Pucker Up, Don't Pout! Lip Balms: A Dentist's Perspective

Even for those who do not wear makeup (myself included), there is a lip balm in every one of my purses. And suitcase. And carry-on. And winter coat pocket. Lip balms come in all shapes, sizes, colors, scents, styles and tastes to serve different needs. That being said, the original purpose of the lip balm was to protect our lips from dryness.

Lip cosmetics have been seen as early as 7000 BC being used by the Sumerians (modern day Kuwait). In 40 B.C. Cleopatra and other pharaohs of ancient Egypt used beeswax, olive oil and animal fat as cosmetic ingredients for skin and lip care. In 1865 in the book “The American Frugal Housewife”, the author, Lydia Maria Child, recommended using earwax to treat cracked lips. In 1870 in Titusville, PA, Robert Chesebrough invented, patented, and distributed his petroleum jelly called Vaseline^®. Before the name Vaseline^®, Chesebrough used the term “Wonder Jelly” for his invention.

Dr. C. D. Fleet, a physician from Lynchburg, Virginia, invented Chapstick in the early 1880s. Fleet made the first Chapstick himself that resembled a small wickless candle wrapped in tin foil. In the 1900s countries like Sweden and Japan were producing lip balms made from ingredients like yuzu (Japanese citrus fruit), camellia oil (tea seed oil), and beeswax. Interesting fact: the first lip balms were all sold directly from creator to consumer. I was curious how the current direct sales companies had kept up with Carmex, Blistex, and LipSmacker so readily available at every store cashier aisle. Why would anyone want to buy anything else?

As a dentist, I perform an oral cancer screening at every exam. This includes examining the lips. I want to see lips that are not cracked, discolored, misshapen or damaged in any way. Generally the top layer of regular skin has more than nine layers mainly for protection purpose. The top layer of the lip contains about only 3 to 4 layers and very thin compared to typical face skin. The lip skin contains very few melanin cells. Because of this, the blood vessels more clearly appear. The lip skin also has no sweat glands. Therefore it does not have the sweat and body oil in protecting the lip from the outside environment. Lip balms must do two things in order for me to recommend them: moisturize dry, cracked lips as well as protect lips from the sun. The most common oral cancer seen is that of the lower lip (squamous cell carcinoma). The higher occurrence of disease of the lower lip has been attributed to its position, which usually means that it receives a higher consistent exposure to solar radiation. Upper lips (basal cell carcinoma) also have seen their share of cancer, but usually mostly found in smokers. However, with the increased use of vaping and other forms and types of smoking, the prevalence is increasing significantly. 3500 new cases of lip cancer are diagnosed each year, and the number continues to rise. Patients do ask me on a regular basis what I feel they should use, so I did my own research.

The one common ingredient in drugstore lip balms is petroleum jelly or mineral oil. Using the umbrella term mineral oil for this blog, mineral oil is still used to this day because it is cheap, easy to mix in with other ingredients, and lasts forever. Lip balms that contain parabens, petrolatum, BHA (common in acne washes to clean pores), or synthetic fragrances are toxic to your digestive system and should not be ingested. Also, mineral oil cannot protect the skin or lips from the sun. It is waterproof, so it can last a long time on the lips, but it can clog the corners in the lips for those that have chronic dry mouth and lips. Mineral oil is an “occlusive emollient”, meaning that it helps to keep our skin hydrated by locking in moisture by forming a barrier on our skin’s surface. But our skin/lips have to be hydrated in the first place in order for mineral oil to do this job. If you have dry lips to begin with, there is nothing to keep hydrated, so it is not doing anything therapeutically.

I asked friends of mine who sell direct-to-consumer cosmetics what their favorite lip balm products were. Here is what they chose (in alphabetical order):

Arbonne’s lip therapy set. The first step is a lip exfoliator made of beet sugar (exfoliator), grape seed oil (hydrates and smooths), Shea butter, coconut pulp and dragon fruit extract (all hydrate). The second step is the actual lip balm or salve as Arbonne calls it. This tube has meadowfoam seed oil to moisturize and soothe dry skin, coconut oil hydrates to smooth and soften, and shea butter.

Beauty Counter has an all in one lip conditioner that contains avocado oil, shea butter, meadowfoam seed and jojoba oils.

Mary Kay also has a satin lip set. The first step is lip exfoliation with natural sugar crystals, shea butter, white tea and citrus. The lip balm contains shea and jojoba butters, white tea and citrus.

All three do a wonderful job to not only moisturize but to hydrate as well. What’s the difference between hydrating and moisturizing? “Moisturizing products actually try to improve the skin by decreasing water loss.” Essentially, dehydrated skin lacks water and needs to be hydrated with hydrating products, while dry skin lacks oil and needs to be moisturized with moisturizing products. Both are needed for lip protection from drying, cracking, and inflammation.

One of the most common habits we have is licking our lips. Licking our lips can cause them to become dry and painful. This is because when saliva evaporates it leaves our lips without moisture. When we lick our lips, saliva adds moisture to the surface of the lips, but only for a brief moment. As the saliva quickly evaporates, lips will likely end up drier than before. We also can lick our lips with lip balm on, thereby consuming it. Have to say all of the above mentioned ingredients are all-natural and safe to be consumed, unlike mineral oil, which, in time, can have a negative effect on our digestive systems. For every day purposes, any of the three described above are absolutely wonderful for healthy, beautiful lips.

If you are going to be out in the sun for any extended period of time, however, I do recommend a lip balm that contains SPF (sun protection factor). There are five main compounds that protect our lips from the sun: zinc oxide, octocrylene, octinoxate, oxybenzone, and titanium dioxide.

Zinc Oxide and Titanium dioxide, metals, work against sunburning ultraviolet radiation by physically reflecting/scattering the sunbeams off and away, thus protecting the skin. Both are generally recognized as safe and effective (GRASE) by the FDA. (Two ingredients – PABA and trolamine salicylate – are not GRASE for use in sunscreens due to safety issues of consumption.)

Octocrylene, octinoxate, oxybenzone actually absorb solar radiation and break it down, but at different wavelengths, so it is thought to have all three. Turns out, something like a shiny lip gloss (not a balm) can absorb sunlight directly into the skin and increase your risk of sunburn! Lip balms with SPF tend to be waxier and adhere better. They also tend to be less reflective. It’s hard to find a lip balm with a high SPF, having both UVA and UVB protection. This may be because it is very hard to mask the potent bitter “flavor” of SPF’s. SPF 15 is the absolute minimum when it comes to all day in the sun lip protection.

Just like applying skin sunscreen, apply generous amounts of this type of lip balm at least 20 minutes before sun exposure. This gives the ingredients time to bind to your skin; then re-apply every two hours. In fact, you should re-apply the sunscreen even more frequently if you are swimming, sweating, and are prone to licking your lips. Once again, look for sunscreens with a variety of ingredients to ensure broad-spectrum protection. Because organic compounds bind better to skin than inorganic ones, make sure your sunscreen contains at least one organic radiation filter, like algae.

Bottom line, whichever lip balm you choose, it is always so important to check out its ingredients. Lips do age, just like our skin, so choosing a product that prevents chapping keeps them appearing as young and fresh as you when you first puckered up.

Aesthetic Dermatology: Current Perspectives By Jaishree Sharad, Maya Vedamurthy

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