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Chapped lips are a common problem during winters, but some people tend to get them throughout the year.
The lips become extremely dry, rough, flaky, and prone to cracking or bleeding. This adverse change in lip texture is due to an underlying inflammation, which damages the outermost layer of the skin covering and surrounding the lips. The drier the skin, the more easily it ruptures.
The medical name for chapped lips is cheilitis. Many different factors can cause chapping of lips, but it is most commonly the result of allergies and environmental exposure.
This article discusses the various causes of chapped lips, the symptoms and risk factors associated with it, and the available treatment modalities.
Possible Causes of Chapped Lips
Some of the major possible causes behind the chapping of lips are:
- Prolonged or frequent exposure to hot or dry wind
- Arid cold weather
- Chronic habit of licking, sucking, or biting the lips
- Drooling
- Breathing through the mouth
- Picking the scaly or flaky skin of the lips
- Allergic reaction to something that is in contact with the lips, such as cosmetics, castor oil, dyes, preservatives, some polymer, toothpastes, and food (1)
- Ill-fitting dentures that rub against the corners of the mouth
- Negligent oral hygiene leading to fungal or bacterial infections of the mouth
- A viral infection, in which case it will usually be accompanied by a cluster of blisters and a burning sensation
- Nutritional deficiencies, particularly deficiencies in B vitamin, iron, and zinc
- Excessive or constant exposure to the sun’s UV rays leading to a premalignant condition, which may progress into cancer (2)
- Certain medications, including retinoids that peel the skin
- Plasma cell cheilitis, which is an uncommon, idiopathic, inflammatory condition
Signs and Symptoms of Chapped Lips
Drying of the lips is the most characteristic sign of chapped lips, but it is usually accompanied by other symptoms that may vary depending upon the root cause.
Here are some common ones:
- Scaly lips
- Dryness of the lips that may extend into the mouth
- Sores or lesions around the corner of the lips, which may have a sandpaper-like texture
- Persistent irritation
- Swelling that makes the lips look large
- Vascularization, or the formation of new blood vessels, in the lips, making them appear unusually red
- Fissures or cracks that may bleed
- Tiny and multiple blisters
- Burning sensation
- Peeling skin at the edges and outline of the lips
Medical Treatment
Chapping of the lips due to temporary causes, such as dry weather, infection, or dehydration, can be easily treated at home. However, persistent or recurrent chapping due to chronic or systemic conditions will require further investigation in order to start any treatment.
Here are some common interventions used for chapped lips, but you must consult your doctor for the proper dosage and application guidelines:
1. For normal and dry, cracking lips:
- Lip balms
- Emollients such as petroleum jelly
- Sometimes topical corticosteroids
2. For infection-related chapped lips:
- Topical antifungal for fungal infections
- Antibiotics for bacterial infections
- Sometimes corticosteroids
3. For allergy-induced chapping of the lips:
- Low to medium topical steroids
- Emollients, applied regularly
4. For lip swelling along with skin peeling:
- Topical corticosteroids
- Topical calcineurin inhibitors
- Psychotherapy, in some cases
5. For chapped lips caused by a drug reaction:
- Emollients, applied regularly
- Discontinuation or substitution of the drug at the doctor’s advice
6. For chapped lips caused by excessive sun exposure:
- Low to medium topical steroids
- 5-Fluorouracil
- Chemical peel
- Cryotherapy
- Electrosurgery
- Vermilionectomy
- Immunosuppressants
- Surgery
- Sunscreen (sun protection), applied regularly
Some of these treatments are meant to prevent the development of cancer.
Diagnosing the Cause of Chapped Lips
The doctor will perform the following to diagnose the exact cause behind chapping of the lips:
- Examination of the lips
- Identification of risk factors by conducting a thorough medical history and other evaluating relevant factors (1)
- Inquiring about all the cosmetic or topical products used by the patient in the recent past, which may have triggered an allergic reaction (3)
- Patch tests, starting with the European baseline series, to rule out any possible allergic reaction
- Biopsies, when the doctor suspects that your condition could be precancerous (3)
Risk Factors Associated With Chapped Lips
The following risk factors can make you increasingly susceptible to chapping of the lips:
- History of recurrent infections or immune defects
- History of allergies, such as food allergies or atopy
- Genetic predisposition to sun damage
- Tobacco use (4)
- Medical conditions or diseases such as sarcoidosis, Crohn’s disease, tuberculosis, celiac disease, Melkersson-Rosenthal syndrome, diabetes, and psychiatric disorders (5)
- Infection-related chapping of the lips equally affects men and women, but it is more prevalent in older adults who wear dentures.
- Light-skinned males with outdoor occupations, such as fishing and farming, in areas with harsh sun often get chapped lips due to the constant UV exposure, especially between the ages of 40 and 80 years. (6)
Complications of Chapped Lips
The problem of chapped lips is mainly a cosmetic concern and source of discomfort, but it can rarely become a health scare as well. It can be chronic or acute, and its severity depends upon the seriousness of the underlying cause.
For instance, chapping of lips due to simple weather conditions will naturally be much less concerning than if it points to a precancerous state, in which case you will need prompt and extensive treatment. Sometimes, an allergic reaction may start off with chapped lips but may escalate into something more serious if not managed timely.
Similarly, chapping of lips can be due to a rare medical condition called plasma cell cheilitis, which can take a turn for the worse if left untreated and can give rise to severe complications. (7)
When to See a Doctor
Most benign cases of chapped lips tend to resolve with proper self-care and lip moisturization in 2–3 weeks. But if your condition persists or becomes worse, consult a board-certified dermatologist to rule out any serious underlying cause and seek further treatment.
Final Word
Dry, cracked, irritated lips are displeasing to look at and greatly discomforting. If left untreated, the peeling can extend to the areas around the mouth and can give rise to bleeding fissure, which can be even more painful and unsightly.
Moreover, anything you eat may sting your sensitive skin. Your lipstick won’t glide smoothly on your jagged skin either and can even aggravate the condition. Chapped lips basically stem from an underlying inflammation, which can be due to a variety of factors. Fortunately, most cases of chapped lips can be easily resolved by excluding the causative agent or addressing the underlying problem.
Regular application of hydrating lip emollients is a must for healing chapped lips, which may be coupled with corticosteroids or antimicrobial creams upon the doctor’s discretion. However, sometimes, the root of the inflammation is a systemic disease, in which case the condition may never go away completely but can still be properly managed.
Chapping of lips due to extensive sun damage can even turn cancerous, so it’s important that you seek the necessary treatment as soon as possible and keep monitoring the state of your lips even after recovery.
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