cracked and inflamed corners of lips

[veronicaneverov]

send help! recently i’ve been getting INSANELY  inflamed and cracked lips, specifically my corners. i’ve been having issues with my dry lips for years, but it’s never been this bad. specifically, when i wake up in the mornings there’s almost this “cast” (lack of a better word) where if i open my mouth too wide too quickly my lips will crack and start bleeding (the corners especially) so i have to carefully remove the product i had on the night before. it is literally impossible for me to go to sleep without any product on and not wake up with chronically dry lips. i currently use the laneige lip sleeping mask but even that doesn’t keep my lips moisturized (it hardens overnight) and frankly i think its breaking me out around my lips.. but also, vaseline and aquaphor dry out by the morning too. when i remove it in the morning the corners of my lips turn red but also the areas around it do too! does anyone have any recommendations to avoid this and any products that don’t dry out in the morning?

[Charmaine75]

Do you use plumping lip products?  I get horrible cracks and inflammation when I use the majority of lip plumping products.  Once I quit using those, my corners heal really quickly!  I'm currently using Too Faced Lip Injection Extreme, which I don't seem to react to.

[danielledanielle]

@veronicaneverov, this sounds like it might be a (minor) medical condition called cheilosis.

From osmosis.org-

What is cheilosis?

Cheilosis, also known as angular cheilitis or perlèche, is an inflammatory condition that causes cracking, crusting, and scaling of the corners of the mouth. 

Spoiler

What causes cheilosis?

There are a variety of causes, both infectious and non-infectious, that can lead to cheilosis. In most cases, cheilosis is caused by excessive moisture and maceration from saliva followed by secondary infection with Candida albicans or, less commonly, Staphylococcus aureus. 

Although cheilosis may occur at any age, it is especially common in infants and elderly individuals. Predisposing local factors include wearing ill-fitted dentures that increase the overhang of the upper lip into the lower one, having a dry mouth, intraoral yeast infections, irritant or allergic reactions to dental products, and poor oral hygiene. In older individuals, drooping of the corners of the mouth due to loss of skin firmness or dental pieces can lead to drooling and retention of saliva in the corners of the mouth. Infants may also experience cheilosis as a result of drooling, thumb sucking, and lip-licking. 

Less common causes in both adults and children include nutritional deficiencies, such as iron, B9 (i.e., folic acid), zinc, B6 (i.e., pyridoxine), B2 (i.e., riboflavin), or B3 (i.e., niacin) deficiency. Finally, other causes include type 2 diabetes, Sjögren syndrome, immunodeficiency, irritant or allergic reactions to oral hygiene products or denture materials, and medications causing dryness of the mouth and decreased salivation (e.g., isotretinoin, acitretin, anticholinergics). 

What are the signs and symptoms of cheilosis?

Cheilosis typically presents with red, edematous, often painful patches of skin on the corners of the mouth. Mild cases may just involve some pink discoloration and a sensation of burning or itchiness around the mouth. As the condition progresses, continued moisture causes the skin to macerate and erode, leading to small, scaly lesions bordering the reddened mucosa. In more severe cases, the skin can become cracked, eczematous, and fissured. In rare cases, fissuring may be deep enough to cause ulceration and bleeding. If the lesions become infected by bacteria, there may also be honey-colored exudates; pustules; and purulent exudates, although that is more rare.

How is cheilosis diagnosed and treated?

Diagnosis of cheilosis is based on the characteristic skin lesions in the corners of the mouth. Since  infections are amongst the most common causes of cheilosis, testing for Candida (i.e., via KOH preparation) or obtaining a bacterial culture can be performed at diagnosis to confirm the underlying cause. However, because the diagnosis is largely clinical, additional tests are usually only performed after initial treatment has failed. 

Treatment of cheilosis depends on the suspected cause. Since the most common risk factor involves maceration of the skin due to excess moisture, general management measures involve applying petrolatum-based lip balms or emollients to protect the corners of the mouth from the saliva. Additionally, barrier creams, such as zinc oxide paste, may also be helpful in reducing skin maceration. In cases where a yeast infection is suspected, individuals may apply a topical antifungal cream or ointment. The combination of a topical antifungal and antibiotic may also be used if bacterial infection is suspected. In all cases, individuals may be advised to maintain proper oral hygiene as well as improve denture fit and cleaning. Finally, future management should focus on investigating and treating any underlying causes in order to prevent future recurrences. Once cleared, a barrier cream or lip balm applied nightly can help protect the skin from moisture. However, recurrence of angular cheilitis is common. 

What are the most important facts to know about cheilosis?

Cheilosis refers to the inflammation and painful cracking of the corners of the mouth. It is mainly caused by maceration of the skin due to overexposure to saliva, but it can also be a symptom of underlying disorders, such as poor dental hygiene, perioral infections, and allergic or irritant reactions to hygiene products or dental materials. Treatment focuses on preventing skin maceration by applying protective lip balms and barrier creams as well as treating any underlying cause when possible.

[Westcoasty]

@veronicaneverov  Usually people reply to these kinds of questions with product recommendations. I'm going to go a different route and suggest that you a) make sure you're drinking tons of pure water (yes, you will pee a lot at first, can't be helped), b) check your salt intake, especially if you adore things like salt and vinegar chips - those always screw up my lips, for sure), and c) invest in a good humidifier for your bedroom. 

Basically, if the products you're mentioning don't work, and they actually dry out while you're wearing them, I doubt any product will. It may even be that you're reacting to them, and need to stop using them for a time while your skin calms down.

I suggest you go see your doctor first, frankly. You may need the help of a doctor or dermatologist to get this sorted out. But while you're waiting to go see your doctor, drink lots of water! And so on.

Good luck, hon. 

[danielledanielle]

Echo'ing a similar sentiment.  Drink fluids, balance your diet and go heavy on vaseline or aquaphor. See a doc if nothing helps.  Good luck!

[JoSometimes]

@danielledanielle @Westcoasty ECHO!!! Echo! echo…

@veronicaneverov Yes! These can definitely help. I used to have similar symptoms. Seeing a doctor is definitely a good way to go and staying hydrated will also help.

While you’re waiting, something that I can help provide a bit of relief if they’re irritated is Blistex Medex lip balm. It’s got a cooling sensation that can help soothe irritation or itchiness. I only use it if absolutely necessary though because I find it becomes counterproductive if I use it for too long. Sometimes an OTC allergy medicine can help if things are extremely itchy. You might be sensitive to something that’s coming into contact with your lips. Blistex Deep Moisture renewal is another good lip balm to get more hydration into your lips while you’re waiting to get in touch with your doctor.