Just back from an evening call night in the office and it was like dermatology clinic! But the funniest thing was that 4 of the children I examined, all of different ages, had the same thing: Lip Lickers Dermatitis.
It is beginning to be the time of year when the weather gets cooler, the humidity drops and children who are in the habit of licking their lips develop dry cracked and chapped lips. Not only do children lick their lips, they also tend to lick the skin around their lips which results in more chapping and irritation, and the cycle begins. One little girl I saw could actually lick all of the way up to her nostrils!! She had to show me for me to believe that this is why her nose was chapped, I foolishly thought it was from blowing her nose.
Every one of the kids habitually licked their lips while I examined them, even before telling them of their diagnosis. Several of the concerned parents “doubted” the diagnosis of lip lickers dermatitis, but I pulled out a derm book and proudly showed them pictures that looked just like their child. The rash can get quite raw and inflamed and if irritated and rubbed enough may even get secondarily infected.
The problem with lip lickers dermatitis is that it is a habit, just like thumb sucking, nail biting and hair twirling. As you know habits are hard to break, even when they cause discomfort. It is so hard not to moisten you lips when they are dry and are becoming drier. Licking your lips seems to improve the dryness but only for a moment.
The treatment of choice is to try and break the habit as well as to use a protective barrier on the lips and around the mouth. This is best accomplished with a thick layer of Aquaphor or Vaseline that must be reapplied quite frequently. For an older child you can give them a pocket tube to carry so that they may apply the moisturizer as often as need be, even every 30 minutes to an hour.
To aid in the treatment the thicker the layer of Aquaphor the better, so once they are heading to bed I would GLOB on enough that they couldn’t possibly lick it all off before falling asleep. It might be prudent to apply once last coat to their mouths after the child is already sleeping as well.
Lip Lickers Dermatitis is definitely a diagnosis and is quite common. I am taking the camera back to the office to grab a few pictures to post at a later date, as it is only the beginning of the dry, chapped and crack lip season.
That's your daily dose for today. We'll chat again tomorrow.