Lips (sore or dry)

Sore or dry lips, medically referred to as cheilitis or xerostomia of the lips, are a common condition that can cause discomfort, cracking, peeling, and pain. While often harmless and temporary, persistent lip soreness or dryness may indicate an underlying medical issue that requires attention.

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Causes

1. Environmental Factors

   • Cold, dry, or windy weather

   • Prolonged sun exposure without lip protection

2. Lifestyle and Habits

   • Frequent lip licking (saliva evaporates and worsens dryness)

   • Dehydration or inadequate fluid intake

   • Smoking or alcohol consumption

3. Allergic and Irritant Reactions

   • Reaction to toothpaste, lip balm, lipstick, or sunscreen

   • Metal allergies (nickel in braces or dental appliances)

4. Nutritional Deficiencies

   • Vitamin B2 (riboflavin), B6, B12

   • Iron deficiency (often linked with angular cheilitis)

   • Zinc deficiency

5. Medical Conditions

   • Angular cheilitis (painful cracks at mouth corners, often due to fungal or bacterial infection)

   • Atopic dermatitis or eczema

   • Psoriasis

   • Diabetes mellitus (due to dehydration and susceptibility to infections)

   • Hypothyroidism (slower metabolism affects skin/lip hydration)

   • Sjogren’s syndrome (autoimmune disease causing dry mouth and lips)

6. Medications

   • Isotretinoin (for acne)

   • Chemotherapy drugs

   • Diuretics

   • Antihistamines (dry mouth side effect)

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Symptoms

• Dryness, cracking, or peeling of lips

• Burning or stinging sensation

• Redness and tenderness

• Painful fissures, especially at the corners of the mouth

• In severe cases, bleeding or infection

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Diagnosis

A healthcare professional may conduct:

• History & Examination: Identifying triggers (diet, environment, medications).

• Blood Tests: Checking for nutritional deficiencies or systemic disease.

• Swabs/Cultures: If infection (fungal/bacterial) is suspected.

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Treatment

1. General Measures

   • Stay hydrated by drinking adequate water.

   • Use fragrance-free, hypoallergenic lip balms containing petrolatum, shea butter, or beeswax.

   • Avoid licking lips and exposure to irritants.

   • Use a humidifier indoors if air is dry.

2. Nutritional Supplements (if deficient)

   • Vitamin B complex (e.g., riboflavin 5–10 mg daily, B12 injections/oral supplements as prescribed).

   • Iron supplements (ferrous sulfate 325 mg orally once or twice daily, under medical guidance).

   • Zinc supplements if deficiency confirmed.

3. Medications (for underlying causes)

   • Antifungal creams (clotrimazole, miconazole) for angular cheilitis caused by Candida.

   • Topical antibiotics (mupirocin, fusidic acid) if bacterial infection is confirmed.

   • Topical corticosteroids (mild hydrocortisone cream 1%) if linked to eczema/dermatitis.

4. Specialized Care

   • Management of systemic conditions such as diabetes, hypothyroidism, or autoimmune disorders.

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Precautions

• Avoid irritants like flavored lip balms or harsh toothpaste.

• Always use lip balm with SPF in sunny environments.

• Don’t peel or bite at dry skin on lips (risk of infection).

• Seek medical help if dryness persists despite self-care.

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Drug Interactions

• Iron supplements may reduce absorption of some antibiotics (e.g., tetracyclines, fluoroquinolones).

• Vitamin B6 (pyridoxine) may reduce effectiveness of levodopa unless combined with carbidopa.

• Antifungal creams (e.g., clotrimazole) may interact with oral anticoagulants like warfarin (if systemically absorbed).

• Topical corticosteroids should be used with caution alongside immunosuppressants due to additive effects.