Exfoliative Cheilitis

What is Exfoliative Cheilitis?

Exfoliative Cheilitis is a chronic skin condition in the lips characterized by continual peeling followed by dryness and flakes. It arouses pain and discomfort while eating in addition to burning, fissures and cracks. Also called eczema and mostly affects adults below 30 years. It primarily affects females more than males.

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Types of Cheilitis

• Angular Cheilitis: Caused by excessive drooling typically seen in children and aged, it affects the corner of the mouth leading to cracks, redness, blistering and bleeding.
• Actinic Cheilitis: Characterized by lower lip thickening and dryness, it is caused by excess sunlight exposure especially in the tropical areas. It can develop cancer in the long run.
• Granulomatous Cheilitis: It appears due to repressed conditions like allergy, cancer, infection, Crohn’s disease and sarcoidosis. It often causes swollen lips, headache, fever, etc.
• Exfoliative Cheilitis: It is a rare condition with HIV infections, lips biting, poor oral hygiene, etc.
• Cutaneous Lupus Erythematosus: It affects joints, skin, and tissues causing rashes on the cheeks.
• Lichenoid Cheilitis: It affects the skin around the lips that turn whitish and develops an appearance similar to the plaque. It mostly occurs in patients suffering from lichen planus.
• Eczematous Cheilitis: It is a condition of cracking, itching and peeling of the lips. It is caused by irritants, allergens, lipsticks etc.
• Cheilitis Glandularis: Enlargement of lower lip due to smoking, biting and excessive sun exposure.

Peeling Cycle of Exfoliative Cheilitis

• Day one: On the first day, lips are quite healthy where changes in the skin cells will be underlying.
• Day two: Lip borders start declining with a reddish outline. The irritation prevails while eating or talking as it stretches.
• Day Three: On this day, lips harden with inflammation in addition to uneven flaking of the lips causing pain, bleeding, burning and tingling sensation.
• Day Four: Similar to the third day it is coupled with the appearance of more flakes. It can worsen due to improper care.

Exfoliative Cheilitis Causes

• Hiv Infection: The patient acquires immune deficiency which results in different health and skin problems including cheilitis.
• Factitious Damage: It is a condition when a person develops symptoms indicating they are suffering from an illness. These factors lead to the development of Exfoliative Cheilitis due to lip sucking, lip biting, mouth breathing, lip licking, etc.
• Poor Oral Hygiene: Poor health causes virus, fungi, and bacteria to increases pathogens causing abnormal lip peelings.
• Depressed Immunity: Although Keratin is essential, it is received as a foreign body. A depressed immunity makes the immune system guard against it resulting in inflammation and lip peeling.
• Nutritional Deficiency: Among primary reasons, nutritional deficiency results in the incomplete creation of keratin.
• Allergy: It is not common, but a possible cause of Excessive Cheilitis.
• Candida Yeast Overgrowth: It is a mouth infection caused by yeast named Candida albicans which thrives in the human body in a limited quantity. Yeast remains inactive for some duration until aroused and starts an infection.
• Antibiotic Therapy: Due to long-term consumption of antibiotics it creates an microbial imbalance inside the body.

Exfoliative Cheilitis Symptoms

• Fissuring or ulceration of the lip
• Dryness of the lips
• Burning and itching sensation on affected part of the lips
• Lip discoloration
• Swelling of Lip
• Tingling sensation on the affected part

Exfoliative Cheilitis Diagnosis

• Lab Investigations: Biopsies and oral swabs help to figure out the unexpressed problem of the disease. Oral swabs are also called culture swabs that are done to eliminate candida, herpes simplex, and staphylococcus bacteria. A biopsy can help to determine a precancerous lesion or a lichen planus.
• Detailed History: Physician will ask several questions to know the history of the disease or will want to know about the related symptoms or complaints. However, the questions might include denture history, skin conditions, oral care, drug history, medicines, smoking habits, nutrition, etc.
• Physical Examination: Overall examination helps in diagnosing the possible symptoms.

Exfoliative Cheilitis Treatment

Exfoliative Cheilitis has no particular treatment, but few methods can help in easing its symptoms. As it is a severe condition, it requires a long-term medication, therapy or management to stop the recurring situation. Treatments goals are also aimed towards the repressed conditions which trigger the problem. Hence, it is essential to treat these conditions first.  Some common treatments include:

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• Application of lip balm regularly
• Tacrolimus or local steroid application in some cases
• Nutritional supplements to fulfill deficiencies
• Antifungal, local antiseptic and antibiotic ointment application on the affected parts
• Keep body hydrated by drinking plenty of fluids
• Inclusion of vegetables and fruits in the diet
• Maintaining oral hygiene
• Wet cold compress is beneficial

Preventions of Exfoliative Cheilitis

• Adopt healthy diet (Include foods rich in vitamin B12, zinc  and Vitamin A)
• Get rid of toxins
• Get a good sleep
• Drink plenty of water
• Maintain proper oral hygiene
• Use balms and keep lips moisturized
• Exfoliation
• Avoid smoking
• Avoid using allergic cosmetics which include lipsticks, lip liners and concealers
• Clear Digestive tracts
• Control lip biting, lip picking habits