Cheilitis is a chronic, recurrent, superficial inflammatory disease of the lip mucosa. During acute episodes, the main symptoms include redness, swelling, pain, exudation, and erosion, while the chronic phase is characterized by dryness of the lip margins, scabbing, cracking, and recurrent desquamation.This condition falls under the TCM categories of “Chun Feng” (唇风) and “Jin Chun” (紧唇), withredness, swelling, dryness, and itching as the four main symptoms.Redness and swelling are attributed to dampness and heat.Dampness leads to swelling; “all dampness and swelling belong to the spleen”. When the spleen’s qi and yin are insufficient, yin deficiency leads to internal heat. The convergence of these two heats ascends along the meridians to the lips, causing pain due to excessive heat, resulting in red, swollen, and painful lips, with dampness manifesting externally as occasional exudation. “Dampness is sticky in nature,” which is why this condition often lingers and is difficult to cure, leading to prolonged illness and signs of blood stasis such as dark purple lips.Itching is attributed to wind.When wind is excessive, it causes itching. Wind is a yang pathogen that transforms into heat, which then dries and injures body fluids. Excessive dryness leads to “dryness”, and with yin deficiency, nourishment is lost, causing patients to frequently feel itching and dryness in the lips.Using TCM theory, cheilitis can be classified into four patterns:
01 Wind-Heat ExcessCommonly seen during acute onset, characterized by rapid onset, red, swollen, and painful lips, cracking with exudation, resembling skinless conditions, accompanied by itching, occasional twitching, halitosis, dry stools, yellow urine, red tongue with yellow or greasy coating, and a slippery or rapid pulse.Treatment principle: Clear heat and cool the blood, disperse wind and eliminate pathogens.Recommended medication:Xiao Feng Zhi Yang Granules (消风止痒颗粒)Effect:Xiao Feng Zhi Yang Granules primarily disperse wind and clear heat, used to treat wind-heat excess type cheilitis, clearing internal heat and alleviating redness and itching symptoms.Precautions: Not suitable for pregnant women; those with yin deficiency and blood deficiency should avoid it; during medication, a light, easily digestible diet is recommended, avoiding spicy and seafood foods.02 Spleen-Stomach Damp-Heat
Swelling and redness of the lips, heat and itching, small blisters and exudation, severe cases may lead to erosion and bleeding, with perioral skin redness, often accompanied by dry throat, bitter mouth, lack of desire to drink, poor appetite, short and red urine, irritability, red tongue, yellow greasy coating, and a slippery pulse.
Treatment principle: Clear and drain stomach heat, transform dampness and reduce turbidity.
Recommended medication: Qing Wei Huang Lian Wan (清胃黄连丸) + Si Jun Zi Wan (四君子丸)
Effect:Primarily using Qing Wei Huang Lian Wan, supplemented with Si Jun Zi Wan, one aspect drains fire and detoxifies, while the other strengthens the spleen to eliminate dampness.
[For external use: For the above two patterns, external application of green tea mixed with Ruyi Jin Huang San (如意金黄散) can be used.]
03 Fluid Deficiency and Blood Dryness
Dryness and desquamation of the lips, often recurring scabs, severe cases may lead to cracking and bleeding, rough lips with deepened folds, often accompanied by overall skin dryness, dry mouth with a desire to drink, dry stools, pale red or red tongue with little coating, and a thin pulse.
Treatment principle: Nourish yin, generate fluids, nourish blood, and moisten dryness.
Recommended medication: Zhi Bai Di Huang Wan (知柏地黄丸) + Xuan Mai Gan Qi Granules (玄麦甘桔颗粒) + Si Wu Decoction (四物合剂)
Effect:Primarily using Zhi Bai Di Huang Wan and Xuan Mai Gan Qi Granules to nourish yin and generate fluids to moisten dryness, supplemented with Si Wu Decoction to tonify deficiency and nourish blood, specifically targeting fluid deficiency and blood dryness type cheilitis.
04 Yin and Blood Deficiency, Spleen Dampness Dysfunction
Slow onset, swelling and dryness of the lips, burning pain, frequently moistening with the tongue, desquamation at the affected area, dryness and itching or cracking with exudation or bleeding, lingering and difficult to heal. Symptoms worsen in cold seasons, dry mouth or sticky tongue, often accompanied by insomnia and vivid dreams, lower back soreness, five hearts heat, red tongue, white greasy coating, and a thin pulse.
Treatment principle: Nourish yin, tonify the kidneys, strengthen the spleen, and eliminate dampness.
Recommended medication: Liu Wei Di Huang Wan (六味地黄丸) + Shen Ling Bai Zhu San (参苓白术散)
Effect: Used to treat yin and blood deficiency, spleen dampness dysfunction type cheilitis.
[For external use: For the above two patterns, applying an appropriate amount of olive oil to the affected lips, after moistening with cool boiled water, provides moisturizing without greasiness.]
TCM treatment, as mentioned above, is often based on different patterns to select corresponding treatment principles. It primarily combines internal treatment with external medications, offering unique advantages in treating difficult-to-cure and recurrent cheilitis.
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