chronic chapped lips

[Alex C]

I have a student who has on ongoing case of chapped lips. This is not your everyday case of chapped lips, they have been craggy and bleeding at times.

If anyone has experience with chronic and serious capped lips, I would appreciate some direction.

Please do not offer an over the counter, topical application. This post is about a condition beyond the scope of those remedies.

He has been to an allergist, no improvement.

He has had blood work done, no help determining a cause.

We switched to a plastic mouthpiece, no relief.

So, with due respect, I am asking only for people who have dealt with serious, chronic chapped lips, for help.

Thanks.

[Doug Elliott]

Has he tried switching toothpastes? I went through a period like that when I was using Crest. Colgate made the difference.

[MileMarkerZero]

Lots of good info here:

http://www.dermadoctor.com/article_Chap ... s_185.html

Does your student perchance use Accutane for acne? That stuff can cause droughts over large continental areas.

But...from the above link:

*Check for periodontal disease or abscesses. There are reports that deep cleansing of the mouth performed by the dentist (possibly under anesthesia) may help solve the problem.
*Clarinet players may develop chapping at the contact area of the reed.
*The ingredient propyl gallate in lipstick may be causing a contact allergy.
*Your toothpaste may be to blame if it contains guaiazulene
*Check out the ingredient label on your toothpaste. If it contains sodium lauryl sulfate, this may be a concern as well. Blamed for chapped lips, skin irritation and even perioral dermatitis, avoidance of sodium lauryl sulfate can be helpful. Squigle Enamel Saver Toothpaste is SLS free.
*A little known (or seen) condition known as chelitis granulomatosa may require a biopsy for diagnosis.
*Being allergic to nickel may surface on the lips too. Remember, don't put metallic items like paper clips in your mouth!
*The juice from citrus fruits cause both irritation as well as a phototoxic reaction that looks like chapped lips.
*Eating figs can result in phototoxicity.
*An ingredient known as phenyl salicylate (salol) used in lip care products may be your culprit.
*You can develop an allergy to cobalt from taking vitamin B12 supplements. It may look like unexplained episodes of recurrent swelling and crusting of lips made worse by wind and sun exposure. And it is important to know that you may have a negative patch test to vitamin B12 despite the presence of the allergy.
*The blood pressure medication, propranolol commonly known as inderal may cause chelitis as a side effect.
*If you've got vertigo and chapped lips, check to see if you're on the medication stemetil, commonly known as prochlorperazine.
*Down's syndrome patients have a genetic predilection to having chapped lips. Treatment with thyroid supplement and potent topical steroid ointments may clear the condition.
*All those years in the sun may have caused precancerous changes known medically as actinic chelitis. Treatment with a topical chemotherapy medication known as Efudex may clear it up.
*An allergy to red dyes used in candy, mouthwash, toothpaste, etc. may be to blame.
*On the same note, cinnamates (for the cinnamon flavor) used in candy, lozenges, gum, mouthwash and toothpaste may be to blame.
*Do you snore? Enlarged tonsils, adenoids or sleep apnea may be to blame for those lips. That continuous flow of breath across your lips all night long can grossly dehydrate your lips. If you don't know if you snore, it may be worthwhile to have someone check on you periodically during the night to find out. Consider applying a protective barrier such as Nouriva Repair Moisturizing Cream on your lips come bedtime.
*Do you have psoriasis or lichen planus? Believe it or not, unusual cases of either may involve the lips. If the scale and crusting is particularly thickened, this could be the culprit.
*Is there scaling and cracking at the angles of your mouth? This is known as perleche and is due to a candida infection (yeast), which could involve the rest of the lips as well. Treatment with an oral anti-yeast preparation called Nystatin Oral Solution may do the trick. Diabetics are particularly prone to this condition which may be recurrent.
*Do you have lupus or a history of autoimmune disease? Photosensitivity may present itself on your lips. Wear a lip balm that includes a minimum SPF of 15 like B. Kamins Lip Balm SPF 20.
*Are your eyes dry and your mouth dry? You may have an autoimmune condition known as Sjogren's syndrome.
*Have a history of thyroid disease? Hypothyroidism can cause dry skin and lips.
*Too much vitamin A whether in oral supplements, prescription medications like Accutane or Soriatane, or too much in your diet may lead to peeling lips. Check the label on your supplement. If you're taking more than 25,000 IU a day you may have found your cause.
*Do you take out your stress by habitually licking or chewing your lips? Continuous contact with saliva can lead to both dehydration as well as irritation due to the enzymes present that are meant to aid in digestion. We call this habit 'factitial', which means self induced. Many people are totally unaware of these sorts of habits. Sometimes they are done in their sleep. Be candid with family and friends if you're uncertain and ask them. Find out how good a friend they are, and have someone check you periodically when you sleep too. Sometimes antidepressants or relaxing medications may be required. Often times, simple awareness of the situation goes a long way to kicking the habit.

[Alex C]

Does your student perchance use Accutane for acne? That stuff can cause droughts over large continental areas.

He is not using accutane, but that is good thinking.

Toothpaste change? I'll have him try it. He is ready to try anything.

[djwesp]

Hey boss,

This legitimately sounds like Oral Thrush. You can have it and keep it without the standard "white tongue" symptom.

[Doug Elliott]

The natural pH of skin is on the acidic side, and that protects against infection from both bacteria and fungus. Most any kind of soap makes the skin quite alkaline, leaving it unprotected, and it takes quite a while to get back to its natural acidic state.

I learned this while taking care of my elderly father who had a huge open sore on his leg that hadn't healed in two years, despite all the efforts of his doctors. I discovered on my own that after cleaning with a mild soap, the trick was to add vinegar to the rinse water, which restored the skin's acidity and the huge sore gradually closed up and healed completely.

It's worth a try. Sometimes just washing does more harm than good, and he may be doing that.

[SRanney]

Please do not offer an over the counter, topical application. This post is about a condition beyond the scope of those remedies.

I was on Accutane throughout most of middle school and suffered cracked, bleeding, chapped lips. While you asked for remedies other than topical applications, Chapstick worked for me. It wasn't instant, but it worked.

Good luck to your student.

Steven

[peter birch]

thrush infection is a possibility, many people would discount it in an "older" young person, as they might a staph infection. Have you discounted herpes simplex? It can be severe and persistent. another cause is prolonged stress. these are shots in the dark, and should be treated as such.