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People’s Pharmacy: Keeping lips comfy in the cold

Lips take a beating at this time of year. When the weather turns cold and dry, lips chap and crack. Dermatologists call this condition cheilitis. Readers sometimes refer to it as “clown mouth.” Whatever the name, it is uncomfortable and unsightly.

One factor contributing to chapped lips is licking. Healthy lips normally have a thin layer of natural oil that helps keep them moisturized. Licking removes this, and they dry out. This can become a vicious cycle. The drier your lips, the more likely you are to try to relieve the discomfort by licking them, which only makes things worse.

Decades ago, we heard from a reader who offered an anecdote of dubious veracity: “I was visiting my uncle’s ranch one day when I saw a ranch hand squat down, drag his finger through fresh chicken manure, and smear it on his lips. I said, ‘Unk, that’s not good for chapped lips, is it?’ ‘In a way,’ my uncle said. ‘It’ll keep you from licking ’em.’ ”

There are better ways to heal chapped lips. Many people use lip balm to moisturize this delicate tissue. But choosing a product requires care. Many lip balms contain sunscreen. While this can be helpful against excessive sun exposure, some ingredients actually trigger an allergic reaction in sensitive individuals. Other sensitizing compounds include lanolin, vitamin E and peppermint.

People report that certain toothpastes make the problem worse. Sodium lauryl sulfate, or SLS, has been identified as contributing to canker sores, also called aphthous ulcers (Deutsches Ärzteblatt International, Oct. 3). SLS also may make chapped lips and angular cheilitis worse.

Angular cheilitis, sometimes referred to as perlèche, is inflammation at the corners of the mouth. One reader described her ordeal: “I had angular cheilitis for more than a year and looked like a clown! I finally discovered it was caused by tartar-control toothpaste with tetrasodium pyrophosphate. Avoiding it solved the problem.”

Other readers have reported that angular cheilitis can sometimes be cleared up by anti-fungal preparations. One person wrote: “I had red, wet cracks at the corners of my mouth. I began using Mentholatum on my lips every night, and that cleared it up.”

Mentholatum, like Vicks VapoRub, contains the anti-fungal compounds camphor and menthol. These ingredients should not be swallowed, so they must be used with care and should be avoided by people who are going to lick their lips.

Another popular product that people use to treat perlèche is Listerine, possibly because it, too, contains herbal oils with anti-fungal activity.

Here’s one report: “I suffer from occasional bouts of angular cheilitis. I find that applying Listerine to the sores helps eliminate the problem within a few days.”

Angular cheilitis also may be a red flag for nutritional deficiency. As one reader reported: “I suffered from chronic angular cheilitis for years. A nutritionist eventually identified the problem as B vitamin malabsorption. I started taking B vitamins sublingually (under the tongue), and I have not had any cheilitis for more than a year and a half.”

Learning not to lick the lips is a crucial first step in keeping them healthy. Dealing with chapped lips and angular cheilitis may require further detective work to find and eliminate the underlying problem.

Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio. In their column, Joe and Teresa Graedon answer letters from readers. Write to them via their website: