Causes of Chapped Lips
Chapped lips (cheilitis sicca) result from environmental exposure, anatomical vulnerability, and underlying systemic or local factors that compromise the lip barrier function.
Primary Environmental and Anatomical Factors
The lips are uniquely vulnerable to chapping due to their anatomical structure and maximal exposure to environmental insults:
- Anatomical susceptibility: The lips consist of striated muscle and connective tissue positioned for maximum exposure to sunlight, environmental conditions, food, and tobacco 1
- Hot, dry environments: Prolonged exposure to hot, dry conditions significantly increases chapping risk, with moderate to severe chapping occurring in approximately one-third of individuals exposed to desert conditions 2
- Low stratum corneum moisture: The lips have inherently small stratum corneum moisture content and low barrier function, making them prone to drying and chapping 3
- Age-related changes: Transepidermal water loss (TEWL) from lips decreases until approximately 30 years of age, with drying problems most prominent before this age 3
Individual Risk Factors
Certain constitutional factors increase susceptibility to chapped lips:
- Fair complexion: Very fair complexion carries 3.23 times higher odds of chapped lips, while fair complexion carries 1.58 times higher odds 2
- Recurrent herpes labialis: Presence of recurrent herpes labialis increases odds of chapped lips by 2.88 times 2
- Atopic eczema: Chapped lips may be the only manifestation of atopic eczema or appear as part of generalized dermatosis 4
Systemic Disease Associations
Chapped lips can indicate underlying systemic conditions:
- Autoimmune disorders: Lupus erythematosus and other systemic disorders can manifest with inflammatory lip changes 4
- Nutritional deficiencies: Nutrient deficiency contributes to recurrent lip problems 5
- Immunosuppression and diabetes: These conditions predispose to angular cheilitis and chronic lip problems 6
- Medications: Systemically administered pharmacologic agents can affect lip integrity 1
Contact and Allergic Factors
External products and allergens frequently cause lip inflammation:
- Lip care cosmetics: Lipsticks, lip balms, lip salve, lip gloss, lip liner, and lip plumper contain allergens including castor oil, benzophenone-3, gallate, wax, and colophony 7
- Contact dermatitis: The sensitive transitional skin of the lips is a favored site for eczematous dermatitis 4
- Petroleum-based products: Chronic use promotes mucosal dehydration and creates an occlusive environment increasing secondary infection risk 6
Infectious Causes
Microbial colonization contributes to lip pathology:
- Candida infection: Fungal overgrowth causes angular cheilitis, particularly at lip commissures 6
- Bacterial infection: Secondary bacterial colonization can complicate chapped lips 6
Behavioral and Mechanical Factors
Habits and mechanical issues perpetuate lip problems:
- Lip licking and mouth breathing: These habits worsen lip dryness and chapping 6
- Ill-fitting dentures: Loss of vertical dimension and poor denture fit contribute to angular cheilitis 6
- Trauma: Mechanical, physical (thermal burns), or chemical (strong acid or alkali) factors cause traumatic ulceration 5
Common Pitfalls
- Ineffective lip protectants: Standard lip protectants appear relatively ineffective in prevention and treatment of chapped lips in harsh environmental conditions 2
- Chronic petroleum product use: Avoid chronic petroleum-based products as they paradoxically worsen mucosal hydration 6
- Overlooking systemic causes: Persistent chapping despite treatment warrants evaluation for diabetes, immunosuppression, nutritional deficiencies, and medication review 6