Lip Eczema: Signs, Triggers and How to Soothe It
Lip eczema is dry, red, scaly and itchy skin on the lips and the rim around them that does not clear with ordinary lip balm. Doctors call it eczematous cheilitis. It has three usual causes: irritation (lip licking, cold wind, a toothpaste or balm that stings), an allergy to something that touches the lips (fragrance, flavouring, a preservative, a sunscreen filter, nickel), or eczema that a person already has elsewhere settling on the lips. The fix is to stop licking, remove every flavoured, fragranced or medicated product from the lips, and apply a plain occlusive balm many times a day; most cases settle in one to three weeks. Lips that stay cracked, swollen or sore beyond that need a doctor, often with a patch test to find the trigger.
What lip eczema looks like
The lips feel tight and rough, like sandpaper, and look dull and dry with fine scale that peels. The border between lip and skin, the vermilion border, turns pink or red and often scales too, so the redness spreads a few millimetres onto the skin around the mouth. There may be small cracks, burning when acidic food touches them, and itching, which is the clue that it is eczema rather than simple chapping. In darker skin the redness may read as darkening instead. Both lips are usually affected, the lower more than the upper.
Four look-alikes:
- Chapped lips. Dry and flaky but not itchy, not red at the border, and gone within days of a plain balm and more water. Lip eczema is what chapping becomes when the lips are also irritated or allergic.
- Angular cheilitis. Cracked, sore, sometimes crusted corners of the mouth only. Saliva pooling in the corners lets yeast and bacteria grow; it is common with dentures, braces and low iron or B vitamins, and it needs a doctor's cream rather than balm.
- Cold sores. A tingling, then a cluster of small blisters on one spot of the lip, crusting within days. Not eczema. Cold sore or pimple on the lip? →
- Sun-damaged lower lip. A persistent rough, pale or white patch on the lower lip in someone with years of sun exposure. It does not itch and does not clear. This is actinic cheilitis and must be checked by a doctor.
What causes eczema on the lips
- Lip licking. Saliva wets the lips, evaporates and takes moisture with it, and its enzymes irritate the skin. The habit is often unconscious and worst in children, in cold weather and under stress. The red ring around the mouth that follows is lip-licker's dermatitis.
- Cold, wind and dry air. The lips have no oil glands and a very thin outer layer, so they lose water faster than any other skin on the face.
- Irritating products. Lip balms with menthol, camphor, phenol, salicylic acid or strong flavours; toothpastes with sodium lauryl sulphate or cinnamon; whitening strips; very spicy, salty or acidic food on skin that is already cracked.
- Allergy. The common culprits in a patch test are fragrance, flavourings (cinnamon, peppermint, vanilla), preservatives, lanolin, propolis, colophony, sunscreen filters in lip balms, nickel from instruments and cutlery, and ingredients in lipstick and toothpaste. Allergic lip eczema often comes on months or years after first using the product.
- Atopic eczema. People with eczema elsewhere, hay fever or asthma have a barrier that is weaker everywhere, lips included, and flare in winter.
- Medicines. Retinoid tablets for blemishes are the classic cause of severely dry, cracked lips; some others do it too.
How to soothe lip eczema
- Stop licking, biting and peeling. This is the hard part and the one that matters. A plain balm within reach at every moment removes the reason to lick.
- Strip the lips back to one product. Remove every lip balm, gloss, lipstick, flavoured product and medicated balm. Change to a fragrance-free toothpaste without sodium lauryl sulphate. If any one item is the trigger, this finds it within two weeks.
- Seal with a plain occlusive. Petroleum jelly, or a balm whose list is only petrolatum, mineral oil, shea or beeswax, applied in a thick layer six to ten times a day: after every meal, after brushing, before going out and generously before bed. Lips that stay covered cannot lose water and cannot be licked dry.
- Rinse after eating and brushing. Toothpaste and food residue sitting on cracked skin keep it inflamed. Water, pat dry, balm.
- Protect from the weather. A scarf over the mouth in cold wind, and in sun a mineral lip balm with SPF 30 whose filter is zinc oxide, since chemical filters are a common allergen on lips.
