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Recurrent Swollen Painful Lips
immaHeel posted:
This is a problem that seems to coincide with my seasonal allergies. I have a rare form of Oral Allergy Syndrome which causes me to get angioedema with certain foods. I carry an epi-pen. Yes, I know that's weird.

The problem is that my lips have been swollen for about 4 weeks now. The swelling ALWAYS increases overnight. In the morning, they are dry, cracked and painful with a fine crust all along the vermillion border, despite putting any variety of balms on them at night. So far I have used Carmex, plain Vaseline, Nivea, Chapstick (plain), Blistex with SPF and Neutrogena with SPF. It doesn't matter what I use, they always stay red, raw and painful.

In terms of medical therapy, I have used low potency steroid ointment (OTC cortisone), higher potency (desonide), non-steroidal ointment (Elidel), antibiotic ointment (mupirocin). NOTHING has helped.

I am currently taking zyrtec 10mg daily, and zantac 150mg BID.

I do not lick my lips. Also, I do not chronically use lip balm, only during the fall/winter when they start getting this way. I do not smoke or use smokeless tobacco. I drink maybe 3-5 alcoholic drinks per week. Typically, alcohol burns them too bad to enjoy the beverage.

My lips are in constant pain. It hurts to smile, laugh and eat. It is as if they are unable to regrow the topmost epidermal layer properly, and instead there is "new skin" on my lips all the time, which is very fragile and painful.

I am a physician, though not a dermatologist. I am in the process of getting an appointment to see one.

For those of you non-physicians reading this, take heart. Even a fellow physician has to get in line and wait to see the skin doctor.

Anyone out here with any expertise or advice, would be most welcome to weigh in. Thank you.
immaHeel responded:
I should add, basically what I am describing is cheilitis. I think mine is atopic or eczematous, however the question is: how the heck should I treat it? Nothing seems to be working.
RB1948 replied to immaHeel's response:
Dear immaHeel,
I am suffering with the same lip trouble as you. I thought i might have had an allergic reaction to strawberries 2 weeks ago, but the redness and inflammation have not resolved. I too have very dry, peeling lips which force me to use various topical oils or petroleum jelly for relief. But this is only a temporary comfort. The lips, especially the upper lip, dry out in a short time. And they feel so irritated... one spot looks like it's missing skin and it stings. It's very uncomfortable and embarrassing, too. Waiting a whole month (earliest available) to see a dermatologist seems crazy. I'll check with my PCP again. I heard that using a steroid ointment, like Desonide which i have applied many times in the past, can cause a thinning of the skin. So I have stopped that. Do you think taking oral steroid might help this type of inflammation?

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