saha 13 hours later
Hello Doc,

Thanks for our reply.

As per your question regarding dandruff, no I do not have.

I have some other questions,

1. If I am dealing with a fungal infection then why wouldn't I apply clotrimazole to my lips if this cream is specifically for antifugal use?

2. What makes aloe vera gel the best candidate for treatment? I have castor, almond, coconut, tea tree, oregano oils at home, any of these worth a try?

3. Can these be Fordyce spots or is it cheilitis?

My main concern is the discoloration. I have an aloe vera plant and will start applying the gel today. How long do I do this for?

Thank you kindly for your help.

Answered by Dr. Prof. Kunal Saha 3 hours later
Brief Answer:
Questions answered in sequence

Detailed Answer:
Let me try to answer your queries.
1. Ketoconazole is also an antifungal. If you use that, no need to use clotrimazole too. However, if you want, you can use it.
2. Aloe vera traps water and hydrates the skin. The mentioned agents are oil based and do not contain water. They can only preserve moisture if the water is already present in the skin. In this case all these agents are unlikely to serve the purpose. Tea tree oil is the best in the list that could somehow serve the purpose.
3. Fordyce spots are sebaceous collections. These are not the same. Chelitis is characterized by cracked angle of lips. That is not the case here.

Continue using aloe vera gel to hydrate your lips. It is overall good and you need not stop using it.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Prof. Kunal Saha 16 hours later
Hello Dr Saha,

I have one last query then I will proceed to close the discussion.

Is the discoloration a result of the fungal infection or is it because the lips are dry?

I purchased aloe vera gel yesterday and have started applying it already.

Thank you.
Answered by Dr. Prof. Kunal Saha 29 minutes later
Brief Answer:
The dryness needs to be dealt with.

Detailed Answer:
Thanks for writing back.

The dryness of the lips is likely to be associated with an eczematous process. As I have already mentioned, eczema involves an autoimmune response and I hold the possibility of the discoloration due to autoimmune cause to be more likely than to be due to fungal cause. Seborrheic dermatitis was a possibility that now seems less likely since you mention that you do not have dandruff. That was the reason that I had considered ketoconazole shampoo to suffice rather than the requirement to apply clotrimazole separately.

Aloe vera gel will help in controlling the eczematous process.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

Answered : 4439 Questions


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