I have just read a new case report on Exfoliative Cheilitis. The study included a case of 21 year old male. He presented with peeling of lips over his vermilion border. He tried Calendula lip balms of various brands, vitamin B5 or hyaluronic acid gels. All of these did not work. There is some improvement with Vitamin E 300 IU a day and Dermosupril 0.1% cream (Desonide; Megalabs Chile S.A).
At clinical examination by the physician, it is noted that both lip vermilions are covered by thick, adherent, whitish-white scales, some of them large, but when removing them, normal-appearing epithelium of the lip is evidenced. I think this is how most Exfoliative Cheilitis sufferers will describe the condition. Like after getting in touch of water or whatever reason with the peeling of that white scale/skin, more normal looking lips are underneath. The patient in the case report also reported regular picking or sucking of his lips since young.
They did investigations including blood tests and an incisional biopsy of the lips. Blood tests are normal. Looking the biopsy lip sample under microscope showed epithelium with hyperplasia, papillomatosis and hyperkeratosis of the parakeratoysis type, without atypia, at the superficial level hyphae and yeasts were identified, as well as bacterial superinfection with exocytosis of some neutrophils. In layman terms meaning the lips cell keep on growing and there is a bit of infection, but no malignancy or stuff.
The patient was put on Diflucan 150mg (Fluconazol; Pfizer PGM, France) is prescribed once a day for 10 days and asked to keep balanced diet and hydration. Also advised a lip balm with SPF protection. The patient chose one called Labello Hydro Care SPF 15 (Natural oils; BDF México S.A.), also using a vitamin E capsule every 8 hours applying a little of that oil instead of the lip balm. 3 months later the follow up showed much improvement.
So I guess the key is to keep hydration, a balanced diet, and regular lip balm use. Also, a big thing is to manage your stress, as it’s shown to worsen exfoliative cheilitis.
Boza-Oreamuno, Y. V., & Mena-Lizano, A. (2022). Exfoliative Cheilitis More than an Aesthetic Problem: Case Report. Odovtos – International Journal of Dental Sciences, 133-141. https://doi.org/10.15517/ijds.2022.50022