Eczema on Lips: Why It Happens and How to Heal

Eczema on Lips: Why It Happens and How to Heal
By Lisa Jensen, Senior Clinical Research Associate •

You reapply lip balm for the fifth time before lunch. By dinner, the sting is back. About 49% of people with atopic dermatitis develop eczema on their lips.[1] Lip skin is unlike any other skin on your body, and that difference explains why standard eczema treatments fail here.[3]

This guide covers why your lips are so vulnerable, the three distinct types of lip eczema, hidden allergens that keep flares going, and a step-by-step treatment protocol for this delicate area. Recent research has pinpointed contact allergens behind up to 54% of chronic cases.[4] If you also struggle with eczema on other parts of your face, our facial eczema treatment guide covers those areas.

Key Takeaways

  • Lip skin has fewer layers and no oil glands, making it 3x more permeable
  • Three types of lip eczema each need a different treatment approach
  • Hidden allergens in everyday lip products drive most chronic cases
  • Licking your lips feeds the problem by breaking down the thin barrier
  • A lip-specific protocol can resolve most cases within 2 to 4 weeks

Table of Contents

Cross-section diagram comparing thin lip skin to normal skin showing why eczema on lips develops more easily

Why Lip Skin Is Different

Your lips sit at the border between skin and mucous membrane. This transition zone, called the vermilion, has a structure unlike anything else on your body.[2]

Normal skin has approximately 16 cell layers in its outer barrier. Lip skin has only 3–5.[2] That thin barrier means moisture escapes faster and irritants penetrate deeper.

Here is what makes lip skin so vulnerable to eczema:

  • No sebaceous glands: Your lips cannot produce their own oil to seal in moisture.[2]
  • No sweat glands: Lips lack the natural moisturizing factors that sweat deposits on other skin.[2]
  • Higher permeability: Lip skin absorbs substances 3–10 times faster than forearm skin.[2]
  • Constant exposure: Lips contact food, drinks, saliva, cosmetics, and the environment all day long.

Your lips have the thinnest, most defenseless barrier on your entire body. That is exactly why eczema on lips demands a different approach than eczema elsewhere.[2]

This fragile barrier also explains why the area around your lips is prone to conditions like perioral dermatitis. But the lip itself faces even greater challenges.

So what types of eczema actually affect this vulnerable area? The answer matters more than you might think.

The 3 Types of Eczema on Lips

Not all lip eczema is the same. Knowing your type changes your treatment entirely.

Comparison chart showing three types of eczema on lips including atopic cheilitis, allergic contact cheilitis, and lip licking dermatitis

Atopic Cheilitis

If you have atopic dermatitis on other parts of your body, your lips are a common target. Atopic cheilitis affects about 49% of people with atopic dermatitis.[1] It causes dry, scaly, cracked lips that flare with your other eczema.

The underlying cause is the same barrier dysfunction that drives eczema everywhere. Filaggrin gene mutations reduce the proteins your skin needs to hold together. These mutations are found in 26-42% of atopic dermatitis patients, with higher rates in adults and those with severe disease.[7] On lips, where the barrier is already thin, this deficiency hits hardest.

Allergic Contact Cheilitis

This type results from an allergic reaction to something touching your lips. It accounts for a large portion of chronic lip dermatitis cases.[4] The tricky part? The allergen is often hiding in a product you use every day.

Common culprits include:

  • Fragrances and flavoring agents: Found in lip balms, toothpaste, and mouthwash.[8]
  • Balsam of Peru: A resin used in cosmetics and flavored foods.[4]
  • Nickel: Transferred from metal objects held between the lips.[8]
  • Preservatives: Especially in medicated lip products.[9]

Our guide on the worst ingredients for eczema covers many of these allergens in detail.

Lip Licking Dermatitis

When your lips feel dry, you lick them. It feels soothing for a moment. Then the saliva evaporates and pulls even more moisture from your lips.[5]

But the damage goes deeper than simple drying. Saliva contains digestive enzymes like amylase and lipase. These enzymes break down the already thin lip barrier.[5] The result is a red, irritated ring around the lips that gets worse with each lick.

Children are especially prone. Studies show lip licking dermatitis is one of the most common causes of cheilitis in pediatric patients.[10]

📚 Related Resource

See our guide: Drying Out Eczema: Why You Should Avoid This "Remedy"

Knowing your type narrows the suspect list. But even with the right diagnosis, lip eczema keeps returning if the trigger is still present.

Hidden Triggers Keeping Your Lips Inflamed

Most people with eczema on lips focus on treatment. But if you do not remove the trigger, no treatment will provide lasting relief.

Bar chart showing the most common allergens causing eczema on lips based on patch testing studies

Patch testing studies reveal the most common allergens behind chronic lip eczema. Research shows that cobalt chloride, nickel sulfate, and thimerosal/mercury are the most frequently identified contact allergens in patients with cheilitis:[4][8]

Top Lip Eczema Allergens Identified by Patch Testing:

  • Fragrance mix and balsam of Peru: Found in lip balms, lipsticks, toothpaste, and flavored foods.[4]
  • Nickel sulfate: Transferred from metal instruments, jewelry, or even orthodontic devices.[8]
  • Propolis (bee glue): A rising allergen in "natural" lip products.[11]
  • Cocamidopropyl betaine: A surfactant in toothpaste and cleansers.[9]

The challenge is that many of these allergens hide in products marketed as "gentle" or "natural." Even medicated lip balms can contain preservatives that worsen your eczema. For a deeper look at common eczema triggers, see our complete guide.

Environmental factors also play a role. Cold, dry conditions increase moisture loss from skin in most people, though research shows mixed results across different climates and seasons.[12] Indoor heating during winter drops humidity to levels that stress even healthy lip skin.

⚠️ Important:

If your lip eczema only affects one side, or if it appeared suddenly after starting a new product, allergic contact cheilitis is the most likely cause. A dermatologist can confirm this with patch testing.[8]

Removing the trigger alone clears some cases. When it does not, a targeted treatment protocol bridges the gap.

How to Treat Eczema on Lips

If you do only one thing: stop all lip products for two weeks and use plain petrolatum instead (Step 1).

Treating eczema on lips requires a specific protocol. The thin barrier, constant movement, and food contact mean you cannot simply apply a cream and forget about it.

Step-by-step process diagram showing the 4-step treatment protocol for eczema on lips

Step 1: Remove the Trigger

Before adding any treatment, stop what is causing the problem.

  • Switch to a flavor-free, SLS-free toothpaste: Sodium lauryl sulfate irritates lip skin in many people.[13]
  • Stop all lip products for 2 weeks: This includes lip balm, lipstick, and lip gloss. Use only plain petrolatum during this period.[6]
  • Check your diet: Cinnamon, citrus, and tomato-based foods can irritate broken lip skin through direct contact.[8]
  • Break the licking habit: Apply a thick occlusive barrier every time you feel the urge to lick.[5]

Step 2: Repair the Barrier

Your lip barrier needs constant support. Unlike body skin, lips cannot repair themselves without external help.

Petrolatum remains the gold standard for lip barrier repair. It forms a protective seal that locks in moisture and rarely causes irritation.[14] Apply it frequently throughout the day, especially after eating and before bed.

Understanding how moisturizers work helps you choose the right products. For lips, you want occlusives first and foremost.

Step 3: Calm the Inflammation

When eczema on lips is actively inflamed, barrier repair alone is not enough. You need to calm the immune response.

Low-potency topical corticosteroids are the first-line treatment for lip eczema flares. For atopic cheilitis resistant to standard treatments, topical tacrolimus 0.03% ointment works well. Apply it twice daily for 2 weeks, then once daily for another 15 days. Most patients see their lips return to normal after this treatment.[6] The key is using the lowest effective strength for the shortest time needed.

For lips specifically, a formulation like SmartLotion addresses both the inflammation and the microbial imbalance that can develop on chronically inflamed lip skin. It combines 0.75% hydrocortisone with microbiome-supporting ingredients. Calcineurin inhibitors like tacrolimus offer another option for longer-term management. Studies show they work well for facial and lip eczema without the risk of skin thinning.[15]

Step 4: Maintain and Prevent

Once your lip eczema clears, prevention becomes the priority.

  • Apply petrolatum before meals: This creates a barrier against food irritants.[14]
  • Use a humidifier in winter: Keeping indoor humidity above 40% protects lip skin from drying.[12]
  • Reintroduce products one at a time: Wait 2 weeks between each new lip product to identify any allergens.[8]
  • Protect lips from wind and cold: A scarf over your mouth in harsh weather makes a real difference.

Knowing what causes eczema flare-ups helps you stay ahead of future episodes.

📚 Related Resource

See our guide: Why Your Eyelid Eczema Won't Heal: 7 Hidden Culprits

Timeline showing expected healing progression for eczema on lips over 4 weeks of treatment

Days 1-3

Burning and tightness may increase slightly as you remove familiar products. This is normal.[6]

Days 4–7

Redness begins to fade. Cracking slows. The urge to lick decreases as the barrier strengthens.

Weeks 2-3

Most patients see significant improvement. Peeling resolves. Lips feel softer.[15]

Week 4+

Maintenance phase begins. Flares become less frequent with consistent barrier care.

When to See a Dermatologist

Most cases of eczema on lips respond to the protocol above. But some situations need professional evaluation.

See a dermatologist if:

  • Your lip eczema persists beyond 4 weeks of consistent treatment.
  • You develop yellow crusting or oozing, which may signal a secondary infection.[16]
  • Only one lip is affected, which raises concern for allergic contact cheilitis or other conditions.
  • You notice persistent white patches, which require biopsy to rule out other diagnoses.

Patch testing can identify the exact allergen causing your lip eczema. This test is especially valuable if you have tried multiple treatments without success.[8] A targeted eczema cream combined with allergen avoidance gives you the best chance of long-term relief.

Frequently Asked Questions

Is eczema on lips the same as chapped lips?

