FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

"MOUTH BREATHING" CAN LEAD TO NIGHTTIME DRY LIPS AND DRY NOSE

Question: Every night my lips get very dry, and so does my nose. I put Vicks on my lips, but it doesn't seem to do any good. I use saline nose drops that help for a few hours. If I awaken in the night I usually need to use both medicines again. What can I do for my dry sore lips and nose?

Answer: As I'm sure you know, the skin of the lips is usually smooth and dry while the tissue inside the nose is usually moist. Neither area should be uncomfortable. I don't have enough information to know which one of the several conditions that can cause your symptoms you actually have, so I'll go over the most common maladies in hope that you can identify your problem.

A deficiency of some of the B vitamins, particularly riboflavin (B2) and pyridoxine (B6), can cause the symptoms you describe, particularly the dry lips. In fact, the painful lips may be among the first signs of this problem. Fortunately, pyridoxine deficiency is quite rare, and the diagnosis is even rarer since there is no easy test to measure the level of it in the body. Riboflavin deficiency is more common, but it still is infrequent. A blood test is available to measure it. Vitamin supplements taken by mouth are all that is necessary to correct either problem, but be aware that taking too much B6 (over 600 mg per day) can cause serious health problems.

Taking large amounts of vitamin A can cause sore lips. This "overdose" can occur from frequently eating liver or from taking large amounts of vitamin supplements in tablet form. If you are doing either of these, you should stop immediately and seek the advice of your physician. There are several drugs that can cause drying of the lips and nose. Antihistamines, antidepressants, cancer drugs, some acne drugs, and some stomach remedies are among the most commonly used ones. You should talk to your doctor or pharmacist if you are using a non-prescription or a prescription product in any of these categories. Often an alternative is available that causes less drying.

An emotional habit of constantly wetting the lips, either by licking them or by frequently sipping a beverage, can cause dry lips. This paradoxical response occurs just as dry hands result from frequent hand washing. The liquid washes away some of the protective oils of the lips so that they dry out easily. Usually a protective film over the lips such as Chapstick or lipstick is quite helpful.

The most likely cause for your nighttime dry lips and dry nose is mouth breathing. The mucosal lining of the nose is usually moist. This is helpful in moisturizing the air that is inhaled. In the winter the inside air is usually quite dry. This "desert dry" air can dry the nasal tissues excessively, thereby causing discomfort. Mouth breathing often occurs as a response to this drying in the nose and ultimately results in a similar drying of the lips and throat. By the time you awaken, you have developed a dry sore nose, throat and lips. The best solution for excessively dry air is the addition of moisture. Using a vaporizer or humidifier in the bedroom is the easiest solution. It is a simple and inexpensive treatment.

Other conditions that cause swelling of the nasal tissues, such as the common conditions allergic rhinitis and vasomotor rhinitis, can also produce the same uncomfortable dry nose and lips.

Try a vaporizer in your bedroom for a few days. If your symptoms persist, go to your family doctor. He or she can help you find a solution for these problems.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.