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Clinical Summary

Lip licker’s dermatitis is caused by repeated exposure of the vermillion border and the cutaneous lips to saliva. Children and young adults are more commonly affected, but older adults, including the elderly, can be afflicted. Irritants in topical lip preparations can initiate this process or can worsen a presentation. Winter is the most common time to see lip licker’s dermatitis due to the constant exposure to cold air and low humidity, but presentations occur throughout the year.

The dermatitis typically starts with red papules that slowly progress into an erythematous, thin plaque. As the cycle of licking continues, the area becomes confluent circumferentially around the vermillion border and the cutaneous lips. The skin begins to break down with fissuring and scaling, and the area can become very painful. The rash does not extend beyond the tongue’s reach on the cutaneous lips.

Management and Disposition

Treatment is focused on identifying and preventing repetitive lip licking. Many children are not aware they are contributing, and care should be taken to not blame them for this predicament (especially younger children). Use of 100% petrolatum (Vaseline) applied all day (any time the area becomes dry or the patient desires to lick) will help. Stop the use of any other topical products. The addition of 1% hydrocortisone ointment may hasten the resolution.

Pearls

  1. Never approach a young child blaming them for their condition; it is best to use indirect questioning to make them aware of the cause (“Do you think you ever lick your lips?”).

  2. The use of over-the-counter lip preparations or flavored lip products may cause or exacerbate the condition.

  3. Lip licker’s dermatitis never ends until the lip licking behavior ends!

FIGURE 13.90

Lip Licker’s Dermatitis. Circumoral dryness and pain. (Photo contributor: Aubrey Mowery, MSN, MPH, CPNP.)

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