What are the other Names for this Condition? (Also known as/Synonyms)

• PCC (Pigmented Contact Cheilitis)

What is Pigmented Contact Cheilitis? (Definition/Background Information)

• Pigmented Contact Cheilitis (PCC) is described as a rare form of pigmented contact dermatitis involving the lips that occurs from several factors, such as hair dye, lipsticks, and even green tea. The condition results in bluish, brownish, or blackish discoloration of the lips
• Pigmented contact dermatitis is a form of contact dermatitis that is mostly not associated with skin inflammation, blistering, or bleeding, but is characterized by increased pigmentation. It is termed the non-eczematous variant of contact dermatitis
• The condition may present swollen lips, itchiness, and burning sensation. Generally, no medication or topical agents are used to treat Pigmented Contact Cheilitis. Managing the underlying cause of PCC can help resolve the condition

Who gets Pigmented Contact Cheilitis? (Age and Sex Distribution)

• Pigmented Contact Cheilitis may be observed in both children and adults. The age category affected depends on the underlying cause of the condition
• Both males and females are affected
• Worldwide, there is no racial or ethnic preference observed

What are the Risk Factors for Pigmented Contact Cheilitis? (Predisposing Factors)

The risk factors for Pigmented Contact Cheilitis may include:

• Use of lipsticks, which generally contain a variety of chemicals
• Hair dye (applied to the moustache), particularly due to the chemical paraphenylene diamine (PPD)
• Green tea - it may be due to the presence of nickel in large quantities
• Red Kumkum: It is a powder used mostly by women in India (and some southeast Asian countries) to mark their forehead as part of a social and/or religious practice

In all of the above cases, the risk for Pigmented Contact Cheilitis is from an allergic reaction between the skin and specific causative chemical.

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Pigmented Contact Cheilitis? (Etiology)

• Pigmented Contact Cheilitis develops as an allergic reaction between certain chemicals found in substances, such as lipsticks, hair dyes, and green tea, among others, on contact with the lips
• Since the condition is rare, medical experts believe that there may be other factors that make some individuals susceptible to this non-eczematous form of contact dermatitis

What are the Signs and Symptoms of Pigmented Contact Cheilitis?

The signs and symptoms of Pigmented Contact Cheilitis may vary from one individual to another and may be mild or severe. The area/region of lip involvement may also differ in relation to the cause.

The signs and symptoms of Pigmented Contact Cheilitis may include:

• Use of the chemical product may cause mildly swollen lips with itching and burning sensation
• Focal areas of the lips turn darker (hyperpigmented), usually a blue-purple-black color
• Both the lips or either the lower or upper lips may be affected depending on the underlying cause

How is Pigmented Contact Cheilitis Diagnosed?

A diagnosis of Pigmented Contact Cheilitis may involve the following exams and procedures:

• Physical examination of the individual and medical history evaluation
• Oral cavity examination
• Skin patch testing

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Pigmented Contact Cheilitis?

The possible complications due to Pigmented Contact Cheilitis include:

• Emotional stress from cosmetic concerns
• Longstanding hyperpigmented lips that does not resolve to treatment
• Recurrence of the condition
• Treatment complications and side effects

How is Pigmented Contact Cheilitis Treated?

The healthcare provider may recommend the following treatment measures for Pigmented Contact Cheilitis:

• Avoidance of the causative allergen
• No topical application or medication is normally required
• Masking cosmetics may be used in case the darkly pigmented areas do not self-resolve over time
• Laser treatment: In some cases, the same lasers used in tattoo removal may be considered

How can Pigmented Contact Cheilitis be Prevented?

The prevention of Pigmented Contact Cheilitis involves avoiding the causative substance or product causing the condition.

What is the Prognosis of Pigmented Contact Cheilitis? (Outcomes/Resolutions)

• The prognosis of Pigmented Contact Cheilitis is generally good with early recognition and stopping usage of the substance
• The dark pigmented areas may resolve (fade) over many months to years. In some cases, a full resolution of the condition may not be observed

Additional and Relevant Useful Information for Pigmented Contact Cheilitis:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/