Allergy to lip products (allergic contact cheilitis) is not common, but when it occurs the resulting inflammation, swelling and/or skin rash can be distressing. Lip products contain several ingredients that can cause an allergic reaction in the lips and surrounding skin. You can manage the reaction by following standard remedies for any other skin allergic reaction.
Lip Allergic Contact Dermatitis
Lip balms, lip glosses, lip plumpers, lip liners and lipsticks share several basic ingredients, plus additional ones depending on the purpose of each type of product. In a susceptible person, many of the ingredients can cause a contact dermatitis of the lips (cheilitis) because of an allergic or irritant reaction. This can also affect the skin around the lips, and the mucous lining just inside the mouth.
According to the website The Dermatologist, symptoms of allergic or irritant cheilitis can include any of the following:
- Inflammation, with redness or swelling
- Burning, tingling, or pain
- A rash, itching, scaling, dryness and blisters (urticaria)
Managing the Symptoms
Whether you have been using a lip product for awhile or just applied one and experienced an allergic reaction, take the following steps to manage your symptoms and prevent a more severe reaction or a recurrence:
- Immediately wash off the product that you think caused your lip allergy or irritation and discontinue using it.
- Stop using any other lip products until the problem resolves.
- Use one or more general remedies recommended by the Mayo Clinic for any skin contact dermatitis:
- Apply a cool wet washcloth to your lips for 15 to 30 minutes several times a day for symptomatic relief.
- Gently apply a small amount of over-the-counter, 1% hydrocortisone cream or ointment to your lips and any affected skin and let it absorb for awhile before drinking or eating.
- For severe itching or rash you may need to take an over-the-counter antihistamine such as Benadryl, but check with your doctor first.
- Avoid using any harsh products to cleanse your face and keep your lips clean and dry.
- Avoid licking your lips as this can cause dryness or further irritation.
If the problem doesn't improve in two to three days, or worsens, see your doctor for further treatment such as a stronger steroid cream or other antihistamine. He may also suggest skin allergy testing, which can help you identify and avoid products with the offending ingredient(s). See your doctor sooner if you also have a rash or itching on other areas of your body.
Allergens and Irritants in Lip Products
It is impossible to keep track of the numerous substances in cosmetics, skin care and other products. Most lip products contain known skin allergens which are also present in a host of other cosmetics and personal care items. They also contain other ingredients that may not be common skin allergens, but there is always a chance that someone might react to them. Be aware that kissing someone on the lips can transfer the allergen and cause your partner to have an allergic reaction as well.
List of Allergens and Irritants
According to DermNetz, the list of potential allergens and irritants in lip care products include:
- Preservatives: These include propyl galate and, according to a 2014 Dermatitis article, parabens, formaldehyde, formaldehyde releasers and isothiazolinones. They all prevent overgrowth of bacteria, mold, and other organisms, and prevent food from spoiling.
- Fragrances: Examples include Balsam of Peru (Myroxilion perelrae), used to add fragrance or flavor to many products; benzyl benzoate, used as a fragrance or preservative additive; and cinnamaldehyde, which has a cinnamon scent.
- Flavorings: Common culprits are peppermint oil and vanilla.
- Dyes: D&C Yellow #11 and D&C Red #7 are popular in lip products.
- Emollients: These include lanolin (from sheep's wool) and propylene glycol, a humectant that locks in moisture.
- Waxes and other oils: Beeswax, carnauba wax, castor oil (with the allergen Ricinoleic acid), coconut oil, vitamin E, and other oils are used as a base for lip products.
- Lip plumpers: Plumpers give the lips a fuller look and include cayenne pepper and cinnamon, which work by irritating the lips leading to the release of the neurohormone Substance P, and benzyl nicotinate and L-arginine which work by dilating blood vessels.
- Medications: Menthol, camphor and phenol can appear in medicated lip balms.
- Other ingredients: These include the sunscreen agent benzophenone, glossing and water resistant agents, and sealants.
If you have used a lip product for ages and suddenly develop an allergy to it, this could mean you became sensitized over time or that the manufacturer added a new ingredient to an old product.
The Most Common Lip Allergens
To identify the most common allergens or irritants in lip products, researchers analyzed a database of patients with dermatitis who were patch-tested in the United States between 2001 and 2004 with the North American Contact Dermatitis Group (NACDG) standard test allergens. The results, reported in 2008 in the journal Dermatitis, showed the most common causes of a lip allergy were:
- Fragrance mix
- Balsam of Peru
- Nickel (from the metal tube containing the lip product)
- Sodium gold thiosulfate (used in medicated products)
- Neomycin antibacterial ointment or cream
Lipstick and facial cosmetics were the most common sources of these allergens and, of the 10,000 patients who were tested:
- The lips alone were involved with dermatitis in 196 (2%) of patients
- 75 (38%) of the 196 were diagnosed with lip allergic contact dermatitis (less than 1% of the original 10.000)
- 27 (36%) of the 75 tested positive to substances in the standard NACDG test group of common allergens or supplemental test allergens
Sometimes, to find the specific ingredient in a product to which you are allergic, you may need extended testing for other substances not in the NACDG standard test group of allergens, or patch testing with the product itself. Be mindful that you could also be reacting to your facial cleanser or soap, your sunscreen, face cream, foods, toothpaste or other oral and dental products.
Alternative Lip Products
To keep your lip moistened, try applying a thin layer of an oil such as coconut, olive, sunflower or vitamin E, or shea butter. Although coconut and vitamin E oils are on the list of potential allergens, they are less likely to cause an allergy than others on the list. One of the benefits of using a pure, single oil with no additives is that if you react to it you will know the culprit. Don't continue to apply an oil if it worsens your lip condition.
Talk to your doctor about alternative products that don't contain the ingredient(s) you are allergic to. After allergy testing he can enter your allergen(s) in the Contact Allergen Replacement Database (CARD), developed by a Mayo Clinic dermatologist, to find a list of products that don't contain them. You can also try doing the search yourself by downloading the CARD app to your phone although users have complained about glitches with it.
Prevention
Although allergy to lip products is not common, everyone is at risk given the number of allergenic agents in cosmetics and personal care items. To decrease your chance of an allergic reaction or becoming sensitized to an allergen, use products with few additives. If you have an allergic reaction to a product, stop using it to prevent a more severe reaction or a recurrence, and apply simple remedies. See your doctor if the problem is severe, distressing, or persistent.
