Abstract

Lip lickers dermatitis, popularly known as perioral dermatitis, is an Irritant contact dermatitis on and around the lips due to saliva from repetitive lip licking. Involving children more than adults, the resulting papules, scaling, erythema and occasional fissures and crusting make a well-defined ring around the lips. The rash extends as far as the tongue can reach and frequently spares the angle of the mouth. Unlike periorificial dermatitis, the vermillion border of the lip is often involved and the treatment is simple moisturisers.

Signs and Symptoms

Redness around the lips in circumoral distribution with dryness and scale is typical. Chapping may also occur, especially in cold weather.

Causes

Repeated licking resulting in a cycle of wetting and drying causes the redness, fissuring and scale. IIt can also occur with lip chewing, thumb sucking or excessive drooling.

Wind instrument players may also experience lip licker's dermatitis.

Compulsive licking of lips causing lick lip dermatitis is also seen as psychological disorder.

Persistent and continuous breathing from the mouth can cause dry lips and result in temptation to repeated lick lips.

Diagnosis

The diagnosis of lip licker's dermatitis is from the history and inspection of the rash. It is important to distinguish it from allergic contact dermatitis and perioral dermatitis which is characterised by papule in the perioral area, sparing of the vermillion border and worsened by topical steroids.

Treatment

Generous application of bland emollients can improve the rash. However, complete resolution will not occur until the lip licking stops. Breaking the cycle of dryness then licking followed by more dryness is key to treatment. Sometimes, unlike in perioral dermatitis, topical steroids may be used for few days only.