Oral Essentials

The previous article discussed xerostomia (dry mouth) as a side effect of chemotherapy. Unfortunately, dehydration of tissues is not restricted to the mouth alone and one of the side effects of chemotherapy one never considers is dry, chapped and cracked lips.

Mouths are like sensitive eco-systems. Just as the bushveld requires adequate drainage, hydration, nutrition and protection, mouths affected by cancer treatment need the same loving care. Gargling and swishing with therapeutic mouth washes should commence on the first day of treatment and continue until such treatment has been completed. The last thing you need, on top of everything else, is a painful mouth ulcer. If you have been remiss with the gargling, and can feel an ulcer coming on, chemists have a number of over-the-counter medications in gargle, gel or spray form.

The previous article discussed xerostomia (dry mouth) as a side effect of chemotherapy. Unfortunately, dehydration of tissues is not restricted to the mouth and one of the side effects of chemotherapy one never considers is dry, chapped and cracked lips.

The medical term for chapped lips is Cheilitis. Cheilitis can be caused by a number of factors, but is exacerbated by chemotherapy. Chapped lips are swollen, red, cracked and sensitive to touch. The lips may look and feel scaly, dry and cracked. Peeling of the lips due to dehydration is common and the mouth may appear to be larger as the redness of the outline of the lips blends in with the surrounding skin.

NB: Angular cheilitis is a fungal infection of the corners of the mouth which can result due to the immunosuppressive action of chemotherapy drugs. This condition can be managed by anti-fungal medications as well as proper lip care.

Causes of chapped lips include exposure to cold, dry air (indoors and outdoors), the wind, excessive sun exposure, mouth breathing, licking the lips, dehydration, high fever and contact with allergens or irritants around the mouth (such as lipstick dyes). A lack of essential fatty acids and / or vitamins (B Vitamins can reduce the risk of developing chapped lips, Vitamin E protects fatty acids and oils and Zinc speeds up healing), poor diet and dehydration may result in chapped lips. Medications, especially retinoids, chemotherapy agents, lithium and high doses of Vitamin A are known culprits in the cause of cheilitis. It has been reported that patients with autoimmune disorders may present with a photosensitivity on the lips that leads to chapped lips.

PreventiNG and TreatING

• Seal in moisture with a lip balm that contains waxes, lanolin or petroleum based products.

• Aloe Vera Cream and Calendula are soothing to the lips.

• Apply cool, salt-water soaked cloths to the lips to hydrate the lips.

• Apply sun-screening lip balm before venturing into the sun.

• Avoid frequent lip licking.

• Use a humidifier when possible.

• Increase water intake in the winter months to help hydrate the lips.

• Never hold items in the mouth, especially metal objects such as paper clips, and avoid licking envelopes.

Lipsticks: 

Lipsticks should only be used when lips are in a good condition.

Some lipsticks may cause allergies which result in a dryness of the lips. Those should be disposed of immediately.

Ensure that your lips are well moisturized and hydrated before applying lipstick to prevent dryness and flaking of the lips. A lip conditioner or lip balm can be used to achieve this.

Use a lip liner to add extra definition to your lips and choose a shade that matches your lipstick.

A creamy lipstick has the added  benefit of moisturizing and hydrating the lips.

Written by Dr Carina van der Linden