What are the causes and treatments of cheilitis (inflammation of the lips)?

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From the Guidelines

Chapped lips can be effectively managed by lubricating them with lip balm, lip cream, or sterile vaseline/white paraffin (petrolatum) as stated in the study by 1. To manage chapped lips, consider the following:

  • Apply lip balm or lip cream 3-4 times daily, especially before bedtime and after exposure to harsh weather.
  • Use products like Vaseline, Aquaphor, Burt's Bees, or Carmex, which contain ingredients like petroleum jelly, beeswax, or shea butter.
  • Stay hydrated by drinking ample amounts of fluids to keep the mouth moist, as dehydration contributes to lip dryness, as recommended by 1.
  • Avoid licking your lips, as saliva evaporation worsens dryness.
  • Use a humidifier in dry environments to add moisture to the air. It's essential to note that while vaseline/white paraffin (petrolatum) can be used to lubricate lips, it should not be used chronically, as it promotes mucosal cell dehydration and is occlusive, leading to a risk of secondary infection, as warned by 1. For severely cracked lips, consider using a medicated lip balm, but limit its use to a short period, as stated in general guidelines. Lips become chapped when the thin skin loses moisture faster than other facial areas, especially in cold, windy, or dry conditions, making consistent protection and moisturization necessary. The study by 1 provides additional guidance on mouth care, including the application of white soft paraffin ointment to the lips, but this is more relevant to specific conditions like Stevens-Johnson syndrome/toxic epidermal necrolysis, and not directly applicable to general chapped lips management.

From the Research

Causes of Chapped Lips

  • Chapped lips can be caused by various inflammatory conditions, including atopic (eczematous) cheilitis 2
  • Contact hypersensitivity reactions are a frequent cause of cheilitis, often due to cosmetic and hygiene products 3
  • Actinic cheilitis is another condition that can cause chapped lips, often treated with topical therapies such as 5% imiquimod cream 4

Treatment Options

  • Topical tacrolimus 0.03% ointment has been used to treat atopic cheilitis, with complete response in some patients 2
  • Topical 5% imiquimod cream has been used to treat actinic cheilitis, with clinical clearing of the condition in all patients studied 4
  • Patch tests can be used to diagnose contact allergy-related cheilitis, starting with the European baseline series and the patient's personal cosmetic and topical products 3

Underlying Mechanisms

  • Proteolytic processing regulates Toll-like receptor 3 stability and endosomal localization, which may play a role in the immune response to chapped lips 5
  • The exact mechanisms of chapped lips are not fully understood, but may involve a combination of inflammatory and immune responses 2, 3, 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Cheilitis, perioral dermatitis and contact allergy.

European journal of dermatology : EJD, 2013

Research

Topical 5% imiquimod for the therapy of actinic cheilitis.

Journal of the American Academy of Dermatology, 2002

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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