Psoriasis is an inflammatory condition that causes lesions and silvery scales on the skin. Although it does not commonly affect the lips, there are some rare cases of lip psoriasis.

Although facial psoriasis can affect 50% of people with the condition, it is rare for psoriasis to affect the lips. It is more likely that another condition is causing symptoms, such as eczema or cold sores.

This article will detail its symptoms before discussing some similar-seeming conditions. It will then look at the triggers, diagnosis, and treatment of lip psoriasis.

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Psoriasis can cause symptoms on the lips, including skin peeling, plaques, and silvery scales. However, it is rare for the condition to affect the lips.

The most common areas of the skin affected by psoriasis include the elbows, knees, and spine. The scalp is also a commonly affected area. By comparison, oral psoriasis is rare. Its most common manifestation is a fissured tongue, which affects between 6.5 to 20% of people whose psoriasis affects their skin.

In extremely rare cases, psoriasis can affect a person’s lips. A 2018 scientific paper noted that at the time of writing, there had only been six cases of isolated lip psoriasis in medical literature. Some of the affected individuals presented with the characteristic red plaques and silvery scales on their lips.

Psoriasis on the lips can also present with other symptoms, such as the following:

  • fissures
  • cracking
  • skin peeling
  • yellowish scales

However, several other conditions can resemble psoriasis on the lips.

Psoriasis that only affects the lips

Psoriasis can affect any part of the body, but it rarely involves the lips. It may cause symptoms in other parts of the body at the same time as it affects the lips.

Researchers in a 2018 case study of a 21-year-old woman noted that the lesions appeared only on her lips and did not affect the inside of her mouth. Her face, body, and scalp were also unaffected.

In an older case study from 2009 involving a 38-year-old man, psoriatic plaques began on his lips but then developed on his fingers 3 years later.

Cheilitis is another condition that may resemble lip psoriasis. As a 2021 review explains, cheilitis refers to any type of inflammation of the lips. Its symptoms can vary greatly, but can include:

  • dry and chapped lips
  • dry and scaly lips
  • fissuring of the lips

Because lip psoriasis is so rare, it is likely that an individual with such symptoms has something other than lip psoriasis.

The following conditions can cause cheilitis:

Dry and cracked lips due to seasonal changes

Dry and cracked lips are common occurrences in cold winters and more arid summers and can cause cheilitis. A person may mistake psoriasis for dry lips because both conditions can cause patches of dead skin or peeling.

When people lick their lips to compensate for lip dryness, the problem can worsen, causing lip dermatitis.

Contact dermatitis

Contact dermatitis is a type of eczema that develops when an irritant, or a substance a person is allergic to, comes into contact with the skin. According to the American Academy of Dermatology, the face is a common area for contact dermatitis to appear.

If a person applies cream or fragrance to their face and has an allergy to an ingredient in the product, they may develop contact dermatitis. Contact dermatitis can appear as:

  • an itchy rash
  • swelling
  • fluid-filled bumps or blisters
  • hives
  • dry, cracking skin

Perioral dermatitis

Perioral dermatitis is another type of eczema. It involves a facial rash that usually affects the skin around the mouth. It can spread up toward the nose and occasionally involve the skin around the eyes. However, it usually avoids the skin adjacent to the lips.

One of the most common causes of perioral dermatitis is excessive use of topical steroid creams and inhaled prescription steroid sprays. Some people experience perioral dermatitis after using heavy face creams and moisturizers.

A doctor will recommend that a person stop applying steroid cream to help treat this rash.

»More on this:Eczema on the lips

Cold sores

Some people may mistake the blisters that happen with cold sores for psoriasis. Cold sores are small blisters that mostly develop on the lip or around the mouth. Cold sores occur because of the herpes simplex virus.

Psoriasis does not usually cause blisters. Cold sores are contagious but typically resolve within 2 weeks in otherwise healthy individuals.

Medical treatment for psoriasis can vary, depending on the severity of the condition. A 2019 study explains that a combination of topical glucocorticoids, vitamin D, and phototherapy may suffice in milder cases. In more severe cases, the condition requires long-term systemic treatments that can involve more specialized medication.

When it comes to the specifics of treating lip psoriasis, there are too few cases to determine an optimum treatment strategy.

At-home treatment

An individual with psoriasis may have some control over their exposure to psoriasis risk factors. By reducing stress, cigarette smoking, and alcohol consumption, some individuals may be able to lower their risk of lip psoriasis flare-ups.

For example, a 2020 review lists some scientifically supported methods for stress management, including exercise and mindfulness-based activities, such as yoga or meditation. While there is no guarantee that these methods would prevent a flare-up, they nonetheless give people with psoriasis some control over the probability of flare-ups.

The symptoms of psoriasis can sometimes improve on their own. However, many people with psoriasis also experience flare-ups, in which the symptoms worsen again. The flare-ups themselves can result from several triggering factors. A 2014 study lists the following common psoriasis flare-ups:

These triggers may vary in their impact on individuals with psoriasis. For instance, stress may cause psoriasis flare-ups in up to 70% of people with this condition. Hormonal changes due to puberty and menopause may cause flare-ups in 36% of females with psoriasis.

Doctors typically diagnose psoriasis by noting which area of skin is affected and examining the lesions on the skin. However, because lip psoriasis is so rare and can share symptoms with other conditions, doctors cannot always simply look at the skin lesions to make a diagnosis.

It can be difficult for doctors to diagnose lip psoriasis. For example, a 2009 case report of a person with lip psoriasis explains that several laboratory tests for other dermatological conditions were negative. The doctors then took a biopsy from the individual’s hand, which was affected by similar skin lesions. This biopsy allowed the doctors to diagnose psoriasis.

Psoriasis often affects the skin on the face, but it very rarely affects the lips. If it does, it can cause reddish or silvery skin lesions to build up on the lips.

A doctor can prescribe topical creams to help treat psoriasis on the lips. A person can also seek to avoid certain triggers, such as overexposure to sunlight and smoking tobacco.

However, it may be more likely that the symptoms are the result of factors such as seasonal changes, or another condition, such as eczema or contact dermatitis.