A Tale of Chapped Lips, Red Lipstick, & Going With Your Gut

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Have you ever tried to wear red lipstick and been frustrated because all it did was highlight how dry and chapped your lips were and/or cause your lips to burn and get more irritated?  

For many years, I had chronically dry, chapped lips and angular cheilitis, tiny cuts and sores around my lips and mouth that were slow to heal.  I used to stock up and stash multiple sticks, tubes, and jars of lip balm and salve everywhere because I’d be applying it at least every hour.  I went through countless brands that promised relief that never arrived: Chapstick, EOS, Burt’s Bees, Vaseline, Aquaphor, and Eucerin, to name a few.  I had perpetually chapped lips that hurt and a drawer full of balms and salves that didn’t work or made things worse.  I dreaded eating and drinking because it burned, stung, and dried my lips out even more.  People told me I had resting bitch face.  They didn’t know how much it hurt to move my mouth, let alone talk, smile, or laugh.   

I grieved the fact that I couldn’t wear red lipstick, the only kind of makeup I longed to wear because red is one of my favorite colors.  But there’s so much more to a red lip than I realized.  The history of red lips is varied and long, it spans thousands of years.  In ancient Roman, Egyptian, and Sumerian cultures, red lips were a symbol of royalty and high social status, whereas in ancient Greece, red lips were a symbol of prostitution.  In the Middle Ages the Church condemned red lips as a symbol of witchcraft, immorality, and the devil.  In the 20th century red lips became a symbol of women’s liberation and political defiance.  The suffragette movement of the early 1900s embraced red lipstick as a sign of rebellion against restrictive Victorian ideals that associated makeup with a lower social standing.  Wearing visible makeup was an act of defiance at a time when “respectable” women were expected to appear bare-faced.  

Hitler hated makeup, especially red lipstick.  So in the 1940s women were encouraged to wear red lipstick as a symbol against fascism.  In fact, the US Army made it mandatory for women in the Women’s Army Corp to wear red lipstick as part of their uniform. The US government went so far as to ask Elizabeth Arden to create a regulation lip and nail color for serving women, called “Montezuma Red”, that accentuated the red piping on their uniforms. 

Unaware of this rich history, I decided I was going to do everything I could to be able to wear red lipstick whenever I wanted. 

Painfully dry skin is one of the most common and visible signs of Sjogren’s disease, a serious, systemic autoimmune and connective tissue disease.  Menopause and Sjogren’s disease cause the same symptoms: dryness, fatigue, and cognitive dysfunction (brain fog).  Perhaps that’s why the myth that Sjogren’s affects women in their 40s-50s persists, because the hormonal changes caused by perimenopause and menopause cause dryness, fatigue, and cognitive impairment on top of the already present dryness, fatigue, and cognitive impairment caused by Sjogren’s disease, all dismissed, ignored, or psychologized for the previous 2-3 decades of a Sjogren’s patient’s life.  

After studying many lip balm and salve formulations, I realized that they only provided oils, fats, and waxes with the occasional peptide and vitamin thrown in for an instant but temporary plump and glow.  These formulations are akin to high fat, ultraprocessed diets for skin.  Diets aren’t sustainable.  They’re quick fixes designed to keep you coming back for more.  Balanced nutrition is sustainable and provides long lasting relief. 

Angular cheilitis can be caused by nutritional deficiencies, irritations, and infections.  Like the hormonal changes that come with perimenopause and menopause, the systemic manifestations of Sjogren’s disease increase your susceptibility to irritation and infection.  Sjogren’s patients are frequently malnourished because the disease negatively impacts the digestive system in myriad ways e.g., decreased production of saliva and other digestive juices, impaired gut motility, gut dysbiosis, etc.  

Your digestive system, or gut, is essentially a long tube that starts in your mouth and runs from gums to bum.  Your gut lining, just like your skin, is exposed to the environment.  The inside of your body, the part that’s protected from the environment, is what lies between your gut lining and your skin.  For example, the outside of your lips is covered in skin, the inside of your lips is covered by your gut lining.  What lies between is the inside of your body.  So, where does your skin stop and your gut lining begin?    

Your gut lining and skin are both made from epithelial tissue and have similar functions that include nutrient absorption.  So it stands to reason that if whole foods improve gut health, they should do the same for skin health.  In 2014, when I was developing my approach to skin care, there was no data showing that there was cross-talk between the gut, brain, and skin.  Despite the lack of published scientific data, it seemed preposterous to assume that my organs were not communicating with each other and with my environment, specifically the microbes growing on and in me.  Everything is interconnected.  Now there’s documentation that the gut, skin, and brain communicate with and influence each other (the gut-brain-skin axis) through neuroendocrine, immune, and microbial interactions. 

Sadly, my doctors dismissed my angular cheilitis and chapped lips as isolated, benign, nuisance occurrences rather than impactful, expensive, and limiting symptoms indicative of a devastating disease.  I can’t blame them.  The little that doctors and other clinicians are taught about Sjogren’s disease is rife with myths.  If you’re a clinician looking for a continuing medical education (CME) course on Sjogren’s that accurately reflects the reality of the disease and introduces highly anticipated new treatments, take PRIME Education’s, “Optimizing the Diagnosis and Care of Sjögren's Disease: Real-World Perspectives From Patients and Clinicians”.  If you’re a Sjogren’s patient, send your doctors a link to this CME course.

The lack of accurate research and medical education on Sjogren’s disease is why I fundraise for the Sjogren’s Foundation through their annual Walk for Sjogren’s event.  Please join my fundraising team, Bexi’s Supporters of Research and Advocacy and/or make a donation.  Your participation and support mean a lot to me.  Thank you.  

Having applied and translated my expertise of nutritional epigenetics into skincare products that healed my dry, chapped lips and angular cheilitis, I’m pleased to report that I now wear red lipstick any time I want and the joy of doing so is priceless.  I’m glad I followed my gut instinct.  Whether you want to wear red lipstick or not, you, too, deserve to eat, drink, talk, smile, and laugh without pain and discomfort. 

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A version of this article can be found in my local newspaper, The Davis Enterprise.