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Angular Cheilitis and Swollen Lips
This is an uncommon condition actually. But in my clinic I often encounter uncommon health complaints like this. And for the fact that it is uncommon, therefore it becomes an enduring issue for many as the solutions are neither always obvious nor readily available. Some people(I should say most people, including health experts in the modern medicine community) believe this is a vitamin deficiency, especially concerning B vitamins. However I have a different opinion, partly from what I observed and also from the fact that many people who have this don't necessarily get any better by supplementing vitamin B.
This patient I recently treated is a woman near her 60s. What's interesting is she did not have a history of this condition or any lip problems in the past. It goes like this: A few months ago, she left Canada to go back to Asia for a brief 3-week vacation. At about the 2nd week there, her lips suddenly became swollen and flakes of skin started to grow on her lips and on the margin of her lips. The corners of her mouth also split. After she returned to Canada, the swelling decreased by itself. Yet the angular cheilitis, inflammation, skin cracking and exfoliation did not really go away. The lips were not as swollen, but they were still somewhat puffy. One could tell it looked different.
From a Chinese Medicine perspective, this is most likely due to the differences of environment between Asia and Canada. The place where she visited is near the equator, which is known to be humid, damp and hot. It's like being confined in a sauna room, for lack of a better description. This causes the retention of "damp-heat" as TCM calls it. She wouldn't go at this time if she had a choice however due to the occasion of a family gathering she traveled nonetheless. On a side note, in the ancient past, Chinese records frequently reported of soldiers who as a result of the obligations of war either traveled from the south to the north or vice versa, and subsequently developed a host of weird diseases. This was termed "not accustomed to the water-soil".
The patient attempted to wait it out and used vaseline to maintain moisturization, but the situation improved little. When she came to see me I prescribed Chinese Medicine to clear away the inflammation and promote the circulation of the area. The situation steadily improved and after almost 2 weeks it was much better. However, just shortly thereafter, the patient woke up one morning to find the swelling to have seemingly returned. She came back to ask why this was the case and was a bit questioning the validity of my herbal medicine. Yet upon my investigation into the recent events leading up to this, I discovered, ironically to her own surprise, that this was due to her switching to a different lipbalm immediately prior to the re-swelling. She finally acknowledged it was her own lapse, as everything was generally on track using vaseline until she switched. She then remarked that this was unusual since she had already used this in the past(before vacation) without any complications.
I explained this was because her condition has not stabilized yet so the lips were still sensitive. And by just comparing the ingredients of the lipbalm to vaseline, vaseline is much more simple in constitution. Not to mention there's a lot of chemical additives in the lipbalm too. Of course I told her to stop using this lipbalm and continue her old vaseline, as well as continue with my herbal medicine. As such, the swelling gradually receded again. By this time the corner splitting had almost healed as well.
Later on, there was still some minor localized inflammation around the upper middle margin of the lips and some skin flakes in the morning. I modified the medicine to strengthen the moisturizing effect and this issue gradually improved as well. Right now, there is ~95% improvement and her lips look almost normal. I tell her the remaining 5% will gradually subside by itself with time. And after a few more doses of medicine she can stop treatment. At this point her treatment has being almost a month.
The reason why I don't believe this has anything to do with vitamin deficiency is simple. She did not have a previous history of this condition. It appeared seemingly out of nowhere with the differences in environment to blame. The place where she went for vacation is highly developed so vitamin deficiency is impossible; it is also a place famed for the diversity of its culinary culture. Given the remote possibility that vitamin deficiency was the case during her stay abroad, it should revert itself once she returned to Canada; yet her situation showed this logic is faulty.
In Chinese Medicine, we believe it's likely the external environment, which she is not used to, severely disrupted her internal organ function leading to this problem. It is for this reason that during the course of her treatment she briefly complained of abdominal discomfort, likely her body readjusting itself back with the aid of the herbs. Patients with conditions similar to this should not be surprised if vitamins don't work. The problem is more complicated than believed.