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Peeling of the skin on the insides of the cheeks and chapped lips (also called the oral mucosa) can be caused to a number of different factors. Some of these may be completely harmless and self resolving, while the others could be a cause for concern.

It is important to get this condition checked out by a dentist as soon as possible. Some of the conditions that can be the cause of peeling mucosa are:

  1. Allergic reaction: This is the most common cause for an adverse reaction from the oral mucosa. A change in the oral hygiene products being used daily like a toothpaste, mouthwash or even a chewing gum can precipitate such an attack from the body.

A reaction that is allergic in nature will be acute in onset, short lived in duration and heal on its own once the offending allergen is removed from the body.

  1. Candidiasis: This is a fungal infection that is most commonly seen in immune-compromised individuals. The fungus responsible for this infection is found commonly inside the oral cavity, however only becomes active once it gets an opportunity due to a bout of decreased immunity.

Clinically, there can be white striations that can be seen on the mucosa which are extremely easy to peel. The part coming off is actually the excess keratotic cells rather than the mucosa itself.

  1. Leukoplakia: This is a pre cancerous condition which should be looked at seriously. The presence of white keratotic patches which do not come off on rubbing is a clinical sign associated with this condition.

Found very commonly in long term heavy smokers, there are many variations of this condition. The presence of reddish mucosa amidst white keratotic patches is particularly indicative of an impending oncogenic incidence.

  1. Oral Malignancy: The incidence of oral cancer is on the rise all over the world. One of the key things to note with clinical symptoms of oral cancer is the presence of ulcers and wounds which do not heal easily or at all. This can be accompanied with sloughing of the mucosa cells itself.

Oral malignant lesions are found commonly in regions of the hard palate, buccal mucosa as well as the angle of the lip.

  1. Lichen Planus, Pemphigus Vulgaris and Pemphigoid: It is difficult to diagnose conditions like Lichen Planus without some specialized lab tests as there are a couple of conditions that can mimic similar conditions.

All the conditions mentioned are autoimmune conditions and thus do not really have a specific set of causes. A genetic link as well a history of the conditions in families may be present, but that is also not always certain.

Tests like immunofluoroscence, antigen antibody testing and histopathology sections may be required to be done to help reach a diagnosis. If present, these conditions are long term in nature and will require treatment with topical and systemic steroids, as well as other treatment according to the symptoms to provide long term relief.

Any condition can be managed better if caught early on and so even though it is more than likely that the peeling of the mucosa will be routine in nature, it is better to be sure. Let a professional take a look.

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