Chapped Lips? Cheilitis
The fancy name for chapped lips is Cheilitis. Actually, any rash on the lips can be called cheilitis. Let’s review the most common types and causes of cheilitis.
Contact cheilitis – This is the most common type of cheilitis that comes from something coming in contact with the skin. There are two types of contact dermatitis – Irritant and Allergic.
Irritant contact cheilitis – This is very very common. The major culprit in irritant reactions on lips is our own saliva. Lip licking, lip rolling, and biting can often lead to scaling and cracking of the lips and a “clown-like” red ring around the mouth. In addition to saliva, many topical lip preparations can cause irritant reactions as well. Cold dry air can also just dry out the lips. Treatment: stop lip licking, moisturize with Vaseline only, and sometimes we prescribe a topical steroid or recommend Dr. Dans Cortibalm to aid in calming the rash down.
Allergic contact cheilitis – This is more of a poison ivy-like reaction on the lips. An allergic contact reaction often takes 30 days to totally run its course. So, the allergen only has to be contacted once a month to keep the reaction going. Common culprits include fragrances and sunscreens in lip balms, lipsticks, and chapsticks. I have also seen this from something the patient is eating, chewing gum, or lozenges. Cinnamon is the allergen I have encountered most in my patients. Finally, toothpaste can also be a culprit. I generally do not recommend changing to natural toothpaste as a first step. However, if there has been any recent change in the patient’s toothpaste, I recommend reverting to their original brand or type. Treatment: stop all topicals except Vaseline, Eliminate gum and lozenges temporarily, keep toothpaste used consistent, and a prescription-strength topical steroid to calm the rash.
Actinic Cheilitis –Chronic chapped lips can be a sign of sun damage on the lips. We can also see similar changes on the lips of chronic smokers. Treatment: moisturizing with Vaseline may give some temporary relief and sunscreen with zinc on the lips is preventative. Long-term treatment requires topical chemotherapy or photodynamic therapy to rejuvenate the skin and get rid of the abnormal cells.
Angular Cheilitis – The corner of the mouth is called the “angle”, so this is the fancy name for a rash at the corner of the mouth. This is most commonly caused by saliva or food getting and sitting on the corner of the mouth, most often with drool during the night. It can also be seen with some vitamin deficiencies. Treatment: Take a multivitamin daily and apply Vaseline at the corner of the mouth prior to eating and sleeping. Often a prescription-strength topical steroid and anti-yeast combination medication is used to relieve this rash.
Take away points….Apply as little as possible in the way of lip products and be consistent in what you use and do. Vaseline, Vaseline, Vaseline. If you are applying sunscreen on the lips, use one that only has zinc or titanium as an active ingredient. The only commercial lip balm we recommend for chapped lips is Dr Dans Cortibalm.
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