Exfoliative cheilitis (EC) is the inflammation of the lips which is an exceptional chronic condition and is basically the eczema of the lips. It is characterized by continuous peeling of the lips and the adjacent skin around it. The lips are swollen, red, dehydrated and dry, and break off very easily. Over time, the lips become painful and have cracks that give a burning sensation and the underlying pink sensitive skin is then revealed. It commonly affects young people under the age of 30 years and may affect females more than males according to one study.
A number of causes have been associated with the occurrence of exfoliative cheilitis but the exact cause of mechanism is still unknown. However, some factors are established which initiate exfoliative cheilitis:
- Liver metabolic failure and other malfunctions
- Genetic predisposition
- Hormonal imbalance
- Allergy/Hypersensitivity reactions: for e.g. allergy to food such as peanut, or due to material like latex gloves etc.
- Suppressed Immunity
- Poor hygiene
- Poor or improper dietary intake
- In babies, continuous salivation in which the saliva may stay on the lips resulting in dryness
- Breathing through the mouth
- Lip biting
- Bacterial infection: of Staph. Aureus
- Yeast infection (fungal): of Candida albicans
Signs & Symptoms
Exfoliative cheilitis usually affects the lower lips and may include following signs and symptoms:
- Redness is the primary indicator of exfoliative cheilitis and is more noticeable in white population
- Swelling of lips
- Dryness of the lips, accompanied by bleeding
- Itching and burning sensation of lips
- Lip discoloration: They become more yellow with a crusty layer
In general, treating exfoliative cheilitis can be difficult due to its chronic nature. However, with long-term treatment, it can be cured and for prevention, treatment should be continued.
If infection is present, then antibiotics and antifungals should be prescribed first, rather than going directly for the conventional therapy. These antimicrobials can be given topically or systemically.
- Topical or systemic antibiotics/antifungals (depending on infection type)
- Topical steroids are helpful in significant reduction of redness and swelling, however it takes more time
- Moisturizing should be given due importance to keep dryness in check and thus prevent bleeding and discoloration of lips.
- Photodynamic therapy can aid in decreasing swelling and itching. Overall, it is estimated to have a 70% rate of success and is recommended in cases with little response to medicines mentioned earlier.
The best approach after conventional treatment, or to prevent exfoliative cheilitis entirely, is always a natural one.
- Have a good dietary intake, eat fresh and healthy vegetables
- A good sleep of at least 7 hours
- Moisturize your lips daily
- Drink plenty of water. Have adequate amount of fresh juices to prevent dehydration and mineral imbalance in the body
- Kumar & Clark, Clinical Medicine, 5th Ed, Chapter 22, Skin Diseases