Chronic Cheilitis: Causes, Treatments, and Remedies

Q: Chronic Cheilitis: Causes, Treatments, and Remedies

Hello, <br>Q1： Recently, I visited another dermatologist who diagnosed me with exfoliative cheilitis and prescribed gentamicin ophthalmic ointment for application. <br>I would like to ask the doctor, is this gentamicin ophthalmic ointment harmful to the lips? <br>A1： Antibiotic

Chronic cheilitis

Hello, Doctor.
I apologize for the lengthy message.
My condition has been ongoing for about 7 to 8 months.
It started with small blisters on my upper lip.
I applied Neomycin ointment a few times (for three to four days, which caused peeling and healing).
After that, both corners of my mouth alternately became inflamed, and I also used Neomycin ointment (for a few days).
I noticed peeling when brushing my teeth, as toothpaste would accumulate on my lower lip.
After rinsing, I discovered the peeling (thin white film).
At that time, I didn't pay much attention and forcibly removed it.
During this period, I didn't avoid any foods, including fried, salty, and hot soups.
Until the end of March this year, I visited a dermatologist.
The doctor prescribed Clobetasol ointment.
I was hesitant to use it due to concerns about steroids, but after applying it on the 3rd and 4th, I experienced immediate redness, swelling, and pain.
I thought it was a side effect of the medication, so I ignored it.
After three days, the condition persisted, with severe peeling and discomfort.
I stopped the medication on the 6th, which provided some relief, but the peeling continued.
I realized that the skin on my lips is very thin and I didn't dare to forcibly remove the accumulated dead skin, which has become quite thick.
Recently, I visited another dermatologist who diagnosed me with exfoliative cheilitis and prescribed Fusidic acid eye ointment for application.
I would like to ask the doctor: First, is the Fusidic acid eye ointment harmful to my lips? Second, I want to see a Traditional Chinese Medicine practitioner, but can exfoliative cheilitis be completely cured? Third, could using various medications lead to a fungal infection? I kindly ask the doctor to answer my questions.
I have been anxious for too long and am very distressed.

Niming, 30~39 year old female. Ask Date: 2023/04/30

Dr. Gao Peiyi reply Traditional Chinese Medicine

Hello,
Q1: Recently, I visited another dermatologist who diagnosed me with exfoliative cheilitis and prescribed gentamicin ophthalmic ointment for application.
I would like to ask the doctor, is this gentamicin ophthalmic ointment harmful to the lips?
A1: Antibiotic ointments theoretically should not worsen the condition unless there is an allergy, but they may not provide significant benefit.
Q2: Secondly, I am considering traditional Chinese medicine.
Can it cure exfoliative cheilitis?
A2: The condition tends to be chronic, and it is not easy to achieve a complete cure solely through oral or topical medications.
Traditional Chinese medicine may offer some relief with herbs that dispel wind, clear heat, nourish yin, and moisten dryness, along with topical moisturizing ointments.
However, achieving a complete cure requires identifying and addressing the specific triggers, which are often physical in nature, such as contact with masks or habitual actions that cause repeated irritation.
One should pay close attention to these factors.
"I noticed that toothpaste accumulates on my lower lip while brushing, and after rinsing, I discovered the peeling (thin white film).
At that time, I didn't think much of it and forcibly removed it." Is it possible that I am using unsuitable skincare products? Recurrent bacterial infections?
Q3: Thirdly, can applying various medications lead to fungal infections?
A3: Generally, this is unlikely unless there is a compromised immune system.
If there is an open wound and skincare products are applied, it can increase the risk of bacterial infections.
Recurrent bacterial infections may also contribute to this condition, which is why dermatologists typically prescribe topical antibiotics, although the incidence of such cases is not high.

Reply Date: 2023/04/30

More Info

Chronic cheilitis, often referred to as exfoliative cheilitis, is a condition characterized by persistent inflammation and peeling of the lips. It can be quite distressing and may arise from various causes, including environmental factors, allergic reactions, infections, and underlying systemic conditions. Understanding the causes, treatments, and potential remedies for chronic cheilitis is essential for effective management.

Causes of Chronic Cheilitis
1. Environmental Factors: Exposure to harsh weather conditions, such as extreme cold or wind, can lead to dryness and irritation of the lips. Additionally, frequent licking of the lips can exacerbate the condition by removing natural moisture.

2. Allergic Reactions: Certain ingredients in lip products, toothpaste, or even food can trigger allergic reactions, leading to inflammation and peeling.

3. Infections: Fungal infections, particularly those caused by Candida species, can lead to chronic cheilitis. Bacterial infections may also contribute to the condition.

4. Underlying Health Conditions: Conditions such as vitamin deficiencies (especially B vitamins), autoimmune diseases, and systemic diseases can manifest as chronic lip inflammation.

