What should you know about pigmented cheilitis treatment?

Cheilitis can cause dryness, scaling, burning, cracking, swelling or soreness. Repeated inflammation may leave darker colour after the active irritation settles. Triggers include fragranced lip products, flavourings in toothpaste, cosmetics, saliva, wind, sun and contact with foods or dental materials. A clinician may review every product touching the lips and examine the mouth and surrounding skin. Persistent pigment without inflammation may have another explanation and should not automatically be labelled cheilitis.

Stop suspected irritants one at a time where practical and use a plain protective ointment such as [Emollient Therapy](/treatments/medical-dermatology/emollient-therapy/). Do not lick, bite or peel the lips. If inflammation is significant, a clinician may prescribe a short, carefully directed course of [Topical Corticosteroids](/treatments/medical-dermatology/topical-corticosteroids/). Use the prescribed strength and duration because thin lip skin can be vulnerable to inappropriate steroid use. Pigment may fade slowly after the trigger and inflammation are controlled.

Seek review for a patch that persists despite removing likely irritants, or for bleeding, ulceration, a firm area, marked swelling or a sore that does not heal. Urgent care is appropriate for sudden lip swelling with breathing difficulty, throat tightness or widespread hives. A clinician can decide whether allergy testing, infection assessment or sampling is needed.

Which product or habit could be maintaining the inflammation? Should I use an emollient alone or a prescribed steroid? How long should improvement take after the trigger is removed? Does the pigmented area need further testing?