However, the skin on our lips is much thinner than the skin covering most of our body. And because there are no sweat glands or hair follicles on our lips, they do not benefit from the same kind of natural protection that skin on other areas of our body enjoys. Not only are our lips more vulnerable to the elements, they are more susceptible to our own bad habits as well.
Common symptoms of chapped lips include lip dryness, flaking, scales, sores, swelling, cracking, and bleeding. The main causes of dry lips include dehydration, malnutrition, and habitual licking. Saliva from the tongue can further strip the lips of moisture, causing more dryness. Lack of moisture can make the problem worse, whether the lack of moisture is due to weather or related to a lack of self-care. Lack of humidity in the air during the winter months is also known to cause chapped lips and frequent sun exposure in the summer is known to worsen the condition. Consuming caffeinated drinks or alcoholic beverages can exacerbate the dehydration that causes this condition.
Dry, chapped lips can occur in people of all ages and genders, particularly if they have dry skin. Taking certain medications can also increase an individual’s risk of developing chapped lips. These medications include vitamin A, retinoids (Retin-A, Differin), lithium, and chemotherapy drugs.

Case Study:

A regular client comes in for her scheduled facial. You cleanse and prepare her skin for treatment, noticing her lips are unusually dry and cracked. When asked about her recent activity, she explains she just spent time camping at a lake for the holiday. She spent several days playing outdoors, water skiing, and canoeing during the day and sitting by the campfire and drinking at night. Ever since her trip, her lips have been dry and irritated and she cannot stop licking them. You examine her face to find it a little dry and flaky. This client is 44 years old and, although she uses sunscreen, admits to recreational sun exposure. Her client intake form references that she does not consume water daily and lists using skin care products with retinol.

As a skin care professional, what solution would you propose to treat this case study on dry lips?

Solutions:

Dieter Kuster, M.D., founder of CA Botana International

“For clients who engage in regular outdoor activities, the key to avoiding dry, chapped skin on the lips is hydration. Hydration occurs both internally and externally. Something that is wet cannot burn easily, if at all, thus the philosophy for moisturizing well before applying sunscreen makes sense for maintenance and protection. Regularly re-applying sunscreen throughout the day helps prevent dry, cracked skin. Once the skin has been damaged, there are key ingredients to look for in a product for moisturization, hydration, protection, and prevention of further damage. This includes natural beeswax, natural oils, and sodium hyaluronate to increase moisture-holding capacity. Silicones, cocoa seed butter, and shea butter also soften cracked skin. More viscous formulations get into the skin’s cracks better than products with a waxier feel. Squalane, a natural oil from the olive pit, helps repair, hydrate, and soften skin. Sweet almond oil is also beneficial because it contains olein, an important amino acid high in vitamin E, which acts as a free radical scavenger and skin protector. It also softens skin and has antiseptic properties. Remember that daily, frequent use of a broad spectrum sunscreen and wearing a hat are wise steps to take towards healthy, soft, protected skin.”

Hyang Joo, senior manager, aesthetics at Murad, Inc.

“This client’s recent activities have all contributed to her dry, cracked lips as dehydration is caused by a number of lifestyle, environmental, and nutritional factors. Additionally, saliva contains digestive enzymes that can exacerbate the condition by over licking.
Topically, I would start by cleansing the lip area with a gentle cleanser with natural botanical oils, followed by applying a hydrating lip serum that contains ingredients such as amino and hyaluronic acids, glycerin, and shea butter. A lip mask that contains honey, allantoin, and essential fatty acids will help calm the lip, followed by an SPF balm with vitamin E to seal in moisture.
Staying hydrated internally is key in keeping your skin healthy. The client does not consume water daily, which indicates possible dehydration. It is recommend to eat more fruits and vegetables, which provide us with nutritious structured water that helps us stay hydrated through a sustained release.
Emotionally, it is vital to take time to relax. When you stress, you are likely to become more dehydrated. Skin care is health care. When we treat our clients’ skin, we need to cultivate a mindset to go beyond skin and focus on the whole person.”

