Lip Resection for Chronic Lip Peeling and Irritation
Q: Dr. Eppley, I have had problems for over ten years with chronically peeling, inflamed lips after taking the acne drug Accutane. I have been extensively assessed by doctors and no ongoing physical cause can be found. My upper lip causes me the most discomfort and when I exhaust all other options, I will be looking into the possibility of surgical treatment.
How feasible is this? I understand that a conservative approach can be taken by taking away a strip of vermilion, but if this failed, is drastically reducing the size of the lip (from relatively full sized to very thin) a realistic option?
A: Thank you for your inquiry. Because your lip symptoms are caused by a medication, this indicates to me that the entire dry vermilion is involved. (unless you can identify focal areas of dryness/peeling) Thus removing a strip of vermilion would seem to provide little improvement. (although it would be a conservative approach) But if that failed then you would to consider removal of all of the dry vermilion (lip resection) with a mucosal advancement flap like is done in cases of lip dysplasia/cancer involvement. The elasticity of wet mucosa allows it to stretch forward towards the vermilion-cutaneous junction.
Dr. Barry Eppley