Cheilitis refers to the inflammation of the lips, which can occur due to various reasons such as infections, frequent licking of lips, or exposure to irritants or allergens. One specific type of cheilitis is allergic contact cheilitis (ACC), which is a form of allergic contact dermatitis (ACD) that affects the lips. Shockingly, ACC affects approximately 14.5 million Americans annually. This article will delve into the specifics of ACC, including its causes and symptoms, as well as the available treatment options.

Allergic Contact Cheilitis Explained

Allergic Contact Cheilitis (ACC) is a type of allergic reaction that specifically affects the lips. This condition occurs due to a Type IV hypersensitivity reaction and is characterized by eczema-like inflammation of the outer lip. ACC is a form of Allergic Contact Dermatitis (ACD), which is caused by exposure to a specific substance that triggers an allergic reaction in a person. It is important to note that ACC should not be confused with Irritant Contact Dermatitis (ICD), which is a non-allergic reaction caused by damage to the skin.

What are the Symptoms of ACC?

Allergic Contact Cheilitis (ACC) can affect one or both lips, either in a small area or across the whole lip, but it typically does not affect the inside of the lips. ACC can manifest on the upper lip, lower lip, or both. Common symptoms of ACC include eczema-like skin reactions such as flaky skin, redness (in lighter-skinned individuals), or darkening of the skin in individuals with a darker complexion. Pigmented ACC is a rare condition that can also occur, which changes the color of a person’s lips. Other symptoms of ACC may include,

• dryness
• scaling or fissuring
• crusting at the corners of the mouth (angular cheilitis)
• burning and itching

Identifying the specific symptoms of ACC can be helpful in determining the cause of the condition. For example, a musician who is allergic to a material in their instrument may only experience symptoms on the parts of their lip that came into contact with the instrument.

What Causes ACC?

Allergic Contact Cheilitis (ACC) can be caused by exposure to various allergens and irritants that trigger an allergic reaction in the body’s immune system. People with allergies are particularly susceptible to ACC, as their immune system overreacts to a particular substance or allergen.

• Exposure to toothpaste or other oral care products, such as denture cleaner or mouthwash
• Fragrances
• Certain medications, such as neomycin or bacitracin
• Certain metals, including dental restorations, medical instruments, and orthodontic devices
• Sunscreen
• Certain foods, such as cinnamon or citrus fruits
• Propylene glycol
• Latex or rubber products
• Nickel or nickel-plated metals
• Ingredients in lipsticks, such as castor oil, shellac, or colophony

It’s important to note that these are just potential causes, and that an individual’s specific allergen or irritant could vary. Additionally, not everyone who comes into contact with these substances will develop ACC, as susceptibility to allergies and immune system responses can vary from person to person.The American College of Allergy, Asthma & Immunology (ACAAI) reports that allergies are the sixth leading cause of chronic illness in the United States, highlighting the importance of recognizing the potential allergens and irritants that could trigger ACC. Some individuals may also refer to ACC as “lipstick cheilitis” due to the fact that certain ingredients in lipsticks can cause an allergic reaction.

How Serious Are Allergic Reactions on the Lips?

ACC is a prevalent cause of lip swelling and will usually go away on its own if a person avoids the allergen that caused the reaction. However, in rare cases, an allergic reaction can lead to anaphylaxis. Anaphylaxis is a severe allergic reaction that could potentially be life-threatening. It can occur within seconds or minutes of exposure to something you’re allergic to, such as peanuts or a bee sting. The following symptoms could be signs of anaphylaxis: Face, tongue, and lip swelling Low blood pressure Trouble breathing Tight throat Diarrhea or vomiting Abdominal discomfort Confusion Seizures Anaphylaxis needs to be treated right away with an injection of epinephrine, usually with an EpiPen. In the event that this is needed, you should seek emergency treatment immediately.

How Can I Treat Allergic Contact Cheilitis?

1. Avoiding the Allergen

The most important step in treating ACC is to identify and avoid the allergen that is causing the reaction. This can be done through patch testing, where a small amount of the suspected allergen is applied to the skin and observed for a reaction.Once the allergen is identified, it is important to avoid it as much as possible. This may involve changing personal care products, such as toothpaste or lipstick, or avoiding certain foods or medications.

2. Medications

In some cases, medication may be necessary to manage the symptoms of ACC. Topical corticosteroids can be applied to the affected area to reduce inflammation and itching. Antihistamines may also be prescribed to reduce swelling and relieve itching.For more severe cases, oral corticosteroids or immunosuppressants may be prescribed by a doctor.

3. Moisturizing and Soothing the Lips

Moisturizing the lips can also help to relieve the symptoms of ACC. Petroleum jelly or lip balms that contain no irritants or allergens can be used to keep the lips hydrated and prevent dryness and cracking.Applying a cool compress or soaking the lips in a warm bath can also help to soothe the skin and relieve itching.

4. Treatment for Pigmented ACC

Pigmented ACC, a rare condition that changes the color of a person’s lips, can be treated with laser therapy or bleaching agents. However, it is important to identify and avoid the allergen causing the condition before undergoing any treatment.

5. Follow-up Care

It is important to follow up with a doctor or dermatologist after a diagnosis of ACC to monitor the condition and ensure that treatment is effective. In some cases, the condition may recur if the allergen is not avoided or if the treatment is not successful.In summary, the treatment of ACC involves identifying and avoiding the allergen, using medication to manage symptoms, moisturizing and soothing the lips, treating pigmented ACC if necessary, and following up with a healthcare professional for ongoing care.

When Should I See a Doctor about an Allergic Reaction on My Lips?

If you experience symptoms of ACC or any other allergic reaction on your lips, you should see a doctor if the symptoms are severe or if they do not go away on their own after a few days. Here are some situations when you should seek medical attention:

1. Symptoms are severe: If you experience severe symptoms such as difficulty breathing, swelling of the tongue or throat, or anaphylaxis, seek medical attention immediately.
2. Symptoms are persistent: If the symptoms do not improve or worsen after a few days of self-treatment, you should see a doctor.
3. Symptoms are interfering with daily activities: If the symptoms are affecting your ability to eat, drink, or speak, you should see a doctor.
4. You are unsure of the cause: If you are not sure what is causing the allergic reaction, it is important to see a doctor to determine the cause and prevent future reactions.
5. History of severe allergies: If you have a history of severe allergies or anaphylaxis, you should see a doctor immediately if you experience any allergic reaction, even if the symptoms are mild.

Remember, it is better to err on the side of caution when it comes to allergic reactions, as they can potentially be life-threatening. If you are experiencing any concerning symptoms, it is always best to seek medical attention promptly.