Exfoliative cheilitis (EC) is a chronic, recurrent, inflammatory condition characterized by excessive peeling of the vermilion lips. EC is more common in women younger than 30 years and involves the lower lip more often than the upper. EC is thought to be caused by repetitive behaviors that increase moisture (eg, lip licking or sucking) and trauma or friction (eg, lip picking or biting), although, in some cases, a habit cannot be identified. These insults induce hyperkeratosis of the vermilion, which clinically leads to excessive scaling and peeling.

Depending on the severity of cheilitis, swelling, rhagades (fissures and cracks), erosions, and hemorrhagic crusting can occur in addition to peeling. Associated symptoms may include pruritus, tingling, pain, and difficulty with speaking or eating. Although the association is not well studied, depression and personality disorders have been reported in patients with EC.

Related topic: lip-licking dermatitis