Alexandra J. Zani, AEsthani Education Pathways

"There are numerous reasons why a client can experience dry lips, including periodontal disease, lipstick ingredients, allergy to nickel or other metals, red dyes, artificial flavorings in toothpaste, snoring, thyroid condition, medications, cosmetics, chemotherapy drugs, or habitually licking the lips. The skin on the lips is very thin and does not contain sebaceous or sweat glands, and no hair follicle. This makes it more prone to becoming dry or cracked. A focus for this condition is to begin with improvement of the integrity and regeneration of the few barrier layers. This includes repair from a nutrient standpoint: lifestyle alterations, dietary habits, especially adequate intake of water, fruits and vegetables, essential fatty acids (omega-3 in particular), and reduction of sugars and refined foods. Traditional lip care products often contain mineral and synthetic hydrocarbons or silicon oils, mineral oils, preservatives, and emulsifiers that can have a “wash out” effect on the skin. Instead, use a lip product that contains shea butter, jojoba oil, and vegetable oils such as olive oil and castor oil.
Evaluate her goals and commitment for correcting her overall skin concerns and let her know that you are also there to support her results. To address her total face concerns, begin with a simple hydrating facial including a gentle enzyme treatment (not on lips). Customize a mask addressing her dehydration concerns. Adjust her home care by eliminating the retinol and replacing it with a regimen that encourages barrier repair with skin mimetic ingredients: ceramides, fatty acids and cholesterols, and phosphatidylcholine."

Christine Heathman, C.M.E., L.M.E., L.M.T., owner and CEO of GlyMed Plus

"The treatment of this client must begin with a thorough pre-treatment examination to ensure the cleansing preparation meets the needs of her changing skin condition due to her outdoor environmental exposure, coupled with treatment products and application methods, juxtaposing the individual’s uncommonly dry skin and lips. Although this client diligently uses sunscreen, acute ultraviolet radiation from the sun induces erythema caused by the dilation of dermal blood vessels, and creates edema, dry skin and burning that exacerbates dehydration of both skin and lips. Her use of retinol is not of a concern as she practices SPF diligence.
Due to the age of this client, I will make the assumption she is in either a peri-menopause or menopause stage of life. Menopause affects surface corneocytes with additional transepidermal water loss, stratum corneum hydration, water-holding capacity, and moisture accumulation. Exposure to the environment increases the skin’s water loss causing dryer skin.
A treatment of a protease lip peel will help remove the dead skin and normalize the lip skin. Use of a deep lip hydration application and direction for the client to use a lip-specific product with ceramides and lipids to treat and protect the lips will support the healing.
Treatment options to reduce emotional stress of the client should incorporate a gentle Protease skin-surface peeling to remove dead corneocytes, balance the basal cell and stratum layer, and stimulate lamellar activity to help rebuild hydration in the stratum corneum, in conjunction with a deep hydrating menopausal treatment, and coupled with the proper home maintenance."

Sanjiv Saini, M.D., medical director at MD Dermatology of Maryland

"One of the biggest offenders of dry lips is licking the lips too frequently. Saliva has digestive proteins that over time can cause dermatitis of the lips. Other additive factors are dry air and low humidity. One of my favorite natural remedies for dry lips is coconut butter or coconut oil. Coconut oil is made of medium chain fatty acids, which are easily absorbed by the skin and are an excellent emollient and moisturizer. Relating to the case study, since this client is active in multiple outdoor activities and will have environmental effects, the retinol she is using will make her sun sensitive. I suggest removing the retinol in this case and her condition should respond rapidly. I would let the client know the benefits and offer a treatment specific to their individual needs."

Melissa Picoli, L.E., founder of BijaBody health+beauty

“As an aesthetician, there are multiple issues to resolve with this client. First and foremost, her use of retinol during summer months filled with outdoor activities needs to be addressed. I would ask her to switch to a high-antioxidant product during recreational months and return to retinol during winter months. Internal dehydration is certainly an issue, but for lip health, internal fat intake is more crucial. I would ask her if she consumes adequate healthy fats such as avocados and olive oil, and recommend an increase in a supplement such as borage oil. Skin cannot hold onto water without adequate fat. In the interim, to help her lips heal, I would recommend a honey treatment: use raw honey to massage lips every morning and night and leave on for a few minutes until it heals, followed by a rich, peptide-filled lip treatment. The honey will reduce inflammation and prevent further damage.”

Liga Upeslacis, M. Sc., project manager for B. Kamins Laboratories

“I would let the client know that her lips are chapped, and the most important thing is to protect the lips. Dry, chapped, cracked lips are vulnerable and need to be protected with petrolatum or natural oils. There are a few options, as long as it is occlusive, simple, non-irritating, such as coconut oil, olive oil, and vitamin E. I recommend petrolatum over waxes because of the slip. The client should reapply often. Dermatological treatments are most effective when they are in constant contact with the skin. The client should like the way it makes her lips feel and she should notice some improvement in a few days.
Chapped lips can be treated with behavioral modifications. She should rest, sleep, and drink herbal tea and water. Having her lips be in contact with clean water will help the healing.
When her lips feel strong again, we can begin the cosmetic treatment. I would recommend a gentle exfoliation by rubbing very gently with a gentle wash cloth wet with warm water, and following it with a nourishing lip balm or natural oils, or tree spa extract of birch or maple. Drinking a lot of water is a great way to maintain overall health.”