Exfoliative Cheilitis

By Editorial Team on March 17, 2018 in Diseases and Conditions

What is Exfoliative Cheilitis?

This chronic skin condition refers to the process of an individuals lips being consistently dry, peeling off and flaking off. There is a constant process of peeling of the lips, which can often reveal the raw skin, causing burning, irritation, and fissures. This condition can be painful, as constant dryness and peeling of the lips revealing the raw skin can lead to increased sensitivity and even difficulty in eating, drinking, and speaking.
This condition, however, is not a common occurrence. There are very few reported cases of exfoliative cheilitis, and this condition can be seen to mostly affect young adults under the age of 30.
While exfoliative cheilitis is not a life-threatening condition, this condition could reveal several other underlying issues going on in the individual’s body. This condition could reveal conditions such as increased amount of toxins in the body, dehydration, or vitamin deficiency.

Symptoms of exfoliative cheilitis

The condition Exfoliate cheilitis is characterized by extremely dryness, cracking and peeling of the lips. This occurs mostly in the outer part of the lips and is more common on the lower lips than the upper lips. However, both upper and lower lips are affected by this condition. The vermillion portion of the lip become reddish and the skin thickens, before it starts peeling off in bits and pieces. Eventually, the peeling of the lips becomes so intense that the raw skin of the lips is exposed, making the individuals lips have a burning sensation.
The other symptoms of exfoliative cheilitis include:
• Swelling of the lips
• Itching, burning and tingling sensation on the lips
• Extreme dryness of the lips
• Ulcerations and fissures, cracks on the lips
• Discoloration of the lips
• Hemorrhagic crusting on the lips

Causes of exfoliative cheilitis

The particular causes of exfoliative cheilitis are yet to be discovered. However, the onset of exfoliative cheilitis can reveal a host of other conditions and diseases, which, the sooner they are discovered, the better.
1. Factitious damage- This occurs when an individual, due to several reasons such as stress, anxiety, self-destructive behaviours, etc. can engage in damaging activities such as lip sucking, lip biting, mouth breathing, picking on the skin of their lips either consciously or subconsciously, constant lip licking which can dry the lips, etc.
2. Candida Yeast overgrowth- Caused by a fungal mouth infection known as Candida albicans, the yeast infection can be one of the causes of exfoliative cheilitis. This infection has the ability to remain dormant in the body of the host for a long time, however, any trigger can cause the infection to spread again.
3. Poor oral hygiene- This can give birth to a lot of diseases such as bacteria, fungi, infections, which can result in peeling of the lips, dryness and exfoliative cheilitis.
4. HIV infection- This autoimmune infection can cause the body of the host to not be able to fight off diseases, bacteria, and viruses. This can cause various diseases which can have symptoms causing exfoliative cheilitis.
5. Depressed immunity- This causes a person’s body to be fooled into believing that the keratin naturally produced by their body is a foreign substance. The body then tries to clear out this keratin, leading to irritation, inflammation, and peeling of the skin of the lips.
6. Nutritional deficiency- The deficiency of the body to either absorb nutrition properly through the intestines or if the individual is not taking a nutritious diet for a long time, can cause the body to have a defective formation of keratin. This can cause many of the symptoms of exfoliative cheilitis.
7. Allergy- Certain allergies can cause the symptoms of exfoliative cheilitis.
8. Antibiotic therapy- Certain antibiotics, when consumed for a period of time, can cause the effects of exfoliative cheilitis to occur.
9. Liver malfunction- Often, if the liver of a person is dysfunctional, it can cause excess toxins to be produced in the body. This can cause exfoliative cheilitis.
10. Response to dental implants- Often, an individuals body might have a reaction or an infection caused by the response to dental implants, causing exfoliative cheilitis.
11. Extreme stress or anxiety- An individual who is suffering from extreme stress and anxiety or other psychological disorders might indulge in acts of self-destructive behavior, such as biting of the lips, sucking the lips, peeling off the skin of the lips, constant licking the lips, etc.

How can exfoliative cheilitis be prevented?

