A Literature Review of the Attempted Treatments for Exfoliative Cheilitis: A Refractory Dermatologic and Distressing Cosmetic Condition

Introduction: Exfoliative cheilitis (EC) is a rare dermatologic and cosmetic condition of the lips affecting both the upper and lower vermilion surfaces by producing thick keratin scales with recurrent desquamation. Although reported in the literature for decades, the etiology of EC remains unclear, which makes treatment challenging. A multitude of treatments has been tried, but none has provided consistent successful results. There is no review of the literature that includes all the proposed and attempted treatments for EC. This review discusses the literature to date and their proposed treatment regimens for EC. Methods: A systematic literature search was conducted from inception to February 3, 2026, in PubMed and Cochrane CENTRAL online databases. “Exfoliative cheilitis” was used as the keyword phrase searched on PubMed and Cochrane. A meta-analysis was unable to be performed due to limited reporting. Results: The search yielded 118 results. Using defined inclusion and exclusion criteria, 20 articles were ultimately included: 15 case reports, 2 case series, 1 systemic review, and 2 randomized controlled trials. Proposed treatments were numerous, and categories included topical, oral, and intramuscular medications, lasers, and various alternative, non-traditional therapies. The most frequently reported and best-studied treatment is tacrolimus. No treatment consistently produced successful and reproducible resolution of EC. Discussion: Treatment of EC remains challenging as the etiology is unclear. Most published literature proposing treatment is case studies. There is no standardized treatment or protocol for the treatment of EC that has produced consistent, successful results. Conclusion: Exfoliative cheilitis is a medical, dermatologic, and cosmetic condition that can be distressing for patients, and there remains no treatment that offers consistent improvement. More and higher-quality investigations are needed to find the best treatment for this condition.