Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
I Have Been Dealing With Eczema For Long
Question: Hello I am a 21 year old female living in Florida. I have been dealing with eczema for as long as I can remember. For the past year and a half I have had what I think is eczema around my mouth and on my lips that is very itchy and inflamed. I've seen multiple doctors (my primary dr, a dermatologist, and an allergist) about this issue. I have been prescribed topical steroids, topical antibiotics, topical antifungal ointments as well as taking antibiotic pills for a certain amount of time. The allergist I saw did a patch test to see if I am allergic to anything but it all came back negative.
Throughout the day I apply vaseline which temporarily relieves the itchiness/dryness. I wake up multiple times throughout the night to reapply. I have noticed that on my bottom lip there are these little white spots (very slight bumps) as well as some on my upper lip. Not sure if that is eczema related or not. I also experience weeping after I eat or wash my face and dry it with a towel. Any ointment that I have left on overnight just seems to sweat off. It ends up dripping off my face most of the time. At time it will get slightly better (more barable) for about a week then it will flare up and get very painful, itchy, and inflamed. I have tried to pay more attention to what I eat to see if I can pinpoint what might be causing these bad flare ups, but I can't distinguish anything specific.
I can't seem to get this itchy rash around my mouth to go away.
Here is a list of everything I have tried so far:
Desonide 0.05%
Mupirocin 2%
Betamethasone 0.05%
Eucrisa 2%
Methylprednisone 4mg
Tacrolimus 0.1%
Abreva
CeraVe healing ointment
Nystatin
I feel like I have tried everything and can not seem to get this under control. I would very much appreciate if anyone can help me.
Throughout the day I apply vaseline which temporarily relieves the itchiness/dryness. I wake up multiple times throughout the night to reapply. I have noticed that on my bottom lip there are these little white spots (very slight bumps) as well as some on my upper lip. Not sure if that is eczema related or not. I also experience weeping after I eat or wash my face and dry it with a towel. Any ointment that I have left on overnight just seems to sweat off. It ends up dripping off my face most of the time. At time it will get slightly better (more barable) for about a week then it will flare up and get very painful, itchy, and inflamed. I have tried to pay more attention to what I eat to see if I can pinpoint what might be causing these bad flare ups, but I can't distinguish anything specific.
I can't seem to get this itchy rash around my mouth to go away.
Here is a list of everything I have tried so far:
Desonide 0.05%
Mupirocin 2%
Betamethasone 0.05%
Eucrisa 2%
Methylprednisone 4mg
Tacrolimus 0.1%
Abreva
CeraVe healing ointment
Nystatin
I feel like I have tried everything and can not seem to get this under control. I would very much appreciate if anyone can help me.
Brief Answer:
See detail bellow
Detailed Answer:
Hello and thank you for your question. Hope I can be of help to you today. Eczema on the lip is also known as lip dermatitis and cheilitis. Common symptoms include erythema, dryness, scaling, fissuring, edema, itching, and burning. The most common caused by atopic dermatitis, contact irritants or allergens, chronic sun exposure, and infection. The secondary involvement of the lips can occur in many systemic disorders, such as lichen planus, lupus erythematosus, autoimmune bullous diseases, nutritional deficiencies, etc. Because you did standard treatments and are not effective or you still have persistent symptoms, a biopsy should be considered and discussed with your doctor to find out the secondary involvement.
Because you are negative patch tests we suspect your diagnosis is preferable to irritant contact dermatitis or atopic dermatitis. Topical treatment may be time-consuming, costly, and is required daily, often for years. You can use low to medium potency corticosteroids applied twice a day and combination with emollients, such as petrolatum. But prolonged use of topical corticosteroids, however, may cause atrophy, which can exacerbate irritant lip eczema. You may try topical calcineurin inhibitors such as pimecrolimus or tacrolimus. These may be used as an alternative to topical corticosteroids for long-term use.
I hope that It can help you, and please let me know if you have any clarification or questions about that, and I would be welcome to discuss it with you further. I hope you have good health.
Best regards,
Dr. Heang Chan Raksmey, General and Family Physician
See detail bellow
Detailed Answer:
Hello and thank you for your question. Hope I can be of help to you today. Eczema on the lip is also known as lip dermatitis and cheilitis. Common symptoms include erythema, dryness, scaling, fissuring, edema, itching, and burning. The most common caused by atopic dermatitis, contact irritants or allergens, chronic sun exposure, and infection. The secondary involvement of the lips can occur in many systemic disorders, such as lichen planus, lupus erythematosus, autoimmune bullous diseases, nutritional deficiencies, etc. Because you did standard treatments and are not effective or you still have persistent symptoms, a biopsy should be considered and discussed with your doctor to find out the secondary involvement.
Because you are negative patch tests we suspect your diagnosis is preferable to irritant contact dermatitis or atopic dermatitis. Topical treatment may be time-consuming, costly, and is required daily, often for years. You can use low to medium potency corticosteroids applied twice a day and combination with emollients, such as petrolatum. But prolonged use of topical corticosteroids, however, may cause atrophy, which can exacerbate irritant lip eczema. You may try topical calcineurin inhibitors such as pimecrolimus or tacrolimus. These may be used as an alternative to topical corticosteroids for long-term use.
I hope that It can help you, and please let me know if you have any clarification or questions about that, and I would be welcome to discuss it with you further. I hope you have good health.
Best regards,
Dr. Heang Chan Raksmey, General and Family Physician
Above answer was peer-reviewed by :
Dr. Kampana
Thank you for answering my question. I have tried tacrolimus before I forgot to mention in in my list of ointments I have tried. When I did leave it on overnight I remember it slightly burning and waking up in the middle of the night to apply vaseline. Is it normal to feel that burning sensation? Also with any ointment I do put on overnight it weeps or drips off down my chin so is there any specific routine or method I should follow before going to bed?
Brief Answer:
Hope you have a good health
Detailed Answer:
Hello,
Thank you again for your question. The burning sensation after application of tacrolimus lasts about 15 to 20 minutes, but only the first few days of treatment. It should help you from burning sensation, pruritus, and erythema within one week. You should apply thinly to the affected areas of the lip. Do not apply the ointment to any areas of skin that could be infected. Be sure that the lip that affected the area is dry, rub the ointment into your skin gently and completely. You may cover the treated area.
Wish you and your good health. Let me know if I can assist you further.
Best regards,
Dr. Heang Chan Raksmey, General and Family Physician
Hope you have a good health
Detailed Answer:
Hello,
Thank you again for your question. The burning sensation after application of tacrolimus lasts about 15 to 20 minutes, but only the first few days of treatment. It should help you from burning sensation, pruritus, and erythema within one week. You should apply thinly to the affected areas of the lip. Do not apply the ointment to any areas of skin that could be infected. Be sure that the lip that affected the area is dry, rub the ointment into your skin gently and completely. You may cover the treated area.
Wish you and your good health. Let me know if I can assist you further.
Best regards,
Dr. Heang Chan Raksmey, General and Family Physician
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