No. Chapped lips result from simple dryness and heal within days with a good lip balm. Eczema on lips involves immune-driven inflammation, lasts weeks or longer, and often causes cracking, peeling, and burning that does not respond to basic moisturizing.[1] If your "chapped lips" persist beyond two weeks despite consistent care, eczema is a likely cause.

Can lip balm make eczema on lips worse?

Yes. Many lip balms contain fragrances, flavoring agents, lanolin, or preservatives that trigger allergic contact cheilitis.[8] If your lips feel worse after applying a product, the product itself may be the problem. Switch to plain petrolatum and see if your symptoms improve within two weeks.

Is lip eczema contagious?

Eczema on lips is not contagious. It results from barrier dysfunction, immune overactivity, or allergic reactions, not from infection.[17] However, if your lip eczema develops yellow crusting or blisters, a secondary bacterial or viral infection may be present, and that infection can spread. See a doctor promptly in that case.

References

  1. Maintz L, Welchowski T, Herrmann N, et al. "Machine Learning–Based Deep Phenotyping of Atopic Dermatitis: Severity-Associated Factors in Adolescent and Adult Patients." JAMA Dermatology. 2021;157(12):1–11. View Study
  2. Sun F, Liu Y, Zhang T. "Aging of the Human Lip: Current Knowledge and Clinical Implications." Journal of Cosmetic Dermatology. 2025. View Study
  3. Dawson DV, Drake DR, Hill JR, Brogden KA, Fischer CL, Wertz PW. "Organization, barrier function and antimicrobial lipids of the oral mucosa." International Journal of Cosmetic Science. 2013. View Study
  4. Blagec T, Crnarić I, Homolak D, Pondeljak N, Buljan M, Lugović-Mihić L. "Association between Allergic Reactions and Lip Inflammatory Lesions (Cheilitis)." Acta Clinica Croatica. 2023. View Study
  5. Fonseca A, Jacob SE, Sindle A. "Art of prevention: Practical interventions in lip-licking dermatitis." Int J Womens Dermatol. 2020. View Study
  6. Georgakopoulou E, Loumou P, Grigoraki A, Panagiotopoulos A. "Isolated lip dermatitis (atopic cheilitis), successfully treated with topical tacrolimus 0.03%." Medicina Oral, Patología Oral y Cirugía Bucal. 2021. View Study
  7. Moosbrugger-Martinz V, Leprince C, Méchin MC, Simon M, Blunder S, Gruber R, Dubrac S. "Revisiting the Roles of Filaggrin in Atopic Dermatitis." Int J Mol Sci. 2022;23(10):5318. View Study
  8. Lugović-Mihić L, Ilić I, Budimir J, Pondeljak N, Mravak Stipetić M. "Common Allergies and Allergens in Oral and Perioral Diseases." Acta Clinica Croatica. 2020. View Study
  9. Symanzik C, Weinert P, Babić Ž, et al. "Skin Toxicity of Selected Hair Cosmetic Ingredients: A Review Focusing on Hairdressers." Int J Environ Res Public Health. 2022;19(13):7588. View Study
  10. Lugović-Mihić L, Pilipović K, Crnarić I, Šitum M, Duvančić T. "Differential Diagnosis of Cheilitis – How to Classify Cheilitis?" Acta Clinica Croatica. 2018. View Study
  11. Sukakul T, Svedman C. "What is New in Contact Allergy To Cosmetics for Physicians, Cosmetologists, and Cosmetic Users?" Current Allergy and Asthma Reports. 2025. View Study
  12. Green M, Kashetsky N, Feschuk A, Maibach HI. "Transepidermal Water Loss (TEWL): Environment and Pollution—A Systematic Review." Skin Health and Disease. 2022. View Study
  13. Thongprasom K. "Glycerin Borax Treatment of Exfoliative Cheilitis Induced by Sodium Lauryl Sulfate: a Case Report." Acta Stomatologica Croatica. 2016. View Study
  14. Rubio-Santoyo A, Sanabria-de la Torre R, Montero-Vílchez T, et al. "Effects of Extra Virgin Olive Oil and Petrolatum on Skin Barrier Function and Microtopography." Journal of Clinical Medicine. 2025. View Study
  15. Lax SJ, Van Vogt E, Candy B, Steele L, Reynolds C, Stuart B, et al. "Topical anti-inflammatory treatments for eczema: network meta-analysis." Cochrane Database of Systematic Reviews. 2024. View Study
  16. George SMC, Karanovic S, Harrison DA, Rani A, Birnie AJ, Bath-Hextall FJ, Ravenscroft JC, Williams HC. "Interventions to reduce Staphylococcus aureus in the management of eczema." Cochrane Database of Systematic Reviews. 2019. View Study
  17. Yang G, Seok JK, Kang HC, Cho YY, Lee HS, Lee JY. "Skin Barrier Abnormalities and Immune Dysfunction in Atopic Dermatitis." International Journal of Molecular Sciences. 2020. View Study

About the Author: Lisa Jensen, Senior Clinical Research Associate

Lisa transforms patient experiences into research insights. As our senior clinical research associate, she bridges the gap between clinical data and the real-world challenges of living with eczema. When she's not reviewing the latest dermatology literature, Lisa enjoys marathon running and amateur photography.