LIP ALLERGIC CONTACT DERMATITIS

 

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If your dermatologist or allergist has diagnosed you with an allergic reaction of the lips, the information below will provide more guidance on what substances to avoid and how to avoid them.

 

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What is allergic contact dermatitis (ACD)? Why is it so hard to diagnose?

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ACD is a type of allergic reaction. In this type of allergy, a substance contacts the skin, and later results in a rash. The rash from poison ivy is one example. The rash classically occurs 2-3 days later, but it may happen just a few hours later, or one week later. This delay is what makes ACD so hard to figure out.

Once the rash occurs, it may last for weeks, and sometimes up to 8 weeks. People may stop using the offending product for 1-2 weeks, but that’s usually not long enough to see results.

 

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What does inflammation of the lips look like?

Many people have dry, chapped lips and require daily use of lip balms. However, if your lips stay chapped despite frequent use of lip balms, you may have more than just chapped lips. You may be experiencing inflammation of the lips. On the skin, this condition is known as dermatitis. On the lips, it is known as cheilitis.

Inflammation may result in redness of the lips or on the skin around the lips. It may also result in a very dry, flaky appearance. When severe, it can result in cracking. Some people feel itchy, while others feel pain or burning of the lips.

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This inflammation may be caused from irritation or may be due to allergic reactions.

 

One of the most common causes of irritation is from licking of the lips. In many cases, patients don't even realize that they lick their lips. It may be parents, spouses, or friends who note the habit. This can start with dry lips, which people may try to wet with their tongue either on purpose or unconsciously. This wetting of the lips, followed by air drying, can set up a wetting/drying cycle that can then progress to inflammation.

 

Making a conscious effort to stop licking the lips can help, although this can be difficult for children [just as it's hard to stop nail biting]. Another must is carrying lip balm and using it frequently. Chapsticks, which are more waxy, may not be moisturizing enough. One of the best products to lock moisture into the lips is pure Vaseline petroleum jelly [without added fragrance or flavorings]. Vaseline is better than Blistex or Carmex. [Even though some people like the mentholated feeling, these are not the best choice.]​

 

Other patients develop inflamed lips due to allergic reactions. There are 2 main types of allergic reactions. One type is classic food allergy. The other type is allergic contact dermatitis (ACD).

Food allergies, such as peanut or shellfish allergy, result in burning, itching, or swelling of the lips. This occurs within minutes to hours after exposure to a food.

With ACD, the reaction classically takes 48 hours to occur, although it can occur less than a day following exposure, or as long as a week following exposure. A typical example would be a woman who wears lipstick, and then 3 days later notes redness and flaking of the lips.

 

 

What substances trigger ACD of the lips? How can I avoid these?

1. The most common allergens are certain fragrance additives. These additives also serve as flavorings. These flavorings can be found in chapsticks, lip balms, toothpaste, mouthwash, chewing gum, make-up, and other products.

2. Some of these flavorings are naturally found in certain foods, such as cinnamon, vanilla, tomatoes, and citrus fruits.

3. Skin care ingredients such as lanolin, which is a moisturizing ingredient found in Aquaphor, can also trigger allergic reactions.

4. Other preservatives and additives in skin care products and makeup can be a trigger.

5. Metals and certain chemicals used in dental procedures can also trigger reactions.

 

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How can I avoid these? What products should I use?

1. STOP all chapsticks, Burt's Bees products, and lip balms such as Carmex, Blistex, or EOS. All of these can contain allergy-causing flavorings.

2. Use only pure Vaseline petroleum jelly for lips (no fragrance or flavoring) or Vanicream Ointment. Other options are 100% coconut oil and 100% shea butter.

3. All patients should STOP chewing gum, mints, and mouthwash for 8 weeks.

4. Change your toothpaste to Cleure Toothpaste for Sensitive Teeth, Pepsodent, VMV Hypoallergenics Essence Simple-Gentle Skin-Saving Toothpaste, or Tom's of Maine Silly Strawberry Children's Fluoride-Free Toothpaste (this flavor only!).

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5. For lip balm with sun protection, you may use Vanicream Lip Protectant/Sunscreen.

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6. Patients should stop wearing lip makeup. Once your lips heal, you may try products that do not contain fragrance/flavoring additives [including botanicals], formaldehyde, lanolin, oxybenzone, or methylisothiazolinone. See our MAKEUP WITH LESS ALLERGENS list for our current recommendations. 

Note that every product must contain some additives, and some people are allergic to less common substances. Therefore, if these recommendations do not help, then you may require further testing. It can take up to 8 weeks of allergen avoidance for your skin to recover. Your physician will recommend or prescribe a medicated ointment to use on your lips during this time to help with the inflammation.

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For more information on lip allergies, please see this blog post: