Causes for chapped lips

Contents

What You Need to Know About Chapped Lips

When winter comes around, many of us experience chapped lips, which are irritated, dry, and peeling lips caused by disruption of the outer skin layer and inflammation, says Joshua Zeichner, MD, director of cosmetic and clinical research in the dermatology department at Mount Sinai Hospital in New York City. They are flaky and sometimes red or bloody, and they can be uncomfortable or painful. Chapped lips, also known as cheilitis, are very common, and they’re most often caused by cold, dry, windy weather. While chapped lips are usually harmless, it’s important to protect and hydrate them with the right treatment.

Common Causes of Chapped Lips: Wetness and Weather

Chapped lips are typically caused by environmental exposures that lead to irritation, including saliva and licking your lips, spicy foods, and cold, dry weather, says Dr. Zeichner. The common cold and sun damage can also cause chapped lips, he adds, as well as medication like cholesterol-lowering agents.

Allergic or irritant contact is another common cause of chapped lips, where exposure to an external product causes a true allergic reaction or a direct irritation to the skin, says Zeichner. But most of the time, chapped lips are caused by dryness, and wind is a prime culprit, explains dermatologist Clay J. Cockerell, MD, founder and medical director of Cockerell Dermatopathology in Dallas.

Health Conditions That Can Cause Chapped Lips

Chapped lips can also be associated with a variety of underlying medical conditions, including thyroid disease, vitamin deficiencies, and inflammatory bowel disease, says Zeichner. Low thyroid function may cause dryness of the mouth and lips, and B complex vitamin deficiencies or low zinc or iron levels have been reported to cause chapped lips, he adds. Crohn’s disease can affect the entire gastrointestinal tract from the lips down to the anus, and if you have severe cracked lips that are not healing as well as belly pain, this may be a rare cause.

Angular cheilitis, or inflammation in the corners of the mouth, is another common condition that can cause dry or chapped lips. It’s typically caused by cold weather, yeast overgrowth, and/or irritation from saliva, and it’s usually treated with anti-yeast medication, anti-inflammatories, or skin protectants overnight, says Rebecca Baxt, MD, a dermatologist in Paramus, New Jersey.

Actinic cheilitis is the term given to chronic chapped lips that develop as a result of sun damage, explains Zeichner. This is a precancerous condition that typically affects the lower lip (which faces upward toward the sun, so is at risk for sudden damage). If you have chapped lips that aren’t getting better and you’re concerned, see a dermatologist.

How to Treat Chapped Lips: Start With Lip Balm

Chapped lips can sometimes heal on their own, but if that isn’t happening after a day or two, try using a lip balm, suggests Zeichner. Lip balms contain a combination of waxes and oils that form a protective seal over the skin, he explains. Your best choice is a basic lip balm with either a petroleum jelly or paraffin base that can keep moisture in your lips, protect them from the elements, and give them time to heal. Zeichner recommends Neutrogena Revitalizing Lip Balm with SPF 20 ($8.99). Vaseline is another dermatologist favorite. Dr. Cockerell advises choosing a formula with built-in sunscreen (look for an SPF number in the product name) and applying it frequently throughout the day.

Stay away from products that contain fragrance, camphor, menthol, and salicylic acid, because these ingredients can cause irritation of the skin, leading to disruption of the skin barrier and loss of hydration, which can make chapped lips worse, warns Zeichner. You also want to avoid exfoliating lips that are already dry and irritated because that can lead to more harm than good, he explains.

If lip balms are not helping, visit your dermatologist. You can also try 1 percent hydrocortisone to treat chapped lips if they are not improving on their own after a few days of using lip balm, says Zeichner.

If you’re looking for a natural home remedy for chapped lips, Zeichner suggests trying coconut oil because it spreads easily without dripping. “The same types of products you use for dry skin can often be used for the lips,” he explains.

What to Do When Your Child Has Chapped Lips

Kids are at risk for getting a superficial skin infection called impetigo, especially if they get open or cracked skin, and it can easily be spread to others, says Zeichner. He recommends touching base with your pediatrician if your child has chapped lips that don’t go away in a day or two.

How to Prevent Chapped Lips: 3 Simple Strategies

Here are three simple ways to prevent chapped lips and keep your lips smooth and hydrated, according to Zeichner:

  • Avoid licking your lips. People sometimes lick their lips to reduce the feeling of dry lips, but saliva actually worsens the situation.
  • Pay attention to your lips. If they start to feel dry or itchy, apply a lip balm early.
  • Skip spicy foods. If you have sensitive skin, try to avoid spicy foods, which can irritate the lips.

Additional reporting by Jennifer D’Angelo Friedman.

Chapped lips: Dry, cracked or sore lips, usually in cold, windy, dry weather and less often in warm weather. Sun exposure can contribute to chapping of the lips. Licking or biting the lips is often a contributing factor.

The lips are more sensitive to chapping than the skin. Unlike the skin, the lips do not produce oils to protect them against drying.

To treat chapped lips, use a good lip emollient, ideally one containing a sunscreen. If you don’t have a lip emollient use lipstick. And, if you don’t have a lip emollient or lipstick around, rub your finger over the side of your nose and then wipe the oil on your lips. In winter and at elevated altitudes, drink lots of fluid.

Some steps to prevent chapped lips are to:

  • Do not lick or bite the lips.
  • Use a lip emollient or lipstick on the lips before going outside. Reapply it several times while outside.
  • Use a lip emollient that has a sunscreen in it when going outside during the day.
  • Avoid a flavored lip balm. The flavor can tempt the user (children included) to lick it.
  • In bitter or blustery cold weather, cover the lips with a scarf or a ski mask.
  • Stay well hydrated by drinking lots of fluid.
  • Use a humidifier at home and, if possible, at work during the winter months.

The word “chapped” meaning “fissured or cracked” dates to the 14th century. “Chapped” can also apply to the parched ground in summer and hands in winter.

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Lip balms, glosses, lipsticks—as a certified lip-color fiend, I’m fanatical about keeping my lips covered at all times (seriously, I could open a drugstore with all of the lip products at my desk). You’d think that would mean perpetually soft, moisturized lips, and yet at least once every winter I can count on developing a lip spot. Not a cold sore, or a blocked hair follicle, or a fungal infection—all of which are suggestions that inevitably turn up when I Google the problem. The spots aren’t sore or itchy; they don’t get red or puff up or crack. They’re just little patches, usually right along the outline of my lower lip, where the skin stays rough, and dry, and frankly desiccated feeling no matter what I do. They turn up seemingly out of nowhere, and after I spend a week or so obsessively applying lip balm and fighting the urge to pick, they disappear. Until the next time.

So what are these annoying little spots? According to the Internet, they could be bacteria from the mouth of my refillable water bottle (gross), or signs that I desperately need to eat even more kale, or an omen of my imminent demise (thanks, alarmists out there!).

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According to Joshua Zeichner, the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City (a.k.a. someone who actually knows what he’s talking about), it’s most likely a sign of sun damage. “Just as you can get a precancerous spot on other parts of your skin, you can get a precancerous spot on your lips,” he says. “Particularly older patients, or patients who are fair-skinned.”

As anyone who’s ever embarked on the quest for a lipstick that will last through lunch can tell you, being a human who consumes food and beverages causes lip products to wear off faster than the rest of your makeup. Throw in the fact that some of the things we eat and drink can break down sunscreen, making sun exposure around the mouth even worse—and that many of us skimp on sunscreen coverage as we get close to our lips because zinc oxide is no one’s favorite flavor—and you’ve got a domino effect that leaves the outer edges of our mouths especially vulnerable.

Help prevent future damage by incorporating SPF-infused lipsticks, glosses, and balms (here are a few of our faves) into your daily routine, reapplying often (even in the winter, duh), and making sure your daily facial sunscreen is covering all the way up to your lips.

Not convinced that your dry spot is anything more than just dry? You can try out low-key exfoliation (Zeichner recommends a gentle sugar scrub for mild chemical exfoliation), but no hard-core peels and definitely no picking! After gently buffing away any flakes, slather on a thick, hydrating lip balm with petrolatum (we like Aquaphor Advanced Therapy Healing Ointment (it’s a classic for a reason) to help boost the skin’s barrier function. If you pass the two-week mark and the dryness is still lingering, make an appointment with a dermatologist.

While Zeichner notes that there are a variety of things that can cause changes in your lips (allergies, vitamin deficiencies, even Crohn’s disease) the bottom line is this: “If you have a rough, scaly spot that’s not improving with typical lip products, get it checked out.”

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History and Physical

Weather-Induced Cheilitis

The cold and wind are two factors that frequently cause drying and desquamation of the lips, which is followed by cracking. Transverse fissures appear secondarily that can become chronic, especially in the midline of the lower lip. Persistent lip-licking often aggravates these lesions, and sometimes by a bacterial or fungal secondary infection.

Chronic Actinic Cheilitis

Chronic actinic cheilitis is secondary to prolonged exposure, for years, to ultraviolet (UV) rays, often related to the professional context (agriculture, marine, outdoor work, altitude). More often it affects men in their 50s with clear skin. It predominately affects the lower lip. It can be desquamative, atrophic, sometimes leucokeratotic, even crustal, fissured, or erosive. The lesions can be unifocal, multifocal, or reach the entire vermilion. The limits between the vermilion and the skin are not clear. The photo-exposed skin may also be the site of actinic elastosis or actinic keratoses. Chronic actinic cheilitis has been classified by the World Health Organizations (WHO) as a “potentially malignant condition.” UV light causes damage to DNA, causing mild to moderate dysplasia, which can progress to squamous cell carcinoma. One or more biopsies are recommended for dysplasia or carcinoma, even in the absence of clinical signs of malignancy. The carcinomatous transformation is systematically evoked in cases of induration, infiltration or ulceration of chronic actinic cheilitis, and needs to be investigated with multiple biopsies.

Acute Actinic Cheilitis

It is related to intense exposure to UV radiation. It primarily affects the lower lip, which is more exposed to ultraviolet (UV) than the upper lip. It is a painful condition with erythema and edema, and possibly even vesicles and bullae followed by erosions and crusting. Skin conditions involving increased photosensitivity (photosensitivity in lupus, drug-induced photosensitivity, in particular, due to voriconazole) are predisposing factors.

Differential diagnoses are herpetic recurrence disease, photodermatosis (lupus), photosensitization induced by topical or systemic drugs.

Allergic Cheilitis

Allergic cheilitis is secondary to contact with an allergenic substance related to a delayed hypersensitivity reaction. It can be acute or chronic. In acute cases, it produces erythema, edema, and vesicles, followed by crusting and pruritus. The lesions are poorly delineated, crossing over to the cutaneous side of the lips and sometimes further. Chronic allergic cheilitis is dry, erythematous and squamous, and there may even be fissures; there may be moderate pruritus or none at all. Allergens are multiple, that is why the diagnosis is difficult.

Anamnesis must be precise and detailed to look for any causative agent in contact with the oral mucosae; patch testing can confirm the diagnosis of delayed hypersensitivity in some cases.

Traumatic Cheilitis

There are numerous clinical manifestations of traumatic cheilitis depending on the origin.

  • Persistent lip-licking, common in children, causes chronic inflammation of the vermilion borders with clearly demarcated perioral erythema. Secondary candidal and bacterial infections are common.
  • Persistent lip-nibbling or an abnormal dental occlusion can be accompanied by cheilitis.
  • Factitious cheilitis or exfoliative cheilitis, which is seen in adolescents and younger subjects, presents as a squamous and crusted maceration of the lips, which is sometimes very thick and unpleasant. This condition is considered to be a pathogenesis. It is provoked and maintained by chronic licking and rubbing of the lips. Appropriate psychological management is needed.

Caustic Cheilitis

Caustic cheilitis is an acute irritation of the lips, or even a burn, secondary to the topical application of a chemical product. Clinically, there is painful inflammatory edema which may progress to bullous or phlyctenular, then erosive and crusty lesions. Lesions are limited to the contact area. In severe cases, lesions may be necrotic and ulcerated depending on the product causing it.

Atopic Cheilitis

Atopic patient (adult or child) may have erythematous and squamous cheilitis with fissures of both lips and commissures associated with lichenification, or even radial peri-buccal fissures. Pruritus is common. It can occur alongside a flare-up of the skin disease or separately.

Immuno-Allergic Cheilitis

Erythema multiforme (EM) and Stevens-Johnson syndrome (SJS) are mucocutaneous and systemic manifestations side effects of an immuno-allergic reaction to an infectious agent (EM) or drug (SJS). Oral involvement is very evocative. It presents as erosive and crusty cheilitis associated with diffuse erosive stomatitis.

Drug-induced Cheilitis

Retinoid treatments (isotretinoin, acitretin, alitretinoin) may cause erythematous and squamous cheilitis that is dry and erosive with fissures. It correlates with a daily dose of treatment.

Infectious Cheilitis

Viral cheilitis: It is mainly due to the herpes simplex virus, especially type 1. The primary herpes infection (herpetic gingivostomatitis) combines post-vesicular erosive and crusted cheilitis with diffuse stomatitis leading to dysphagia, perioral vesicles, fever and cervical lymphadenopathy. Recurrence of oral herpes affects the lips in most cases. It manifests as a cluster of vesicles accompanied by a burning sensation. Next, the vesicles erode to leave behind crusted erosions that resolve in a week.

Bacterial Cheilitis: The most common cause of bacterial cheilitis is infection with group A Streptococcus or Staphylococcus

Mycotic cheilitis: Cheilitis caused by candida manifests with erythema and painful edema of the lips, sometimes with fissures, and it is usually accompanied by acute (pseudo-membranous candidiasis) or chronic stomatitis, and/or angular cheilitis. The diagnosis is confirmed by taking a specimen for mycological examination.

Parasitic cheilitis: Leishmaniasis is a possible cause of cheilitis in endemic regions. It gives the appearance of a chronic plaque ulcero-crustose, lipoid and painless, occupying part or the entire lip.

Cheilitis Glandularis

It is a chronic inflammation with tumefaction and sometimes suppuration of salivary glands at the lower lip and heterotopic salivary glands at the vermilion zone. The most cases are reported in adults between 50 and 70 years of age. The etiology is unknown, but it probably involves multifactorial causes associating irritation, mechanical, climate, and genetic factors. The most common clinical form is the simple cheilitis glandularis, which manifests as a moderate thickening of the lower lip with inflammatory dilated gland duct orifices, and pressure here will elicit a droplet of saliva.

Cheilitis Granulomatosa

This is labial edema affecting one or both lips that is intermittent at first, then permanent. The diagnosis is made following a biopsy that will demonstrate granulomas without necrosis, and with a lymphocytic infiltrate. Cheilitis granulomatosa can be isolated, idiopathic (Miescher cheilitis granulomatosa) or associated with various systemic conditions (sarcoidosis, Crohn’s disease, tuberculosis). The complete form of Melkersson Rosenthal syndrome combines cheilitis granulomatosa, peripheral facial paralysis, and a fissured tongue.

Nutritional Deficiency Cheilitis

Several nutritional deficiencies such as avitaminosis B2, B9, B12, scurvy (vitamin C), iron deficiency, or zinc deficiency may cause exfoliative cheilitis associated with other oral manifestations (stomatitis, erythematous glossitis). In pellagra (vitamin PP deficiency), vermilion is shiny and cracked, sometimes eroded. The diagnosis is made through biological assays.

Other Inflammatory Causes of Cheilitis

Lupus: All types of lupus can entail cheilitis.

Lichen: Keratotic lichen planus of the lips produces painless leukokeratosis. Erosive lichen planus triggers painful and widespread ulceration of the buccal mucosa and the lips.

Bullous Autoimmune: Pemphigus, in particular, can entail erosive and crusted cheilitis. Biopsy and immunofluorescence confirm the diagnosis. The cheilitis will resolve with treatment of the skin disease.

Recognition and Treatment of Actinic Cheilitis

Original Article: Treatment Options for Actinic Keratoses

Issue Date: September 1, 2007

Available at: https://www.aafp.org/afp/20070901/667.html

to the editor: The article in American Family Physician is a comprehensive review of the available therapeutic options for patients with actinic keratoses. Although the article illustrates useful recommendations for actinic keratoses, we would like to make some clarifications and suggest further treatments.

Actinic cheilitis is a clinical variant of actinic keratoses developing typically on the lower lip (the more sunexposed area), which has a greater risk of progression to invasive squamous cell carcinoma compared with normal skin.1 Early actinic, keratotic lesions of the lips may have a rough contour and/or appear slightly white (milky discoloration). More advanced lesions appear erythematous, thickened, and may show fissuring, scaliness, or ulcerations (Figure 1A) with loss of the vermilion border.1 Any suspicious thickened, ulcerated, or cryotherapy-resistant lesions should be biopsied first; we advise using the shave technique to avoid scarring.2

Figure 1A.

Typical eroded lesion of actinic cheilitis at the lower lip with evident fissuring inflammation and mild scaliness.

Figure 1A.

Typical eroded lesion of actinic cheilitis at the lower lip with evident fissuring inflammation and mild scaliness.

Treatment options for actinic cheilitis include emollients, electrosurgery, cryotherapy (Figure 1B), 5-fluorouracil, photodynamic therapy, curettage, excision, lasers, and occasionally, radiotherapy. The use of a prophylactic sunscreen containing lip pomade slows the rate of development of solar lesions and protects the skin from further damage.2 Carbon dioxide laser treatment of actinic cheilitis is a highly effective option for extensive lesions and usually results in minimal recurrence with excellent cosmetic results.3

Figure 1B

Cryotherapy treatment of a single lesion of actinic cheilitis.

Figure 1B

Cryotherapy treatment of a single lesion of actinic cheilitis.

Topical 5-fluorouracil is preferable for patients with multiple thin lesions, for whom the use of cryotherapy or other more aggressive treatments would cause unwanted aesthetic results.4 Photodynamic therapy using 5-aminolevulinic acid5 can lead to satisfactory outcomes. Other options include topical therapy with diclofenac 3% gel (Solaraze) or imiquimod 5% (Aldara). The optimal dose and duration of topical therapies, as well as their long-term effectiveness, need to be established in large prospective studies.

You Go Commando

Your lips don’t have oil glands, and they’re almost always exposed to the elements. So if you don’t take care of them, you’ll pay the price. What can you do to keep them safe?

Use lip balm. A good balm can buffer your delicate lip skin from the elements. Choose one high in emollients. Check the ingredient list for petrolatum, which locks in moisture, and dimethicone, which seals off cracks and splits in drying lips. Don’t limit yourself to products with the word balm in them, either. Lip ointments are just as good a choice.

Apply early and often. Whatever type of product you choose, apply it before you put on lipstick or lip gloss, not after. To keep your lips protected, reapply frequently. You need about six to eight coats during the day, so apply first thing in the morning, last thing at night, and every couple of hours during the day. To make this easier, stash a tube in your purse, one in the car, a third your desk, and another near the bed.

Protect your lips when you’re outside. You cover your hands and feet when the temperature drops; do the same for your lips. Wear a scarf or a ski mask that covers your mouth when you go out in the cold. And remember to choose a lip balm with broad spectrum UV protection year-round.

7 Ways Chapped Lips Could Be A Sign of Something Else

Winter is a hard time for every skin type, whether you’re dry or oily. The outdoor air combined with the indoor heat can dehydrate our skin and cause lips to crack, bleed, and peel. Many of us shrug off chapped lips as par for the course, but really, they can be a sign of more significant health issues. Here are seven ways chapped lips could be a sign of something else more serious than a dehydrated pout.

Your peeling and cracked dry lips can be a sign of a number of things, including dehydration, an allergy, or a vitamin deficiency Sure, the typical culprit of chapped lips is licking our lips (using saliva to hydrate our lip’s skin), but that’s not always the reason for your rough skin. A good indication that your dry lips are signaling something else about your health is if it seems like they’re impossible to hydrate, and they even cause you pain. Those are both signs that may give you reason to seek some medical attention.

If you suspect that your dry pucker is being caused by something more serious than winter’s dry and cold weather, take a look at these seven common, but more alarming causes of chapped lips.

1. A Yeast Infection

Did you know that your cracked lips may be a sign of a yeast infection? This is especially true if you have cracks around the corner of our mouth. “When you lick your lips excessively, the warm, moist saliva encourages yeast to grow, especially when the saliva builds up in the corners of the mouth,” Dr. Michele Green, a New York-based dermatologist, tells Bustle over email. The best remedy is to hydrate — drink lots of water and avoid licking your lips. It can also help to use a moisturizing barrier like beeswax balm or Vaseline to stop the buildup of saliva, Green says.

2. An Allergic Reaction

If your lips look like you just came back from a filler appointment, this may be an allergic reaction. Lip-plumping products are a common reason for allergic reactions, Dr. Debra Jaliman, a New York-based dermatologist, tells Bustle over email. “Cinnamon and cayenne powder are commonly found in lip plumpers and can cause a reaction,” she says. You could also be allergic to certain foods. Take note of what you’re eating and using and adjust until you find the right product for you.

3. Dehydration

Dry lips, mouth, and eyes are all signs of dehydrated skin that lacks a proper amount of water. To avoid dehydration, “drink at least eight cups of water a day,” Jaliman says. You should also use lips balms with hydrating ingredients such as jojoba oil or shea butter, she adds.

4. Sun Damage

“Long-term sun exposure can cause the lips to become dry and stiff, resulting in cracking or splitting,” Green says. If you don’t protect your lips from the sun’s UV rays, that can also lead to inflammation, she adds. Even on the coldest winter days, make sure to use a lip product with SPF in it.

5. A Vitamin Deficiency

Vitamin B plays an important role in the regular functioning of your body. It provides energy, helps your immune system fight off diseases, and contributes to healthy skin, Green says. Without enough Vitamin B in your system, you may experience a variety of skin issues, such as dry lips, she adds. To make sure you’re not deficient, eat plenty of Vitamin B-rich foods like eggs and lean meat.

6. Too Much Vitamin A

On the flip side, dry lips can mean you’re intaking too much Vitamin A. Vitamin A toxicity can occur if you’re taking too many supplements — you should be careful in taking Vitamin A supplements because most of it should come from your diet. “The excess amount of Vitamin A is stored in the liver, and it accumulates over time, causing a variety of symptoms, such as excessive cracking on the corners of the mouth, dryness, and peeling of the skin,” Green says.

7. Medication

Certain medications can also lead to dry, cracked lips. “High blood pressure meds, anti-depressants, and chemotherapy drugs are among some that are known to cause dry lips,” Jaliman says. These drugs decrease the production of saliva, which can dry out your lips and mouth. Consult your doctor if you think a medication is the reason behind your dry lips.

Studies referenced:

Experts:

Dr. Michele Green, New York-based dermatologist

Dr. Debra Jaliman, New York-based dermatologist

Additional reporting by Eden Lichterman.

How 20 Minutes of Exercise a Day Can Prevent Chapped Lips (2:18)

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There aren’t too many of us fortunate enough to escape some degree of chapped lips each winter. However, there are a surprising number of causes of chapping that have absolutely nothing to do with the cold weather and rather are the symptom of something else going on.

Chronic chapped lips can look identical to the everyday variety, but they never seem to get better regardless of how often you apply your lip balm. While it is very helpful to have a dermatologist act as your medical sleuth, here are a number of possibilities you can consider.

Chapped Lip Causes:

  • Check for periodontal disease or abscesses. There are reports that deep cleansing of the mouth performed by the dentist (possibly under anesthesia) may help solve the problem.
  • Clarinet players may develop chapping at the contact area of the reed.
  • The ingredient propyl gallate in lipstick may be causing a contact allergy.
  • Your toothpaste may be to blame if it contains guaiazulene or sodium lauryl sulfate.
  • A little-known (or seen) condition known as chelitis granulomatosa may require a biopsy for diagnosis.
  • Allergic reactions to nickel may surface on the lips too. Remember; don’t put metallic items like paper clips in your mouth!
  • The juice from citrus fruits may cause both irritation as well as a sun-sensitive allergy that looks like chapped lips.
  • Eating figs can result in a light allergy.
  • An ingredient known as phenyl salicylate (salol) used in lip-care products may be your culprit.
  • You can develop an allergy to cobalt from taking vitamin B12 supplements. It may look like unexplained episodes of recurrent swelling and crusting of lips made worse by wind and sun exposure. And it is important to know that you may have a negative patch test to vitamin B12 despite the presence of the allergy.
  • The blood-pressure medication propranolol may cause chapping as a side effect.
  • If you’ve got vertigo and chapped lips, it may be due to the medication prochlorperazine.
  • Down’s syndrome patients have a genetic predilection to having chapped lips. Treatment with thyroid supplement and potent topical steroid ointments may clear the condition.
  • All those years in the sun may have caused precancerous changes known medically as actinic chelitis. Treatment with a topical chemotherapy medication known as 5-florouracil may clear it up.
  • An allergy to red dyes used in candy, mouthwash, toothpaste, etc. may be to blame.
  • On the same note, cinnamates (the source of cinnamon flavor) used in candy, lozenges, gum, mouthwash and toothpaste may be to blame.
  • Do you snore? Enlarged tonsils, adenoids or sleep apnea may be to blame for those lips. That continuous flow of breath across your lips all night long can grossly dehydrate your lips. If you don’t know if you snore, it may be worthwhile to have someone check on you periodically during the night to find out. Consider applying a protective barrier on your lips come bedtime.
  • Do you have psoriasis or lichen planus? Believe it or not, unusual cases of either may involve the lips. If the scale and crusting is particularly thickened, this could be the culprit.

Chapped Lip Causes (Continued):

  • Is there scaling and cracking at the angles of your mouth? This is known as perleche and is due to a yeast infection that could involve the rest of the lips as well. Treatment with a prescription oral anti-yeast preparation should do the trick. Diabetics are particularly prone to this condition, which may be recurrent.
  • Do you have lupus or a history of autoimmune disease? Photosensitivity may present itself on your lips. Wear a lip balm that includes a minimum SPF 15.
  • Are your eyes dry and your mouth dry? You may have an autoimmune condition known as Sjogren’s syndrome.
  • Have a history of thyroid disease? Hypothyroidism can cause dry skin and lips.
  • Too much vitamin A, whether in oral supplements, prescription medications like Accutane or too much in your diet may lead to peeling lips. Check the label on your supplement. If you’re taking more than 25,000 IU a day, you may have found your cause.
  • Do you take out your stress by habitually licking or chewing your lips? Continuous contact with saliva can lead to dehydration as well as irritation due to the enzymes present that are meant to aid in digestion. Many people are totally unaware of this habit. Sometimes this even happens during sleep. Be candid with family and friends if you’re uncertain and ask them. Find out how good a friend they are, and have someone check you periodically when you sleep too. Sometimes antidepressants or relaxing medications may be required. Often times, simple awareness of the situation goes a long way to kicking the habit.

Don’t You Dare

Still haven’t gotten to the bottom of the cause? While you wait for your dermatology appointment for further workup, follow the don’t list:

  • Don’t hold metal objects in your mouth such as paper clips.
  • Don’t lick envelopes.
  • Don’t suck on citrus fruit rinds such as orange peels.
  • Don’t kiss someone on the lips who is wearing lipstick.
  • And finally, don’t lose hope!

Chapped lips can be a challenge. Be prepared, as your doctor may put you through the paces of eliminating foods and personal care products from your routine if nothing surfaces with your work-up. But again, don’t lose hope. Unusual causes are always out there waiting to be diagnosed by your own medical private investigator.

Dry Lips Causes| When Chapped Lips Are a Sign of Something Much Worse

The Off the Record series features real-life excerpts from Dr. Kaplan’s dermatology case files.

When you live in a sunny climate, such as Southern California, the trade off for our beautiful sunny weather is having chronically dry skin and lips. Other factors that can cause chronic dry, chapped lips include genetics, your skin type, tanning and medications.

WHAT CAUSES DRY LIPS?

Dryness is significant on the lips because our lips are not like the rest of our skin. The wet shiny part of our lips is covered, not with normal skin, but with a thin delicate mucous membrane. Mucous membranes don’t have the outer, water-proof covering that normal skin has. This is why, when we become dehydrated or sunburned, our lips are one of the first places we notice dryness.

Chronic sun burn can also lead to pre-cancerous changes in our lips, that feel like persistently dry, rough, thickened skin. Sometimes scabs or white, scaly patches develop on the lip. This condition is called ACTINIC CHEILITIS. The good news is that actinic cheilitis is a PRE-cancerous condition. The bad news is, it can develop into skin cancer, if left untreated.

WHAT CAUSES ACTINIC CHEILITIS?

Many patients are surprised when I tell them that they can get skin cancer on their lips. Most of us know by now that sun protection is important to prevent skin cancer on our face and bodies. But for some reason, we do not give our lips the same care.

In fact, lips are treated worse, because the majority of lipsticks and glosses on the market today contain petroleum jelly and oils as their main ingredient, without offering any SPF sun protection. When you go outside after using these ingredients, you are essentially frying your lips in the sun. This causes our lips to become dry, thin, and discolored. That is why you need to use a lip treatment, that not only nourishes and plumps our lips with healthy ingredients, but also protects the mucous membranes on our lips from sun damage.

Chronic sun exposure, along with lifestyle factors that negatively impact your immune system, such as smoking, drinking excessive alcohol, and getting sunburned, make your lips a primary target for actinic cheilitis. Because the lower lip sticks out more, and faces upwards toward the sun, actinic cheilitis can occur more frequently on the lower lip.

HOW DO I TREAT ACTINIC CHEILITIS?

No one ever wants skin cancer. But if skin cancer is found on the face or body, most of the time it can be treated by a simple excision and stitches. Even on the lips, skin cancers can also be be excised and repaired with stitches. But who wants the risk of a scar on such a visible part on your face?

The good news is that if you develop actinic cheilitis, it usually does not need to be surgically treated. Because actinic cheilitis is still pre-cancerous, if it is caught early before a true cancer develops, lasers and creams may be successful in preventing it from developing into skin cancer. But it needs to be treated early. So if your lips remain persistently dry and scabbed, see your dermatologist, because it may be something more than just dry skin.

In the meantime, always keep your lips protected with a nourishing lip balm that contains SPF, like the Perfect Pout Lip Balm.

7 dermatologists’ tips for healing dry, chapped lips

While it may seem that dry, cracked lips are something you must live with until spring comes, you can have soft, supple lips year-round. Here’s what dermatologists recommend.

  1. Use non-irritating lip balm, lipstick, and other products that you apply to your lips. Many people mistake discomfort, such as burning, stinging, or tingling, as a sign that the active ingredients in a product are working. That’s not what’s happening. You’re actually irritating your lips, so you want to stop using any product that irritates your lips.
    Ingredients to avoid while your lips are chapped: To help chapped lips heal, stop applying lip products that contain any of the following:

    Camphor

  2. Eucalyptus
  3. Flavoring: Cinnamon, citrus, mint, and peppermint flavors can be especially irritating to dry, chapped lips
  4. Fragrance
  5. Lanolin
  6. Menthol
  7. Octinoxate or oxybenzone
  8. Phenol (or phenyl)
  9. Propyl gallate
  10. Salicylic acid Ingredients that can help heal chapped lips: While some ingredients can irritate dry, cracked lips, others can help them heal. When looking for products to use on your chapped lips, dermatologists recommend ones that contain one or more of the following:
      Castor seed oil
  11. Ceramides
  12. Dimethicone
  13. Hemp seed oil
  14. Mineral oil
  15. Petrolatum
  16. Shea butter
  17. Sun-protective ingredients, such as titanium oxide or zinc oxide
  18. White petroleum jelly
  19. It also helps to use products that are fragrance free and hypoallergenic.

    If your lips burn, sting, or feel uncomfortable when you apply a product to your lips, it means you’re irritating your lips, so you want to stop using that product.

  20. Apply a non-irritating lip balm (or lip moisturizer) several times a day and before bed. If your lips are very dry and cracked, try a thick ointment, such as white petroleum jelly. Ointment seals in water longer than waxes or oils.

  21. Slather on a non-irritating lip balm with SPF 30 or higher before going outdoors. Even in the winter, it’s important to protect your lips from the sun. The sun can burn dry, chapped lips more easily, which could trigger cold sores.
    To protect dry, chapped lips from the sun, use lip balm that contains offers SPF 30 or higher and one (or both) of these sun-protective ingredients:

      Titanium oxide
  22. Zinc oxide While outdoors, generously apply the lip balm every 2 hours.
  23. Drink plenty of water. Chapped lips are dry lips, so you want to stay hydrated.

  24. Stop licking, biting, and picking at your lips. When lips feel dry, it may feel natural to wet them by licking them, but this can worsen the problem. As saliva evaporates, your lips become drier.
    Picking or biting your lips also irritates them, which can prevent healing.

    Lip licking can be a hard habit to break. When you catch yourself licking your lips, try applying a non-irritating lip balm instead.

  25. Avoid holding items made of metal with your lips. Paperclips, jewelry, and other everyday products made of metal can irritate your already sensitive lips.

  26. Plug in a humidifier at home. A humidifier in your bedroom can be especially helpful, especially if you breathe through your mouth at night.

By following these dermatologists’ tips for chapped lips, you should have noticeable improvement in 2 to 3 weeks. To prevent your lips from chapping again, continue applying lip balm whenever it’s dry indoors or outside.

When to see a dermatologist?

Most of the time, the above self-care can heal dry, chapped lips in 2 to 3 weeks. If it doesn’t, see a board-certified dermatologist.

Your chapped lips could be caused by something aside from dry weather. An allergic reaction, yeast infection, or something more serious can make your lips feel dry and uncomfortable. Actinic cheilitis is a precancerous condition that turns one or both lips dry and scaly. A board-certified dermatologist can diagnose the cause.

Related AAD resources

  • Dermatologists’ top tips for relieving dry skin

  • Dry skin relief (video)

Images
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What Can You Do About Chronic Dry Lips?

Anyone who’s experienced chapped lips knows how uncomfortable they can be. Your lips feel tender and might crack or peel easily. Without the right care, chronic dry lips can become a person’s reality. Knowing what causes persistent chapped lips is the first step to understanding what you can do to treat and soothe them.

What Causes Dry Lips?

Most people experience dry or chapped lips from time to time. The issue is common because lip skin is thinner and dries out 10 times faster than the skin on the rest of the face, as the Cleveland Clinic explains.

Common causes of dry lips include an allergic reaction to a substance that’s come in contact with the lips, such as lipstick, trauma to the lips (including chewing on them), frequently licking the lips and vitamin or other nutritional deficiencies.

While most people develop dry lips from these everyday circumstances, the source could also be certain kinds of medicine or a chronic illness. See which medications can cause dry mouth, as those may also dry out the lips. Dry lips, mouth sores, skin rashes and sun sensitivity are also often associated with lupus, an autoimmune disorder.

Dry Lips and Cheilitis

Dry lips are related to cheilitis, the cracking of the corners of the mouth. According to the National Center for Biotechnology Information, cheilitis is frequently caused by wind and cold air, which dry out the lips and lead to cracking of the skin.

Sun exposure can lead to a specific type of dry, chapped lips known as actinic cheilitis. The Journal of Indian Academy of Oral Medicine and Radiology states that chronic actinic cheilitis develops after prolonged sun exposure, such as working a job that requires being outdoors most of the time.

Excessive moisture at the corners of the mouth can cause angular cheilitis. Once the saliva disappears, dry patches form at the corners of the lips, and bacteria can infect the cracked skin. Thumb-sucking and wearing poor fitting dentures can increase your chances of developing angular cheilitis.

Dry Lips Treatment

Although dry or chapped lips can be a pain — and painful — to deal with, you can treat them and find ways to prevent dryness. If you have chapped lips, a lip balm may help hydrate them. The American Academy of Dermatology recommends using a lip product that contains petroleum, also referred to as petroleum jelly or mineral oil.

In the winter, it’s a good idea to take extra steps to protect your lips from the cold air and from the sun and wind. You should apply a lip balm that has a SPF of at least 15 before venturing outdoors. If it’s especially windy out, cover your lips with a scarf to protect them from the drying effects of the wind. Drinking plenty of fluids, especially when outside, will help you maintain healthy, hydrated lips no matter the time of year.

If the air in your home gets dry, a humidifier can add moisture to the air and reduce the chance of chapped lips. You’ll also want to avoid licking your lips as much as possible. Although licking the lips may seem like a way to instantly moisturize them, it’s actually very drying. Once the saliva evaporates from the surface of the lips, it leaves them drier than before. Saliva also irritates the lips, making your symptoms worse.

If lip balm, avoiding the sun and wind and other attempts to hydrate your lips don’t seem to help, it’s a good idea to ask your dermatologist or doctor about your chronic dry lips. Your doctor can evaluate any chronic conditions that might be drying out your lips and help you find a path to relief.

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