What is the recommended management for dry lips?

Management of Dry Lips

The recommended management for dry lips includes applying white soft paraffin ointment (lip balm) every 2-4 hours, drinking plenty of water, and maintaining good oral hygiene. 1

First-Line Interventions

Lip Moisturization

• Apply lip balm containing occlusive ingredients regularly throughout the day 1
• Choose products with:
  • Neutral pH
  • Preservative-free formulations (especially if applying more than 4 times daily)
  • Pseudo-ceramides (shown to be effective in sensitive skin patients) 2
  • Highly occlusive formulations that combine common oils and waxes 3
• Apply more frequently in dry, cold, or windy conditions 4
• Include UV protection in lip balms when outdoors 4

Hydration and Environmental Measures

• Drink plenty of water throughout the day 1
• Avoid licking lips, as this worsens dryness by removing natural oils and creating a cycle of lip-licking dermatitis 4
• Protect lips from harsh weather conditions using scarves or face coverings in extreme cold or wind 4
• Use humidifiers in dry indoor environments

Management Based on Severity

For Mild Dry Lips

• Regular application of lip balm containing occlusive ingredients
• Increased water intake
• Avoidance of lip-licking behavior

For Moderate to Severe Dry Lips

• More frequent application of lip balm (every 2 hours)
• Consider specialized formulations with pseudo-ceramides 2
• For cracked or painful lips, use white soft paraffin ointment every 2-4 hours 1
• Clean the mouth daily with warm saline mouthwashes 1

For Underlying Salivary Dysfunction

• Assess salivary gland function before initiating treatment 1, 5
• For mild salivary dysfunction: non-pharmacological stimulation with sugar-free acidic candies, lozenges, or xylitol 1, 5
• For moderate dysfunction: pharmacological stimulation with pilocarpine or cevimeline 5
• For severe dysfunction: saliva substitutes with neutral pH and fluoride content 5

Special Considerations

For Allergic or Irritant Contact Dermatitis

• Discontinue suspected lip products
• Choose hypoallergenic formulations without common allergens such as castor oil, benzophenone-3, gallate, wax, and colophony 6
• Consider patch testing if symptoms persist despite using hypoallergenic products

For Persistent or Severe Cases

• Evaluate for underlying conditions such as:
  • Cheilitis (angular, contact, actinic, exfoliative) 7
  • Sjögren's syndrome 1, 5
  • Nutritional deficiencies (vitamin B12, iron)
  • Medication side effects (especially retinoids)

Pitfalls and Caveats

• Avoid lip-licking as a compensatory measure, as it perpetuates dryness and can lead to dermatitis 4
• Avoid alcohol-containing mouthwashes which can worsen dryness 1
• Be aware that some lip care products may cause allergic reactions in sensitive individuals 6
• Don't rely solely on subjective symptoms when assessing dryness, as environmental and personal stressors may influence perception 5
• Recognize when simple dry lips have progressed to a more serious condition requiring medical attention (persistent cracking, bleeding, or pain)

By following these recommendations and addressing the underlying causes of dry lips, most patients will experience significant improvement in their symptoms and prevent complications such as cheilitis or secondary infections.