Dealing with red or dry lips

Because lips are what someone may first notice about your face, red or dry lips can be a confidence killer, writes Stella Nakakande. Carol is happy with most of the parts of her body except her lips. “They have always been dry. I have used so many things, in vain. I used lip balms till I was told they could actually worsen the situation. So I changed to petroleum jelly which sometimes works. But there are days I do all those things magazines and medical books recommend; drinking water, eating fruits etc., and I still end up with chapped lips. It is annoying.”

Lisa’s (not real name) problem is slightly different. Her lips are always red. This has earned her funny and sometimes terrible nicknames from way back in school. Worse still, her “problem” sometimes comes with HIV/Aids stigma since it is a common belief that the latter is synonymous with red lips.

If constant application of lip balm does not seem to solve any of the above problems, what does?

Lips according to Dr Ronald Ssentongo of the Department of Plastic Surgery in Mulago Hospital, are a bunch of muscles lined by mucosa (mucus membrane) on the inside and skin on the outside. “The mucosa next to the opening of the mouth called the wet mucosa, is thin and represents a transition from the inside of the mouth which is pink and the outside, red. The dry mucosa forms the remaining part of the lip,” he adds.

Red lips therefore mean, he explains, the occurrence of lips which appear as a darker colour than what is considered the normal red spreading beyond the normal margins. The causes are classified and the first class is the congenital causes group, present before the person is born. Under this class are various examples, one of which is the fact that people in certain tribes naturally have darker pigmentations of their mucosa than others.

Albinism and vitiligo referred to locally as abalongo bamwokya are also under this class. An albino has partial or complete absence of skin pigment. Vitiligo on the other hand occurs in patches and the skin cells responsible for pigmentation in this case are either dead or unable to function. There is also a tendency for some lesions to hyper pigment (have more colour) around the edges.

The second class of causes is those that occur after one is born, Dr. Ssentongo adds, an example being repetitive trauma to the lip. “This may happen in people whose teeth are mal-aligned; the teeth project outwards and come in contact with the lips,” he notes. It may be slight contact and easy to ignore but given that it is recurring the effect is cumulative and therefore detrimental.

Infections from viruses, like HIV, herpes simplex and measles and fungus like Candida (found in areas with lips hence its existence in the female sexual organ), could also lead to one having red lips.

The doctor further notes that injuries due to radiation for example from the sun especially for those with no or insufficient amounts of protective pigmentation like whites and albinos fall under the second class of causes. “The radiation leads to actinic keratitis, a condition in which the skin becomes inflamed, particularly in areas that have been exposed to sunlight. The lips become dry, they crack and are then red,” Dr Ssentongo notes. Tumours which affect the mouth, the skin both inside and outside the mouth, and malnutrition usually to do with deficiency of certain vitamins and micro-nutrients are some of the causes. And so are the autoimmune and hypersensitivity reactions.

In the autoimmune reaction, one’s body destroys their own cells, while in hypersensitivity, there are damaging, discomfort-producing and sometimes fatal reactions produced by the normal immune system. Despite this, 65 per cent of the causes of red lips are unknown, Dr. Sentongo further notes.

As earlier said though, red lips are not the only problem, dry lips with a chapped skin are too. And according to nutritionist Michael Kibuule of Kim’s Medical Centre on Kampala Road, these too have their causes, the first of which is malnutrition and in this case a deficiency of vitamin B –complex.

The complex is made of Vitamins B1, 2, 3, 5, 6, and12. “These vitamins are water soluble and are found mainly in fruits, avocado and berries, although maize bran, wheat bran and other cereals have much more quantities of this group of vitamins,” he says. Animal products like liver, chicken, beef, fish, dairy products, eggs and plants sources like legumes are other sources.

Some of these vitamins though are manufactured in the digestive system with the help of the normal bacteria that live there. So the appearance of dry lips may be symptomatic of a defect in this system.

And given that deficiency of each of the vitamins above leads to a certain condition for example, deficiency of B1 leads to night blindness and B2 pellagra; dry lips may be an early symptom of any of these, Mr. Kibuule adds. It is necessary then for the doctor to ascertain what deficiency it is, he adds.

Vitamin B aside, deficiency of vitamins A and C or even water in the body could also manifest through dry chapped lips. Exposure to certain environments or conditions also brings about the condition. “They can also be as a result of allergic reactions to food and weather,” he adds. It may even be a deficiency of water in the body.

So how does one stay clear of these?
Prevention is dependent on the causes. According to Dr Ssentongo, if it is viral, (HIV measles and Herpes Simplex) then it is wisest to begin on antiviral drugs early enough, or get vaccinated if possible against measles and Herpes Simplex Virus.

It is also possible to avoid injuries from radiation especially for those prone for example the albinos, by wearing broad hats and applying sunscreen. And to avoid trauma to the lips. For those with mal-aligned teeth, a visit to a dentist for to fix the situation could be of great help. For dry lips, eating foods rich in Vitamins B, A and C, Mr. Kibuule says like wheat, maize, milk, fish, meat, legumes like beans and peas and taking lots of water among others is the way to go.

Treatment is determined by the cause and is best handled by a certified health worker. And in those cases where the latter is unknown especially for red lips; something can be done by a plastic surgeon. Choices are given when you pay the doctor a visit.

This is why finding out the answers from a health practitioner should be done first before anything else. If you are doing everything right and you still battle with red or dry lips, it is even more crucial that you visit a doctor as soon as possible.

What are oral ulcers?

• Oral ulcer is the appearance of an open sore inside the mouth.
• It is as a result of a break in the mucosa/mucous membrane on the lips or in the mouth.
• It is caused by physical or chemical trauma, infection from microorganisms like viruses, some medications, diseases, nutritional deficiencies and tumours while majority causes are not known.
• Menstruation, cigarette smoking, changes in hormone levels, stress, and sudden weight loss could also provoke these sores.
• There are two types of oral sores, one of which is the cold sores caused by the Herpes Simplex Virus.
• They persist when one acquires infections or the area is inflamed (gets swollen with accumulation of fluid)
• Having dry lips can also lead to these sores so try to avoid dry lips at all costs by eating a diet rich in vitamins. Get these from fruits, milk, fish, and cereals among others.