How to treat my lips, which are dull, bumpy, and pigmented?

Question

Hello doctor,

I have white, uneven, dull, and patchy lips. They appear very pigmented and bumpy.

Please suggest what I can do.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern, and thank you for sharing your picture (attachments removed to protect the patient’s identity).

From the appearance of your lips, the patchy pale areas along with the darker surrounding pigmentation suggest a combination of chronic dryness, lip dermatitis (cheilitis), Fordyce spots, and post-inflammatory pigmentation. The uneven texture and white patches on the lower lip look like areas where the skin barrier may be damaged, which can occur due to lip-licking, dryness, irritant lip products, or previous inflammation. The darker rim around the lips is commonly seen in individuals with long-standing irritation or eczema.

At this stage, the main focus should be on healing the damaged lip skin.

Avoid all fragranced lip balms, lipsticks, whitening creams, strongly mint-based toothpastes, or any product that causes burning or stinging.
Using a gentle, healing ointment such as plain petroleum jelly several times a day may help restore the barrier.
Staying well hydrated and avoiding lip-licking can also reduce dryness and help the lips recover.
You may also use 0.1% Tacrolimus ointment at night for two to three weeks to repair the barrier if available, or Hydrocortisone 1% once daily for just three days if there is itching. The Tacrolimus ointment will help with the white patches, as we also give it for vitiligo and post-inflammatory hypopigmentation.

Consult your specialist doctor, discuss with them, and take the medicines with their consent. Once the irritation settles, the darker pigmentation may gradually improve over time, though this can take a few weeks.

I hope this helps. If you would like to discuss further or need more guidance, feel free to ask. I am always happy to help.

Thank you.