Q. My eczema flared up after ten years of remission. Why?

Answered by
Dr. Shama Naaz
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Aug 27, 2021

Hello doctor,

I was suffering from eczema since childhood. But it was not showing any symptoms for the past ten years. Now, my skin started itching suddenly about a week ago, and my eczema flared up on my arm. And also, my lips started itching, and there are brownish patches on the inner lip. The outer lip has dry patches.

Please advise.



Welcome to

I have seen your attachments (attachments removed to protect the patient’s identity)

Kindly answer the following questions to help you better;

1) Is there itching over lips?

2) Did you make any changes in your diet? Because some people may develop an allergy to eggs, fish, sour food, milk, nuts.

3) Do you have any food allergies?

In the meantime, to get rid of pigmentation, I suggest you use a hypoallergenic lip balm with SPF 30 (sun protection factor) or higher during daytime like Sunkroma lip balm (Bisoctrizole, Avobenzone, Zinc oxide). And use lip balm containing lightening agents like Kojic cream (Azeloglicina, Kojic acid dipalmitate, Lactokine) during the night.

You should maintain a proper skin barrier for eczema by using hypoallergenic moisturizer two to three times a day. Bathe with mild moisturizing soap and do not rub. You can also use mild steroid cream like Desonide or Mometasone for one week.

Thanks and regards.

Hello doctor,

Thanks for the reply.

I still have a little bit of itching on the lips. I do not think I ate anything new. I have attached pictures of my inner lip and outer lip. Kindly advise on what it is. Can I use the lip balm on the inner lip as well or just the outer?

Kindly help.



Welcome back to

Dry, itchy patches over lips commonly occur due to a condition called eczematous cheilitis or lip dermatitis. I suggest you doing a patch test to confirm the diagnosis.

If you still have itching, apply a good lip moisturizer (paraben-free) like Lipz SPF 15 (Kokum butter, Shea butter, Mineral oil, Squalene) during the daytime and use Desonide cream at night only on the outer lip for five days. Kindly avoid contact with oral mucosa.

For inner lips, kindly let me know if there are any symptoms like itching, burning, or ulcers. But pigmentation after an inflammatory condition will heal with time. Hence pigmentation should be treated after dermatitis has completely subsided. So after the dry patches heal, use the depigmenting lip balm (only on the outer lip surface).

Thank you.

Hello doctor,

Thank you for your speedy response.

There is no itching or burning inside my lip. I will go with the plan you recommended.

Thank you so much.



Welcome back to

If the symptoms are persistent and there are frequent recurrences, it should not be ignored. In that case, you should get a clinical examination along with laboratory tests. In the case of eczematous cheilitis, a patch test and other relevant tests should confirm the diagnosis.

Do not forget to moisturize the dry patches and look out for any triggers like cosmetics (lipstick), food items, facewash, sun exposure, or weather changes that might be causing eczematous changes.

Please follow up after five days.

Thank you.

Hello doctor,

Thanks for the reply.

Have you seen this inner lip pigmentation before? Can it be something serious?

Please advise.



Welcome back to

Inner lip pigmentation is seen in oral post-inflammatory hyperpigmentation. It is a condition in which there is an excess of melanin production and deposition within the basal layer. It usually occurs following an inflammatory process. If there was itching initially over the area followed by pigmentation, then most commonly, it is associated with oral post-inflammatory hyperpigmentation.

Other causes are as follow;

1) Smoking can cause your lips and gums to darken.

2) Trauma results in dry, cracked, damaged lips.

3) Burns can cause pigmentation.

4) Addison’s disease, when the adrenal gland is not producing enough cortisol, can cause pigmentation of both skin and lips along with other medical problems.

5) Certain medications can also cause pigmentation.

6) Sometimes, a dark spot on the lip can be associated with cancerous growth or melanoma.

Since your duration of symptoms is one week. The initial approach is to focus on the symptoms like itching. If there is no improvement after one week or changes in the shape and size of lesions, it would require more evaluation.


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