Dear Doctors Column, December 1, 2008

 

Preventing Chapped Lips

 

 

Question:

During the winter, my lips stay dry and chapped. Sometimes I also get cracks at the corner of my mouth that take forever to heal and really hurt. What can I do?

 

Answer:

You’re really talking about two separate problems — chapped lips and painful cracking at the corners of your mouth. Let’s address the chapped lips first. Chapped lips are a common cold-weather problem resulting in dry, red, peeling, and cracked lips that can become inflamed and tender. Some individuals have a genetic predisposition to dry skin, which worsens with age. Dry air from winter’s low humidity and indoor heat can cause skin to dry out and long, hot baths and showers can dry skin.

 

Other factors that increase the risk of chapped lips include:

Ø       prolonged exposure to cold dry weather

Ø       sunburn or windburn

Ø       smoking

Ø       a history of a skin disorder such as eczema

Ø       certain medications, particularly those used to treat acne

Ø       allergic reactions to cosmetics or skin care products

Ø       dehydration

 

One of the worst things you can do to chapped lips is to lick them, which strips your lips of moisture and natural oils. Your lips get dry and then you lick them even more, starting a vicious cycle that’s difficult to break.

 

Here are measures you can take to help prevent chapped lips:

Ø       Stay hydrated by drinking six to eight glasses of water a day.

Ø       Use a humidifier to help add moisture to indoor air.

Ø       Stop smoking, which evaporates natural oils from lips.

Ø       Cover and/or moisturize your lips to protect them from the drying effects of the wind. Don’t forget that your lips need sunscreen!

Ø       Check with your pharmacist or physician about medications that can dry out your lips, particularly if you’re taking acne medications.

Ø       Eliminate any skin care products that may be triggering an allergic reaction.

Ø       Apply lip balm frequently to keep lips moist.

 

Now, let’s talk about the painful cracking that sometimes occurs in the corners of your mouth. This condition has several medical names —— perlèche, angular cheilitis, or angular stomatitis —— and occurs in individuals who maintain a lot of moisture in the corners of their mouths, either from frequent licking, ill-fitting dentures, a bad bite called malocclusion, or other dental problems. People with underlying health disorders, such as anemia, diabetes, and immune deficiencies, are particularly vulnerable.

 

Because these cracks are constantly kept moist by saliva, they often become infected with the bacteria or yeast organisms that normally live in the mouth. Lip balms can make the condition worse by trapping the bacteria or fungus. Persistent infections may require treatment with topical steroids or topical antifungal medications. Severe infections, particularly in people with underlying medical problems, may require systemic antifungal or antibiotic drug therapy.

 

Some cases of cheilitis are associated with a deficiency of the vitamin riboflavin, but vitamin deficiency is so rare in the United States (except in those who are alcohol dependent or constantly on fad diets that limit certain foods) that this is an unlikely explanation for your problem.

 

We suggest you see your dentist to determine if there is a dental issue or problem with your bite that might account for your cheilitis. If the dentist can find no underlying cause, then the treatment consists of keeping the area as dry as possible and treating infections until they are completely cleared.