Treatment of Cracked Lips

Apply white soft paraffin ointment to the lips every 2 hours as the cornerstone of therapy for cracked lips. 1, 2

Primary Treatment Approach

The most effective treatment for cracked lips centers on frequent application of emollients combined with proper oral hygiene:

Apply white soft paraffin ointment every 2 hours during the acute phase to provide continuous protection and moisturization 1, 2, 3
Clean the mouth daily with warm saline mouthwashes to reduce bacterial load and remove debris 1, 2, 3
Use benzydamine hydrochloride oral rinse or spray every 2-4 hours, particularly before eating, for anti-inflammatory and analgesic effects 1, 2, 3

If cracked lips are accompanied by significant inflammation or pain:

Apply a potent topical corticosteroid mouthwash (betamethasone sodium phosphate) four times daily to reduce inflammation 1
For localized lesions in infants or severe cases, consider clobetasol propionate 0.05% cream or ointment applied topically to affected areas including lips 1, 3
Avoid alcohol-containing mouthwashes as they cause additional pain and irritation 1, 2, 3

Angular cheilitis and secondary infections commonly complicate cracked lips:

For fungal infections (Candida), use nystatin oral suspension or miconazole oral gel as prescribed 2, 4, 3
For bacterial infections, use antiseptic oral rinse containing 0.2% chlorhexidine digluconate twice daily 2
When infection is suspected, obtain bacterial cultures and administer appropriate antibiotics for at least 14 days 2
For angular cheilitis specifically, use combination therapy with antifungal and corticosteroid components to address both Candida infection and inflammation 2

When cracked lips cause significant discomfort:

Viscous lidocaine 2% can be applied and held for 1-2 minutes before spitting, repeated every 3 hours as needed, particularly before meals 2, 3
Barrier preparations such as Gengigel mouth rinse/gel or Gelclair provide additional pain control 4, 3

Long-term management requires addressing underlying causes:

Use a bland lip balm with ultraviolet protection and apply sunscreen SPF 15 to lips, reapplying every 2 hours when outside 2, 5
Avoid frequent washing with hot water and skin irritants including over-the-counter anti-acne medications, solvents, or disinfectants 2, 3
Maintain adequate hydration and protect lips from harsh weather conditions 5
Use alcohol-free moisturizing creams or ointments twice daily to keep lips hydrated 2

Vaseline/white paraffin should not be used chronically on the lips as this promotes mucosal cell dehydration and is occlusive, leading to risk of secondary infection 1
Evaluate treatment response within 2 weeks; if no improvement is seen, reevaluate diagnosis or consider alternative treatments 2
Immunocompromised patients may require more aggressive and prolonged therapy 2
For patients with Kawasaki disease presenting with cracked lips, this is part of a systemic illness requiring erythema, dryness, fissuring, peeling, cracking, and bleeding of the lips as diagnostic criteria, necessitating comprehensive systemic management 1