- Mind the diet while the lips are open. Citrus, tomato, vinegar, chilli and very salty food sting cracked lips and slow recovery. Drink more water; dehydration shows on the lips first.
- Reintroduce slowly. Once the lips have been calm for two weeks, bring products back one at a time, a week apart, and stop at the one that brings the itch back.
The skin around the mouth: a NEODERMA routine
NEODERMA does not make lip products; a plain occlusive balm is the right choice for the lips themselves. For the skin around the mouth, which lip eczema often reaches and which lip licking dries out, the routine for delicate skin keeps the border calm.
- Cleanse: The Cleansing Milk, a soft cleanse that removes toothpaste and food residue around the mouth without foam or fragrance load.
- Calm and comfort: Neo-Sense Day Face Cream, with chamomile and calendula, relieves the feeling of tightness and helps reduce the look of redness; worked into the skin around the lips, not on them. At night, Neo-Sense Night Face Cream for very dry, delicate skin.
Vegan, dermatologically tested, sealed airless. Developed in Switzerland · Made in the EU. The Neo-Sense line →
How long does lip eczema last?
Irritant lip eczema and lip-licker's dermatitis improve within a few days of stopping the licking and sealing the lips, and clear in one to three weeks. Allergic lip eczema clears two to four weeks after the trigger is removed, and returns within days if it comes back. Lip eczema that is part of atopic eczema tends to come and go with the seasons and needs a maintenance habit: balm every day, not only when the lips crack. Lips that have not improved after three weeks of a single plain balm and no licking need a doctor.
When to see a doctor
See a GP or dermatologist if the lips are still red, scaly or cracked after three weeks of the routine above; if they bleed, crust or swell; if the redness spreads well beyond the lip border; if the corners are cracked and sore; if a rough patch sits on the lower lip and does not change; if there is pain, fever or sores inside the mouth; or if a child's lips are sore and the licking cannot be stopped. A dermatologist can prescribe a short course of an anti-inflammatory cream for the lips and arrange patch testing, which finds the allergen in a large share of stubborn cases.
Frequently asked questions
Can you get eczema on your lips?
Yes. The lips and the skin around them can develop eczema, called eczematous cheilitis, from irritation, from an allergy to something that touches the lips, or as part of atopic eczema. It shows as dry, scaly, itchy, red lips and a red rim around them, and it does not clear with an ordinary flavoured balm.
Why do my lips feel like sandpaper?
Because the outer layer has dried and roughened. The usual causes are lip licking, cold and wind, dehydration, a balm or toothpaste that irritates, or lip eczema. A plain occlusive balm applied many times a day, more water and no licking smooth them within days; if they stay rough and itchy, it is eczema and needs the trigger removed.
How long does lip-licking dermatitis last?
Once the licking stops and the lips are kept sealed with a plain balm, the red ring around the mouth fades in one to two weeks and the lips recover in two to three. The habit is the limiting factor; a balm kept always within reach is what breaks it. If the ring persists, a doctor can prescribe a short course of cream.
Does lip eczema go away for good?
Irritant and allergic lip eczema go away for good once the cause is found and avoided. Lip eczema that is part of atopic eczema is a tendency rather than a one-off, so it can return in winter or under stress, but a daily plain balm and avoiding known triggers keep most people clear most of the time.
What should I put on eczema on my lips?
The plainest balm you can find: petroleum jelly, or one whose ingredients are only petrolatum, mineral oil, shea or beeswax, with no fragrance, flavour, menthol, camphor, phenol or salicylic acid. Apply it thickly and often. If three weeks of that has not worked, a doctor can prescribe something stronger for a short course.
What is the difference between lip eczema and chapped lips?
Chapped lips are dry and peeling from cold or dehydration, not itchy, not red at the border, and gone within days of balm and water. Lip eczema itches, reddens and scales the lip border and the skin just beyond it, and it keeps coming back until the irritant or allergen is removed. Chapping that will not clear has usually become eczema.
Related: Dry skin around the mouth · Dark lips and lip hyperpigmentation · Damaged skin barrier: signs and how to repair it
