Treatment of Cracked Lips After Sucking
For cracked lips caused by sucking habits, apply animal or plant-based emollients (beeswax, cocoa butter, or lanolin) every 2 hours and avoid petroleum-based products which worsen drying and cracking. 1
Immediate Topical Management
Primary Emollient Therapy
- Use white soft paraffin ointment applied to the lips every 2 hours throughout the acute phase to protect and moisturize damaged tissue 1, 2
- Apply animal or plant-based oils such as beeswax, cocoa butter, or lanolin specifically for lip lubrication 1
- Avoid petroleum-based products entirely as these cause further drying and cracking 1, 3
- Highly occlusive formulations combining common oils and waxes significantly improve lip roughness and moisture content within 2-4 weeks of continuous use 4
Adjunctive Wound Care
- Clean the mouth daily with warm saline mouthwashes (1 teaspoon salt, 1 teaspoon baking soda in 4 cups water) to reduce bacterial load and promote healing 1, 2
- Use antiseptic oral rinse such as 0.2% chlorhexidine digluconate mouthwash (10 mL twice daily) if secondary infection is suspected 1, 2
- For severe cracking with pain, apply benzydamine hydrochloride spray every 3 hours, particularly before eating 1, 2
Addressing the Underlying Habit
Behavioral Modification
- Breaking the sucking habit is essential to prevent recurrence - morphological improvement combined with increased patient awareness effectively eliminates the habit within 5-6 months 5, 6
- Lip-licking and sucking are compensatory measures that perpetuate the condition and can lead to irritant contact dermatitis, cheilitis simplex, and angular cheilitis 7
- Increasing patient awareness of the habit combined with creating an oral environment that makes sucking difficult is more effective than emollients alone 6
Treatment for Complications
If Angular Cheilitis Develops
- Use combination antifungal and corticosteroid therapy - the antifungal addresses Candida infection while corticosteroid reduces inflammation 3
- Alternative: nystatin oral suspension 100,000 units four times daily for 1 week or miconazole oral gel 5-10 mL held in mouth after food four times daily 1, 2, 3
If Severe Inflammation Present
- Apply topical corticosteroid four times daily (betamethasone sodium phosphate 0.5 mg in 10 mL water as rinse-and-spit preparation) 1, 2
- For more severe cases, clobetasol propionate 0.05% mixed with Orabase can be applied directly to affected areas 1
Follow-Up and Monitoring
- Evaluate treatment response within 2 weeks - if no improvement, reevaluate diagnosis or consider alternative treatments 2, 8
- Daily examination during acute phase is necessary to monitor for secondary infection or complications 1, 2
- Once healed, continue preventive emollient application at least twice daily to maintain lip hydration 8
Common Pitfalls to Avoid
- Do not use alcohol-containing mouthwashes which cause additional pain and irritation 2, 8
- Avoid glycerin or lemon-glycerin swabs as they dry the mouth rather than moisturize 1
- Do not use petroleum-based products chronically as they promote mucosal dehydration and create an occlusive environment increasing secondary infection risk 3
- Overlooking adequate pain management can impact nutrition and hydration 2