• Healthy eating habits, getting proper nutrition and vitamins can prevent this condition from occurring.
• Protecting oneself against pollution, dirt, dust, smoke, etc.
• Keeping your lips hydrated by using creams, gel, and balms and also keeping yourself hydrated by drinking enough fluids.
• Keeping good oral hygiene.
• Ensuring you are away from situations that induce stress and anxiety.
• Not taking any medication without being informed about all the side effects.
• Not indulging in behaviors such as lip licking, bit biting, picking on the skin of the lips, etc.
• Getting rid of toxins from the body.
• Clearing the digestive tract.
• Maintaining a good sleep cycle.

Other related/linked diseases

Exfoliative cheilitis is mainly caused due to underlying conditions and diseases. Some of these diseases and conditions are:
1. HIV infection
2. Candida yeast overgrowth
3. Staphylococcus aureus
4. Liver malfunctioning

When should you see a doctor?

The condition of exfoliative cheilitis is not a life-threatening one, neither is it contagious. The condition can, however, cause a great deal of discomfort, pain, swelling, infection and be aesthetically discomforting to individuals suffering from it.
It is important for an individual to see a doctor when they are experiencing pain, swelling and difficulty in talking, eating or drinking due to this condition. The doctor may be able to diagnose certain underlying conditions causing exfoliative cheilitis.

Complications

Left on its own, exfoliative cheilitis will not have any serious complications, leaving aside the fact obvious sensations of pain and even bleeding due to the extreme dryness and peeling of the lips. The raw, exposed portion of the lips may, however, get infected, causing more pain and swelling.

Treatment of exfoliative cheilitis

Home remedies:

1. Proper hydration, exfoliation and taking care of the lips
2. Applying coconut oil or olive oil to hydrate the lips
3. Applying glycerin and the cream of milk to the lips for ten minutes
4. Applying sunscreen, cream, moisturizer and lip balms
5. Application of a paste made of milk and crushed rose petals
6. Lotions containing lactic acid in them
7. Practicing good, healthy oral hygiene
8. Including organic foods and having a nutritious diet
9. Taking supplements and vitamins to avoid deficiency
10. Cold compress with water on the lips
11. Exfoliation using homemade remedies such as oatmeal powder, rice powder, etc.
12. Keeping the body well hydrated by drinking plenty of water
13. Avoiding picking the skin off the lips, biting, chewing, licking and sucking one’s own lips
14. Increasing vitamin B, Zinc, and Iron intake
15. Taking natural probiotics to clear out toxins and the digestive system
16. Keratolytic lip balm application
17. Antifungal creams

Surgical procedures to treat exfoliative cheilitis:

1. Photodynamic therapy
2. Electrocautery
3. Cryosurgery
4. Scalpel vermilionectomy
5. Laser treatment

How to test for exfoliative cheilitis?

It can be difficult to test for exfoliative cheilitis, as more often than not, the symptoms of this condition are caused by other underlying diseases or conditions. These underlying conditions must be tested for. However, a doctor can test for candida yeast infection, and even take a biopsy to test for other diseases.

Differential diagnosis of exfoliative cheilitis

The differential diagnosis of exfoliative cheilitis include:
• Atopy
• Candida yeast infection
• Hypervitaminosis A
• Actinic cheilitis
• Cheilitisglandularis
• Contact dermatitis
• Photosensitivity

Medicines and therapies

1. keratolytic lip balms
2. sunscreens, moisturizers and creams
3. lactic acid lotions
4. antifungal cream
5. topical steroids
6. systematic steroids
7. antibiotics
8. cryotherapy

Diagnosis of exfoliative cheilitis

There are no specific tests to diagnose exfoliative cheilitis. This is because this condition can be caused by a secondary effect of some other primary disease or condition.
• A doctor can take swabs to test for candida and Staphylococcus aureus.
• A biopsy of the peeling of the skin can be taken.
However, psychiatric assessments must also be conducted as they can be extremely helpful in the treatment of certain disorders such as anxiety disorders, mood swings, and other conditions which can cause exfoliative cheilitis.

Prognosis of exfoliative cheilitis

Exfoliative cheilitis is a non life-threatening, non-contagious condition. However, this condition can cause a lot of embarrassment and discomfort to the patient. There are several underlying causes of this condition, and these conditions must be taken care of. However, even after treatment of these conditions if the symptoms of exfoliative cheilitis do not fade away, a doctor must be visited for proper diagnosis and treatment.
After proper treatment and medication, it can be seen that the symptoms of exfoliative cheilitis are gone completely, with full remission. This treatment can take anywhere from a few months to one year time.