Lip tremor, also known as "lip twitching" or "exfoliative cheilitis," commonly referred to as "exfoliative cheilitis," can occur on both the upper and lower lips, with the lower lip tremor being more common. It is more prevalent during the autumn and winter seasons.

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1. Stomach Fire with Wind︰Initially, there is itching of the lips, redness of the skin, and a localized burning sensation, followed by trembling of the lips, severe constipation, yellow and dry tongue coating, and wiry and slippery pulse manifestation. This is due to stomach fire and can be treated with dispersing wind and clearing heat, therapy for releasing both the internal and external, such as Shuangjie Tongsheng Powder. If accompanied by severe constipation, Stomach-Regulating Purgative Decoction can be used.
2. Spleen Deficiency with Blood Dryness︰Initially, there is itching in the lower layer, accompanied by redness and swelling. Subsequently, the lips become dry and cracked, with pain as intense as a burning fire, resembling a state of being skinless. The lips may tremble, and the stool becomes dry. The tongue texture is red with scant coating, and the pulse is thin and rapid. This condition is attributed to blood dryness. Stomach fire can arise from the external contraction of wind-cold or wind-heat failing to resolve, transforming into heat internally, which then transmits to the Yangming channel. Alternatively, it may result from habitual consumption of pungent and rich foods, leading to accumulated heat in the stomach organ. The Foot Yangming Stomach Channel encircles the lips, and excess fire from the stomach channel ascends along the channel, combining with external wind. The mutual agitation of wind and fire can thus cause lip tremors. Blood dryness may occur due to exposure to autumn dryness (warm dryness or cool dryness) or the mistaken intake of bitter-cold or warm-drying substances, which deplete yin and blood, transforming into dryness. The lips are the outward manifestation of the spleen. Lingshu. Wuyue Wushi states: "The lips are the orifice of the spleen." The lips belong to the Foot Taiyin Spleen Channel. Spleen deficiency and blood dryness producing wind can thus lead to lip tremors. Both conditions clinically exhibit "heat" manifestations, but stomach fire is an excess pattern, while the "heat" in blood dryness arises from the depletion of yin and blood transforming into dryness, constituting a deficiency pattern with excess. Regarding lip pain: in cases caused by stomach fire, there is obvious swelling and pain with a local burning sensation; in cases caused by blood dryness, the lips are dry, cracked, and painful. Regarding constipation: in stomach fire cases, it results from intense pathogenic heat in the Yangming stomach organ, leading to dryness accumulation and solidification of stool. The lower lip is connected to the Foot Yangming Stomach Channel, and the upper lip to the Hand Yangming Large Intestine Channel. Thus, the longer the constipation persists, the more severe the lip tremors, swelling, and pain become. Once the bowel qi is unblocked, the symptoms immediately diminish. In cases of blood dryness producing wind leading to tremors, it is due to the spleen's failure to distribute fluids and insufficient body fluids in the Hand Yangming Large Intestine, resulting in sluggish and difficult bowel movements, without the "stuffiness," "fullness," "dryness," "hardness," or "excess" manifestations of the Yangming organ excess pattern. Treatment should focus on nourishing blood and resolving wind-dryness. Internally, Siwu Xiaofeng Yin can be taken, while externally, Coptis Rhizome ointment or Zigu oil may be applied.

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1. Waike Zhengzong．exfoliative cheilitis》: "exfoliative cheilitis, caused by the upward attack of stomach fire in the Yangming meridian, manifests as itching and swelling of the lower lip, cracking like water from a river, painless but difficult to heal. It is advisable to wash with Tongfen Pill and take Six-Ingredient Rehmannia Pill for self-healing." (Note: The composition of Tongfen Pill includes copper green, official powder, alum, calomel, musk, borneol, and Coptis Rhizome.)