Eczema can affect many different parts of the face and body, including the mouth and lips. Eczema that develops around the mouth is generally referred to as perioral eczema. However, several different types of eczema can affect the mouth area, causing uncomfortable and irritating symptoms such as a red or purplish, bumpy rash around the mouth and scaly, dry skin on the lips.
Eczema around the mouth and lips is sometimes confused with other conditions. You might mistake this itchy, bumpy rash for acne, seasonal dryness, an allergic reaction, or cold sores. It’s important not to make assumptions. If you think you may be experiencing eczema around your mouth or on the lips, make sure to get the right diagnosis and work with your dermatologist to find the best treatment.
Eczema around the mouth and lips isn’t as common as on other parts of the body, but it’s just as irritating. It’s also harder to hide. People with this kind of eczema may be embarrassed and sometimes don’t want to be in public until it goes away.
Besides looking dry and unpleasant, when left untreated, this type of eczema can lead to other problems, such as itching and discomfort.
“I feel like I want to claw my lips off, they are so itchy,” wrote one MyEczemaTeam member. “Can’t smile, can hardly talk, and it hurts to eat.”
This can affect a person’s mental state, as well. “My flare-ups from my eczema made my anxiety go through the roof,” said another member. “It’s worse around my mouth.”
The pain and irritation, as well as increased anxiety, can make sleeping more difficult.
Symptoms of eczema around the mouth and on the lips are like any other type of eczema. These symptoms include:
Although anyone with eczema can develop symptoms on their lips and around their mouth, children are particularly prone to developing facial eczema. Several kinds of eczema, including atopic dermatitis, cause problems around the mouth and on the lips. See your doctor or dermatologist for the right diagnosis. Knowing what kind of eczema you are dealing with means getting the right treatment to make it better.
Perioral (around the mouth) dermatitis is a form of dermatitis that affects the area on or around the mouth and lips. The rash seen in people with perioral eczema often resembles acne. The bumps may be red or skin-colored, and they are often dry and surrounded by dry skin.
The big difference between perioral dermatitis and acne is how it feels. Unlike pimples, the bumps and the area around them are likely to itch or even burn when caused by perioral eczema. Usually, an area of several millimeters around the lips is spared from the rash.
One particular type of perioral dermatitis is known as interstitial granulomatous periorificial dermatitis. This condition is less common than the above-mentioned type of perioral eczema. It can also resemble acne, causing white or yellowish bumps that may look like closed comedones (whiteheads).
Eczematous cheilitis is another type of eczema that can affect the lips. It can be acute (short-term) or chronic (long-term). It can be caused by allergies, irritation, or infection, or it can be a symptom of other health issues, such as lupus and other autoimmune conditions.
Angular cheilitis is a type of eczematous cheilitis that affects the corners of the mouth, leaving cracked sores that are often confused with cold sores. This painful and annoying condition may slowly go away on its own, but it can be helped by ointments or medications.
Lip licker’s dermatitis is a specific kind of irritant or allergic contact cheilitis. It can affect people of any age, but it’s more common in children. Unlike other kinds of irritant contact cheilitis, lip licker’s dermatitis is caused by your saliva. When you lick your lips a lot, it causes dryness and irritation. That dryness and irritation can then cause you to lick your lips even more, leading to worsened dryness and irritation. This often appears with discoloration around the lips where the skin is irritated by saliva from the tongue.
Doctors are not sure why eczema occurs. Right now, scientists think that genetic and environmental factors both may play a role. The absence of certain proteins from the skin barrier increases the likelihood that the area will become irritated by chemicals.
A person who already has eczema may develop symptoms on their lips or around their mouth. Read on to find out which factors and substances can trigger or worsen these symptoms.
The long-term use of topical steroids such as hydrocortisone cream and steroid inhalers can cause perioral dermatitis. The Cleveland Clinic notes that overuse of topical steroid medications is the most common cause of perioral dermatitis. This condition is treated more like rosacea than traditional eczema.
Moisturizers can help manage eczema symptoms such as dry skin. However, overuse of thick emollients, facial creams, and lip balm is a common cause of perioral eczema. Talk with your health care provider about your skin care routine to see if the products you use might be causing your eczema.
