<s>[INST] Hi doctor, I am suffering from dried, itchy, chappy, dark and extremely ugly lips since I was 10 years old. I am tired of dealing with this. I have tried everything throughout the years. I am 28 years old now, and today my lips are in their worst state. At 13 years of age, I also used to have swollen fingers with pus and sort of bumps. The bumps still appear sometimes, but not that severely. At the age of 23 years, I experienced vaginal thrush, and this has been on and off till now. Not sure if the situation of my lips is connected to this. The doctors told me to avoid detergents so that the bumps will not come out on my fingers anymore. For my lips, they said not to lick it, but it is hard, as it is a habit already. I tried a treatment last year which started to work; as I stopped but I gradually licked my lips again, and until now it is worst. Please help me cure my lips. I am a lady and lips count for 40 % of my beauty. I avoid wearing lipsticks, not to aggravate the situation. My ugly lips are making my life miserable. I have used lip balms, shea butter, soothing lip butter or balms. The medicines prescribed two years back were 1% Terbinafine Lamisil 10 mg and 0.05 % Desonide DesOwen cream 15 mg. Nothing was found in the skin test and biopsy performed by an immunologist three years back. [/INST] Hello. I have viewed the images (attachment removed to protect patient identity). Apart from what you have said I also noticed that you have depigmentation of lips. I suggest you to use a Tacrolimus 0.1 % ointment, twice daily and a moderately potent topical steroid, for e.g, Fluticasone Propionate 0.05 % cream once every night. Consult your specialist doctor, discuss with him or her and take medications with their consent. For more information consult a dermatologist online --> </s>