What is Cheilitis? How to Heal Chapped Lips

Drier, cooler winter weather can irritate the delicate skin of the lips. Here in South Florida, sunburns may likewise cause dryness and peeling. Simple chapping will usually heal with a moisturizing lip balm. However, lip dermatitis has other causes, including allergies, infections, chronic sun damage, and even nutritional deficiencies. Cheilitis, the term used for inflammation of the lips, is a more persistent condition that will not resolve with moisturizers alone and may require medical intervention for both diagnosis and treatment.

Multiple products, including lipstick, toothpaste, fragrance, mouthwash, chewing gum and even food, can cause an allergic reaction of the lips. Women are more often affected by such allergic contact dermatitis due to frequent use of lip cosmetics. Clinically, scaling, redness, and swelling of the lips are present, accompanied by symptoms of itching and burning. Treatment is withdrawal of the offending agent. Patch testing can help to identify the allergen if necessary. A short course of topical steroids may be prescribed to reduce the inflammation and relieve symptoms, but it is not meant for long-term use because of potential atrophy or thinning of the skin.

Patients who suffer from atopic dermatitis or eczema are more susceptible to cheilitis, both due to their underlying condition and to their increased sensitivity to environmental irritants. Atopic cheilitis presents with similar red, scaly, fissured skin, most prominent at the edges or vermillion borders of the lips. Children with atopic dermatitis are particularly prone to a form of cheilitis known as lip-licker’s dermatitis. Saliva from frequent licking of dry lips irritates the skin even further, resulting in a rash that encircles the mouth.

Actinic cheilitis is a common cause of lip dermatitis due to chronic sun exposure or repeated sunburns. Dry, flaky patches develop that persist despite the use of lip balm. It frequently presents on the lower lip, which is more exposed to the sun. Actinic cheilitis is a precancerous condition that promotes the development of squamous cell carcinoma. Sun protection with hats, lip balms containing SPF and sun avoidance are key to prevention. Actinic cheilitis can be successfully treated with liquid nitrogen, lasers, or topical medications that target the sun-damaged cells.

Angular cheilitis is usually caused by a Candida yeast infection that occurs at the corners of the mouth. It presents with redness, crusting, and erosions in the mouth creases due to the accumulation of saliva and is more prevalent in people who wear dentures. Treatment with topical antifungal cream is usually successful, but recurrence is common. Less often, angular cheilitis can be a sign of nutritional disorders, including iron deficiency anemia and vitamin B9 (folate) or B12 deficiencies.

To care for your lips this winter, first try the simple measures listed below:

Use bland lip balms or moisturizers. Ointments such as petroleum jelly or Aquaphor™ are better options than balms with fragrance, flavoring, camphor, or menthol.
Regularly wear sun protection with SPF or higher. Avoid chemical sunscreens in favor of products with mineral filters, zinc oxide or titanium dioxide.
Avoid licking your lips. Saliva may moisten the skin initially, but as it evaporates, it dries the lips even more.
Consider a humidifier at night, especially if you breathe through your mouth while asleep.

If symptoms persist, consult your dermatologist, who can evaluate your dermatitis for possible cheilitis.

Are you experiencing dry, chapped lips that won’t heal? We provide diagnosis and care for cheilitis in Naples and Marco Island at Florida’s Skin Wellness Physicians. Call us at (239) 732-0044 or contact us online to request your consultation.