A flare-up of eczema corresponds to an inflammatory reaction, often of allergic origin. It can be quite spectacular on thin, fragile skin such as the lips. This red plate can be unsightly but, one thing is certain, it is not never contagious.
Eczema of the mouth and lips: what symptoms?
Details from Claire Boulard, dermatologist: “Parts affected can be around the mouth, the vermilion (delimitation lines between the red part of the lips and the skin) and the red lips. Eczema can affect the upper and/or lower lip, unilaterally or bilaterally. We frequently find cracks at the corner of the lips (also called angular cheilitis) which have more difficulty healing due to the movement of the lips and the humidity in this area. »
In general, a eczema flare-up evolves in four phases. The duration and intensity of the lesions vary from person to person:
1- At first, the lips begin to swell. The edema is sometimes accompanied by small oozing then crusty vesicles.
2- Some Red plaques appear around the mouth. The skin is very itchy and tends to peel. The lips chap and crack, especially at the commissure (angular cheilitis).
3- The skin becomes dry and cracks.
4- After healing, the plaques disappear without leaving marks.
Why do we have eczema around the mouth?
Two possible origins
This eczema of the mouth can have two origins:
- An atopic origin: this type of eczema, also called atopic dermatitis, causes patches all over the body, not just the mouth. It develops in genetically predisposed people and usually appears in childhood.
- An allergic origin : this type of eczema, called cheilitis when it touches the lips and the mouth, is due to contact with an allergen (present for example in a lipstick) or an irritating substance. This contact can be made either directly or through the hands.
The allergens involved in lip eczema
According to Claire Boulard, the allergens most frequently involved in lip eczema are found in:
- lipsticks and lipsticks (Baume du Pérou, perfumes, gallates, etc.);
- nail polish;
- cosmetics applied to the mouth or face, containing preservatives or perfumes;
- toothpastes (menthol, essential oils contained in certain toothpastes);
- musical instruments in contact with the mouth (metal in wind instruments, wood in reed instruments);
- dental solutions or dental materials;
- more rarely, a drug or food.
In consultation, the allergist doctor will propose a battery of tests with the suspect products. The result is known in two to seven days. “Do not throw away products that you suspect may be causing the allergy. They can be tested and their composition can help us identify the allergen, recalls Dr. Claire Boulard. If the patient suspects a lip balm or a cream, he can also do a simple realization test by applying the suspect product to his forearm morning and evening, for a maximum of 15 days. If an eczema reaction appears before, the product is strongly suspected of containing lallergen responsible for his eczema of the mouth and, pending allergological tests, it is not recommended to use it! If no reaction occurs after 15 days, the product can be reapplied without a second thought. »
Onceidentified allergen, the dermatologist gives the patient an avoidance sheet which lists the products containing the substance to avoid. Advice is also given to learn how to decipher the labels and the composition of each product. You can also use smartphone applications like Allergobox or Yuka.
What are the aggravating factors?
Scratching the lesions only further irritates the skin. You have to try, as much as possible, to hold back.
Other factors may be mouth irritants. We try to avoid them:
- climatic factors: cold or wind
- traumatic factors: tearing tic of small scales, repeated rubbing.
- chemical factors: saliva, lip licking, application of cosmetics (lipstick, make-up removers, etc.), toothpaste, acidic foods, etc.
- Other: drugs that dry out the skin (isotretinoin for acne, for example), vitamin deficiencies, inflammatory diseases, etc.
In case of’contact eczemait is logically necessary to avoid contact with the allergen or the irritating substance, once it has been identified.
Whatever the origin of the eczema, thelip hydration is an integral part of the treatment. « There are special lip sticks with very oily and thick textures formulated specifically for atopic patients », explains the dermatologist.
What anti-inflammatory cream or ointment?
To treat the inflammation, the doctor suggests applying a cortisone cream. « In combination with moisturizing and healing creams, the doctor may prescribe treatment with topical corticosteroid of low class, used in short cure (a few days). You must avoid applying it too regularly, otherwise you will have lesions induced by local corticosteroid therapy, in particular perioral dermatitis (sometimes confused with eczema)”, explains Dr. Claire Boulard.
To avoid the too frequent use of topical corticosteroid creams, the dermatologist can offer a relay tacrolimus ointment.
Finally, in patients with atopic eczema, systemic treatment is recommended either orally or by injection. It offers a global solution against lesions that can affect not only the mouth and lips, but also other areas.
What daily hygiene and care?
The fine and fragile skin of the mouth requires very gentle care.
Yes the lips are dry, avoid irritants such as make-up, exposure to cold and wind. The application of a moisturizer must be daily, and even several times a day in winter.
To avoid aggravating the lesions, avoid bad reflexes such as:
- wet your lips with your tongue, as friction and saliva aggravate dryness and inflammation;
- tear off small dry skin (dander) with your teeth, which makes the lip raw and delays healing;
- putting hands to mouth too often;
- put in contact with the damaged mouth irritating tissues or foods that are too acidic.
What about natural care?
Essential oils are not recommended on sensitive mucous membranes, and especially on the lips, as they can be allergenic. In addition, Claire Boulard recommends reading the composition of organic cosmetics carefully: « Organic does not mean that they do not contain allergens », she recalls.
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