5. Irritants: Exposure to irritants, including certain medications (like topical steroids), can lead to adverse reactions, resulting in chronic inflammation.

Treatments for Chronic Cheilitis
1. Topical Treatments: Depending on the underlying cause, various topical treatments may be prescribed. For instance, antifungal creams may be effective if a fungal infection is present. In your case, the use of gentamicin ointment (often used for bacterial infections) may not be harmful, but it is essential to monitor for any adverse reactions.

2. Avoiding Irritants: Identifying and avoiding potential irritants, such as certain lip balms or toothpaste, is crucial. Switching to hypoallergenic products may help reduce inflammation.

3. Moisturization: Regularly applying a gentle, fragrance-free lip balm can help maintain moisture and protect the lips from environmental factors.

4. Dietary Considerations: Ensuring a balanced diet rich in vitamins and minerals can help support skin health. If a vitamin deficiency is suspected, supplementation may be necessary.

5. Consultation with Specialists: If symptoms persist, consulting with a dermatologist or an allergist can provide further insights and tailored treatment options.

Home Remedies and Lifestyle Adjustments
1. Hydration: Staying well-hydrated is essential for maintaining skin moisture, including the lips.

2. Gentle Exfoliation: If there is a buildup of dead skin, gentle exfoliation with a soft cloth may help, but it should be done cautiously to avoid further irritation.

3. Avoiding Lip Licking: This habit can worsen dryness and irritation, so it’s best to avoid it.

4. Stress Management: Chronic stress can exacerbate skin conditions, so incorporating stress-reducing practices such as mindfulness or yoga may be beneficial.

Concerns About Treatments
Regarding your specific questions:
1. Use of Gentamicin Ointment: While gentamicin is primarily used for bacterial infections, it is generally safe for short-term use on the lips. However, if you experience increased redness or irritation, it may be best to discontinue use and consult your healthcare provider.

2. Traditional Chinese Medicine (TCM): TCM approaches may offer alternative treatments for chronic cheilitis, focusing on balancing the body's internal systems. While some individuals find relief through TCM, results can vary, and it’s essential to consult a qualified practitioner.

3. Risk of Fungal Infection from Overuse of Medications: Overusing topical medications, especially those containing steroids or antibiotics, can disrupt the natural flora of the skin and potentially lead to secondary infections, including fungal infections. It’s crucial to use medications as directed and to consult a healthcare provider if symptoms worsen.

In conclusion, chronic cheilitis can be a complex condition requiring a multifaceted approach to treatment. Identifying the underlying cause, avoiding irritants, and maintaining proper lip care are vital steps in managing this condition. If symptoms persist or worsen, seeking professional medical advice is essential for appropriate diagnosis and treatment.

Similar Q&A

Understanding Chronic Cheilitis: Treatment Options and Concerns

Hello Dr. Wu: I have been suffering from chronic cheilitis since childhood. I have seen many doctors who all said that it cannot be completely cured and only prescribed topical medications. As I grew older, I realized that those medications contained steroids. My question is, is ...

Dr. Wu Yuxin reply Dermatology
Without actually seeing the lesion, it is impossible to determine. If it is very concerning, please seek medical attention as soon as possible.

Understanding Angular Cheilitis: Causes, Treatments, and Recurrence

I have had the same experience as previous patients; my doctor prescribed me a medication called Linoleic Acid, but after using it for a week, my condition worsened. I then visited another clinic and saw some improvement, but after another week, the same symptoms reappeared. I ha...

Dr. Chen Yiying reply Dermatology
Hello: In response to your question regarding recurrent angular cheilitis, it is important to consider whether there is a Candida infection. I am not sure if you stopped the medication and then experienced a relapse, or if you have been continuously applying the medication but st...

Understanding Cheilitis: Causes, Treatments, and Management Tips

Hello Dr. Cheng, I have been experiencing dry and cracked lips for the past three years, with severe peeling occurring even without the use of lipstick, and there has been no improvement. Despite visiting numerous doctors, the condition keeps recurring. A previous doctor mentio...

Dr. Zheng Lizhen reply Dermatology
In addition to the most common cause of contact dermatitis from lipstick, other factors that may trigger contact dermatitis should also be considered, such as toothpaste and cigarettes. Furthermore, ultraviolet light-induced actinic cheilitis should be taken into account. It is a...

Effective Treatments for Angular Cheilitis: Relief and Remedies

Hello Doctor, it seems that I have developed angular cheilitis recently. There is a sore at the corner of my mouth, and around the sore and on my lips, there are red, itchy bumps. The sore hurts when I open my mouth, and it feels dry and sticks together when my mouth is closed, c...

Dr. Wu Yuxin reply Dermatology
If there is no infection, it is recommended to apply petroleum jelly every 2 hours. The lesions that are becoming increasingly numerous and itchy are concerning, and without seeing the lesions, it is difficult to determine the exact issue. If this is very bothersome, please seek ...