What should you know about pigmented contact cheilitis lips?

Contact cheilitis may cause dryness, scaling, itching, burning, redness, cracking or swelling around the lip edge. Brown or grey colour can remain after repeated inflammation. Common exposures include lipsticks, glosses, balms, sunscreens, toothpaste flavourings, dental products, foods, musical instruments and fragrances transferred from the hands. The responsible ingredient is not always the newest product, because reactions can develop after repeated exposure. A clinician may map the timing of symptoms against every product touching the lips.

Simplify lip care to a bland product through [Emollient Therapy](/treatments/medical-dermatology/emollient-therapy/) and avoid licking, rubbing and peeling. Stop suspected cosmetics and strongly flavoured oral products while the skin settles. Keep a product list and reintroduce items only with clinical guidance. A clinician may recommend [Topical Corticosteroids](/treatments/medical-dermatology/topical-corticosteroids/) for a limited course when inflammation warrants it. Patch testing may help identify an allergy, while improvement after avoidance can provide an additional clue.

Arrange an assessment when lip pigment or inflammation continues after careful avoidance, recurs often, or extends beyond the lip border. Seek prompt care for an ulcer, bleeding, a firm lump, severe pain or a non-healing sore. Emergency help is needed for rapid swelling with breathing trouble or throat tightness.

Could this be allergic contact cheilitis or simple irritation? Which ingredients should I avoid while healing? Would patch testing help? How should I use a prescribed steroid safely, and when should persistent pigment be reassessed?