Chronic chapped lips: causes and how to heal them

Why are my lips always chapped?

Cheilitis means inflammation of the lips. Lip skin is thinner and more sensitive than skin elsewhere and has no oil glands, making dryness a recurring problem. Cold or hot dry weather, sun exposure and dehydration can all contribute. Chapping can cause tightness, scaling, peeling, itching, cracks and mild pain. Severely cracked lips can sting when you eat citrus, spicy or salty foods.1

Persistent inflammation is not always ordinary weather related dryness. Eczema, contact allergy, infection and reactions to medication, including retinoids, are possible causes. Iron or vitamin B deficiency can also contribute. Cracks at the mouth corners, repeated peeling and persistent swelling can belong to different forms of cheilitis; the location and appearance help a clinician work out the cause.34

What should I put on chapped lips?

For very dry, cracked lips, try a thick ointment such as white petroleum jelly. Ointment holds water in longer than waxes or oils. A balm helps keep existing moisture from escaping, rather than installing a new water supply. Choose a fragrance free product, and look for one labelled hypoallergenic.25

Other ingredients used to help chapped lips include ceramides, dimethicone, mineral oil, shea butter, hemp seed oil and castor seed oil. However, castor oil can also cause contact allergy. If a product repeatedly makes your lips worse, stop using it rather than choosing it solely because one ingredient appears on a helpful ingredients list.26

Which lip products should I stop using?

While your lips are chapped, avoid lip products containing:

• Fragrance or flavouring, especially cinnamon, citrus, mint and peppermint.
• Camphor, eucalyptus or menthol.
• Lanolin, phenol or propyl gallate.
• Salicylic acid.
• Octinoxate or oxybenzone.

Stop any balm, lipstick or other lip product that burns, stings, tingles or feels uncomfortable. Those sensations indicate irritation, not successful treatment. Apply this rule to lip gloss and plumpers as well as balm: lip cosmetics can cause both irritation and allergic reactions.26

How to care for your lips each day

1. 1Wash your hands before applying lip balm, especially if you use a pot.
2. 2Apply a gentle balm or ointment when you wake up. Reapply whenever your lips feel dry and after eating or drinking.
3. 3Before going outdoors, apply a nonirritating lip balm with SPF 30 or higher containing zinc oxide or titanium oxide. Reapply every two hours outdoors, including in winter.
4. 4Before bed, apply your gentle balm or ointment again. A thick ointment is useful when your lips are very dry and cracked.

Lip balm belongs within reach, rather than in the ceremonial drawer of products you forget you own. Keep one by your bed and another in your bag or pocket. Do not share lip balms, because sharing can spread germs.57

What keeps chapped lips from healing?

Licking feels like adding moisture, but saliva leaves lips drier as it evaporates. Saliva also contains digestive enzymes that can irritate lip skin. When you catch yourself licking, apply a gentle balm instead. Biting or picking away flakes can create cracks and sores, so leave peeling skin alone. Repeated licking can keep irritation going even after you stop the product that originally caused it.56

Dry air makes moisture evaporate from lips more quickly. Run a humidifier at home; the bedroom is especially useful if you breathe through your mouth at night. Cover your lips with a scarf in cold, windy weather. Drink enough water to avoid dehydration. Keep pens, jewellery and other metal objects away from your lips, since they can irritate already sensitive skin.235

Could my lip balm be causing an allergy?

Yes. A contact allergy to lip cosmetics can cause redness, dryness, scaling, itching and mild swelling. The reaction can affect the border where the red lip meets the surrounding skin and spread around the mouth. A chronic reaction can begin hours after contact and persist for weeks or months if you keep using the allergen. Fragrances, flavourings, lanolin, castor oil and propolis are among the possible triggers.6

A dermatologist can investigate delayed contact allergy with patch testing, including tests with your own products. Some people react to more than one ingredient. Avoiding the identified allergen usually clears the inflammation, but persistent symptoms need reassessment because more than one factor can be involved. Bring the lip products you use to the appointment so they can be considered for testing.6

How long should healing take?

Regular balm or ointment should ease discomfort while the skin heals. Expect noticeable improvement within 2 to 3 weeks; severely cracked or bleeding lips can take that long to recover fully. Start care when tightness or dryness first appears. Once your lips heal, continue protection during dry weather rather than waiting for the next crack.15

When should I see a doctor?

Arrange an appointment if your lips worsen, do not improve after 2 to 3 weeks of care, or frequently bleed despite using ointment. Seek medical assessment for lips that are hot, painful and swollen, which can indicate infection. A pharmacist can help you choose a treatment and decide whether you need a GP.17

Persistent dry, scaly lips also need assessment because actinic cheilitis, a precancerous condition linked to sun exposure, can resemble chapping. A clinician will review your history and examine your lips. Depending on the suspected cause, testing can include an infection swab, blood tests, allergy testing or a biopsy, which takes a small tissue sample. Treatment depends on the cause; an infection, allergy and medication reaction do not all need the same treatment.234