Other types of irritants, including spicy foods and toothpaste that contains fluoride, can cause perioral eczema.
Extreme temperatures may also irritate the skin and lead to eczema around the mouth. As one member wrote, “I have eczema on my hands, but recently, it has spread to around my mouth and my eyes in the cold weather.”
Rosacea, a skin condition that causes discoloration and bumps on the face, may also cause perioral dermatitis.
If you develop eczema around your mouth or lips, take a trip to your dermatologist. They will be able to determine what is behind your symptoms — and if it is eczema, which type. A dermatologist will ask about your symptoms and examine the affected area. In some cases, your doctor might also do a skin biopsy. This entails removing a small sample of skin for examination under a microscope.
Once you and your doctor know what’s going on, it’s time for a treatment plan. The first step will likely be to eliminate potential irritants. This may include topical steroids, as well as lip products or lotions that could be causing more irritation.
If eliminating triggers is not enough to improve your symptoms, your dermatologist may recommend the following.
Medications used to treat eczema in the mouth area can be topical, oral, or injectable.
Topicals are applied directly to the skin to help reduce inflammation and irritation. Some are available over the counter, and others are prescription only. Prescription topicals include:
Oral medications can also help with perioral eczema. Oral antibiotics, in particular, can help treat or prevent infection when scratching itchy skin has led to sores or lesions. These antibiotics may include tetracycline, doxycycline, oral erythromycin, or low-dose isotretinoin.
Injectable medications, called biologics, are a newer class of drugs for treating eczema. Biologics offer targeted treatment that can be administered subcutaneously (under the skin). They work directly on the immune system to help keep the system from overreacting and causing more inflammation. Dupilumab (Dupixent) and tralokinumab-ldrm (Adbry) are currently on the market, and new biologics are being tested and developed. Talk with your doctor to see if biologics are treatment options for you.
Prescription medications aren’t the only way to treat eczema around the mouth and on the lips. Over-the-counter and home remedies can also help. Always talk to your doctor or dermatologist before trying home remedies. Their medical advice may differ depending on your needs. Certain products may clog the pores on the face and lead to acne, so look for those that are noncomedogenic.
Certain natural, cold-pressed (“virgin”) oils are safe and potentially effective for people with eczema. These include coconut oil, jojoba oil, and sunflower oil.
Aloe vera is well-known for soothing burns. It can also help with the skin irritation of eczema. Make sure to use all-natural aloe vera without fragrances, dyes, or alcohol. Start with a small amount and be gentle when applying.
Colloidal oatmeal is a powder made from fine-ground oat kernels. It can be helpful as a skin protectant and a soothing treatment for eczema. Products that contain colloidal oatmeal are useful in treating dryness and irritation, and the ingredient is also especially helpful in managing itchy skin.
Living a healthy lifestyle is important for everyone, but it can make a big difference in the lives of people with eczema. Making certain changes to your daily routine may help improve symptoms of eczema around your mouth or on your lips.
If you have eczema on your face or around your mouth and lips, stop using facial products that are harsh or irritating, such as scrubs or products with perfumes or scents.
Try to avoid salty, spicy foods when you have eczema around your mouth and on your lips, as they may trigger symptoms.
If you suspect an allergy to an ingredient, talk to your dermatologist about patch testing.
Wash and rinse your face with warm water. Water that is too hot or too cold can be irritating to eczema-prone skin.
Gentle but effective moisturizers are also important to keep dry, itchy skin at bay. You can search the National Eczema Association’s product directory to find eczema-safe creams, cleansers, sunscreen, and more. Thick ointments will be better for the lips, whereas creams may be better for the skin.
You should always wash your bedclothes and towels in hot water to get rid of germs, allergens, and dirt. Wash these items frequently in a mild detergent at least once a week to keep them clean. Use detergents that are free of dye and fragrances.
Make sure you are getting enough quality sleep. Not sleeping enough or sleeping poorly leads to stress, which can exacerbate eczema.
Do what you can to reduce stress, too, including meeting with a therapist or counselor if you need help.
Smoke can badly irritate sensitive, eczema-prone skin — especially around the mouth.
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Have you developed eczema around your mouth or on your lips? How have you managed it? Share your thoughts and tips in the comments below or by posting on MyEczemaTeam.