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Ask Dr. David Your Own Question
Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 46734
Experience:  Board Certified Physician
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Hi, I had some sort of allergic reaction to a lip balm back

Customer Question

Hi, I had some sort of allergic reaction to a lip balm back in September last year. I put in on before going to bed at night, and woke up with burning lips, with some raised little 'bumpy' areas. I thought then that maybe I was getting a colesaw (I think I had one as a child, but never since) so used Aciclovir for five days. I used another lip balm at the same time. I read only afterwards in the small print that you mustn't use a balm over the Aciclovir.

6 months on my lips - around the entrance - are peeling every morning. It's not like when people have chapped lips. The skin that forms each morning is soft, thin and fragile. I look like I have a layer of skin missing, that's refusing to heal. Dermatologists that I have seen say hopefully it will 'calm down', and to use only hydromol. This acts as a barrier - but at the same time, disturbs the ever so fragile skin. I can't see how after 6 months, it's going to suddenly stop. I'm desperate for an answer, from somebody who has seen this.

I'm doing all the things I should be doing, like drinking plenty of water to stay hydrated from the inside out.

I hope one of your team can help me. Many thanks!
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. David replied 3 years ago.

Dr. David :

This is Dr. David

Dr. David :

this sounds like perioral dermatitis.

Dr. David :

or it could be due to impetigo as well.

Dr. David :

you should not use steroid creams around your mouth.

Dr. David :

you might need a course of antibiotics to help the perioral dermatitis.

Dr. David :

hydromol is just a moisturizer.

Dr. David :

ask to see if a course of antibotics can help

Dr. David :

you can read more here

Dr. David :

http://www.nlm.nih.gov/medlineplus/ency/article/001455.htm

Customer: Hi Dr David. I know hydromol is just a moisturiser...hence my searching the web for answers, as this alone is not working. No, it's not impetigo as there are no sores or blisters. And nor is it Perioral Dermatisis, as there is no rash...
Dr. David :

it could be stomatitis

Dr. David :

or a fungal infection possibly around your mouth.

Dr. David :

or burning mouth syndrome

Customer: Stomatitis has been ruled out, I have been tested for fungal infection...and burning mouth syndrome is sensory; I physically have peeling skin. This is not a side effect of BMS.
Dr. David :

you don't have to have a rash for perioral dermatitis.

Dr. David :

it sounds like you have a lot of inflammation of your lips.

Dr. David :

you can always get a lip skin biopsy

Dr. David :

and I bet it will show dermatitis or inflammation of the skin.

Customer: Getting a skin biopsy does sound useful. But, wouldn't my lips be swollen if there was inflammation? Also I have been taking Metronidazole for two weeks now, for another condition. As this is an antibiotic than can be used for treating this condition, wouldn't I have seen some improvement after the two weeks of taking it?
Customer: ...if it was PD?
Dr. David :

metronidazole is flagyl and usually is used for GI bacterial issues.

Dr. David :

why doesn't getting a skin biopsy sound useful?

Dr. David :

many diagnosis are made by biopsy.

Dr. David :

a biopsy can allow a pathologist to look at cellular information

Dr. David :

also you can take a photo of your lips and mouth area and upload it here for me to review as well.

Customer: I said getting a biopsy WOULD be useful! :)
Dr. David :

sorry.

Dr. David :

I mis read.

Dr. David :

yes, a biopsy would be useful

Dr. David :

you might need to see a dermatologist to get a skin biopsy of the area.

Dr. David :

sometimes in rare cases, autoimmune disorders can cause this as well.

Dr. David :

so getting blood testing for ANA

Dr. David :

antinuclear antibodies and ESR to see if these are elevated can signal if you might have a possible autoimmune condition causing this

Dr. David :

where your body makes anitibodies which attacks your own cells.

Customer: Ah..ok...now that's interesting. I have had a slightly positive ANA result recently....and have thought something may be going on connected to an Autoimmune Condition. I know there are many...but which are connected to what's happening with my lips?
Dr. David :

sjorgren's syndrome.

Dr. David :

lupus

Dr. David :

can both affect the lips.

Dr. David :

a biopsy of the lips can sometimes help with diagnosis of sjorgren's syndrome.

Dr. David :

do you have dry mouth?

Customer: Those ideas have been tossed around before...the Consultant decided that it wasn't sjorgren's syndrome as my eyes are fine. I do get a dry mouth but I think only through the night sometimes, as I breath through my mouth. They decided also I don't have enough 'ticks' against the symptoms of the condition of Lupus.
Dr. David :

I would get blood testing to check your ANA and ESR levels to be sure.

Customer: ...but I know that can be incredibly difficult and challenging to diagnose.
Dr. David :

lupus and sjorgren's can be hard to diagnose.

Dr. David :

yes.

Dr. David :

you need objective proof.

Dr. David :

like a lip biopsy

Dr. David :

and blood testing to check for autoimmune conditions.

Dr. David :

and a repeat ANA test

Dr. David :

best of luck to you

Dr. David :

let me know if you have other questions.

Dr. David :

if done for now, please leave +++ positive feedback below the chat box

Dr. David :

you can always reach me as Dr. David if you have other questions.

Dr. David :

you might have to scroll down to see the ratings area below.

Dr. David :

thanks for using Justanswer.com

Customer: Yes. I shall. Many thanks for your help...you've been interesting to chat to. Enjoy your evening!
Dr. David :

thanks.

Dr. David :

thanks for using JustAnswer.com

Dr. David :

http://www.justanswer.com/medical/expert-dr-david/

Dr. David :

is my website if you need to reach me again

Dr. David :

don't forget to leave +++ positive feedback when done.

Dr. David :

positive feedback is how we get credit for helping clients.

Customer: Many thanks
Dr. David :

thanks.

Dr. David and 2 other Medical Specialists are ready to help you