Lip eczema refers to the symptoms of lip erosion, often accompanied by swelling, dryness, cracking, scaling, and crusting of the lips. It is similar to the conditions described in medical literature as "exfoliative cheilitis," "tight lips," and "shen lips."

bubble_chart Pattern Analysis

1. Dampness-heat of Spleen and Stomach︰It is commonly seen on the lower lip with slight swelling and redness, covered by a dirty yellow crust or layers of scaling. After the crust falls off, it leaves a smooth, shiny red base, on which new crusts continuously form. Fissures may appear with a burning sensation and tenderness, recurring without healing. The tongue is red with a thin yellow coating, and the pulse is deep and wiry. This is caused by prolonged accumulation of dampness in the spleen and stomach transforming into heat, resulting in dampness-heat steaming upward. Thus, it often presents with obvious heat signs, such as a subjective burning sensation, tenderness, local lesions that are often red, and a surface frequently covered with yellow crusts, along with a red tongue and yellow coating. The treatment principle is to clear heat and dispel dampness, using a modified version of the Clearing Heat and Dispelling Dampness Decoction.
2. Spleen Deficiency with Dampness Retention︰The lip margins are swollen, moist, and eroded, with a non-red base, significant exudation that dries to form scabs, fissures, and desquamation. Symptoms fluctuate in severity, accompanied by mild itching and pain. The tongue is pale and swollen, with a greasy coating of blackened swallowwort root, and the pulse is deep and slow. This condition arises from spleen and stomach dampness stagnation, where dampness obstructs the spleen, impairing its transportation and transformation functions, leading to lip erosion. Common manifestations include swollen, moist, and eroded lip margins with a non-red base, copious exudation, grayish-white scabs, a pale and swollen tongue with tooth marks, and a deep, slow pulse. Treatment should focus on invigorating the spleen and draining dampness, using modified Dampness-Expelling Stomach Poria Decoction.
3. Qi Stagnation and Blood Stasis︰The skin of the lips becomes thickened and appears dark purplish-red or pale red, sometimes with superficial atrophy, often accompanied by thin scaling. Similar patches may appear on the cheeks and bridge of the nose. Lesions on the cheeks may exhibit telangiectasia. The tongue is dark red with thin white coating, and the pulse is deep and thin. This condition is caused by the stagnation of qi movement, leading to blood stagnation and inadequate nourishment of the lips. The characteristics of lip eczema and erosion include: dark red margins of the lips, thickened and infiltrated patches of skin, scaling and fissures on the surface, or atrophy. Similar lesions may also appear on the cheeks and bridge of the nose. Treatment should focus on {|###|}tonifying qi, invigorating blood, and resolving stasis{|###|}, as well as softening and dispersing nodules. The recommended formula is Peach Kernel, Carthamus and Four-Ingredient Decoction with modifications.
4. Blood Deficiencywind-dryness︰There is a circular skin lesion on the vermilion border of the lips, with slightly raised edges, a pale and glossy color, and possible erosion. A reticular white membrane may be visible on the buccal mucosa inside the mouth, occasionally accompanied by numbness and itching, with no systemic symptoms. The tongue texture is red with a thin coating, and the pulse is soft and fine. This condition is often seen in individuals with inherent stomach yin deficiency, insufficient nutrient yin, and blood deficiency generating wind, which transforms into dryness and scorches the lips, leading to lip eczema and erosion. The characteristics of lip eczema and erosion include: a pale or whitish color on the vermilion border, possible surface erosion and desquamation, but often smooth, affecting the buccal mucosa, frequently accompanied by itching, and generally no systemic symptoms. Treatment should focus on nourishing blood, yin, and moistening dryness, using the Enriching Yin and Eliminating Dampness Decoction.

bubble_chart Documentation

1. Zhubing Yuanhou Lun．Angular Stomatitis: "The Foot Taiyin is the spleen meridian, its qi connects to the mouth. The Foot Yangming is the stomach meridian, and the Hand Yangming is the large intestine meridian. These two meridians both flank the mouth. When the organs are deficient, they are invaded by wind evil dampness-heat, and the qi arises from the vessels, clashing with body fluids to produce sores, which are constantly moist and exude fluid. This is commonly known as fat sore (tinea favosa), also called angular stomatitis."
2. Waike Dacheng．Lip Section: "Exfoliative cheilitis occurs on the lower lip, causing itching without pain, swelling, and cracking like water from a river, due to the stomach fire attacking upwards."