Sorry to sound negative but I will tell you my honest opinion. The leave
alone method is highly unlikely to cure EC.
Why? 1) Most people see their lips get worse with the leave it alone method in the forum, from my reading.
2) More persuasively, the logic this method is premised on is very flawed.
The logic behind the leave alone method is, as I understand it, that EC is some kind of self-induced wound caused by chronic lip picking ect and it just needs time to heal. However, if the person with EC trialling the method genuinely did not pick, lick or manipulate the lips at all, then even the most severe EC case would heal within two to three weeks max, not months.
People claim that the "skin layers just need time to rebuild"
but this is based on flawed understanding of dermatology. Healthy skin regenerates quickly.
Look at this case study of a woman with a severe dog bite to her lip which healed within three weeks
Upper lip defect by dog-bite
A 70-year-old woman presented with dog bite avulsion to her upper lip. She lost about seventy percent of upper red lip and a part of white lip including the vermilion border. Through the wound, we could see the cut edges of the obricularis oris muscle in both sides. In the center of the wound, there was a part of mucosa left and she lost most of the obricularis oris muscle.
She said that blood spouted from the wound directly after injury. We supposed that the both side of labial arteries were cut off in the muscle stumps. When she arrived the hospital, hemostasis had been achieved.
We gave her the infusions of Antibiotic
Cefazolin only one day. Day 2, we confirmed that no signs of infection were seen. We did not use Antibiotics
during following days.
We used Gentamicin ointment for topical use, and sealed the wound with the dressing which had brand name Tielle(tm) over the applied ointment.
Day 4, the wound was covered with proper granulation. Days 7, we changed the dressing materials to Allevyn(tm) and ointment.
Day 11, the defect of mucosa and skin reduced rapidly. Her lip was regenerated to form normally. We changed dressing materials to Duoactive ET(TM) only.
Day 21, the wound closed completely and her lip formed normally. With regenerated lip, she could close her mouth, eat without problems and speak fully functionally"
Also, if EC is genuinely self induced by injury, how come everyone has almost the same EC crusting formation in the Peeling Lip Gallery? How come everyone's EC has almost the exact same pattern (triangle of dead skin on upper lip and upper half of lower lip is usually involved). Is everybody on the forum a secret member of some kind of Dry Triangle Lip Cult or something? No. Sometimes Drs are prejudiced against people who have mental health problems. They prefer to conclude that because some patients with anxiety disorders have higher likelihood of a rare skin problem then it must be caused by self-induced injury. They prefer to blame the patient than admit they don't know the cause of the problem. Most of the EC cases under constant observation by psychiatrists, which was presumed to be factitious initially, eventually concluded the patient didn't have any factitious activity.
I can tell you my EC looks exactly like most other people's EC in the gallery and I didn't pick, lick or bite my skin at all. So I really think that, in a lot of if not most instances, EC is not caused by chronic lip picking. I think it's probably akin to acne. A lot of patients with Acne
pick their Acne
and it does make it worse. But the picking is not the direct cause of the acne. Because we know the cause of acne, Drs don't feel the need to blame patients for their condition.
If the person with EC genuinely did not pick or otherwise manipulate the EC for a long time and it didn't clear up or even seemed to get worse, then the picking categorically did not cause the EC.
There is, however, a very slight possibility that the skin picking triggered off some kind of autoimmune inflammatory process akin to psoriasis. However, if you have stopped picking/licking/manipulating altogether for three- to four weeks and EC persists , then you need to eliminate self-injury from causality. It is not even speculative: if the above statement is true , I can say with 100% certainty that self injury is not the cause. Even third degree, necrotic burn wounds to the mouth from electrical injury heal within six weeks (and there is destruction of not just skin but underlying muscle).
EC is very superficial by comparison!
It is still open to debate, though, whether trauma from picking or biting resulted in some kind of autoimmune inflammatory condition for some people with EC.
However, if the latter is the case, then leave alone (in the sense of no moisturisers or products) is not going to speed up resolution. If the reason for leaving alone was that the moisturisers seem to make the skin more inflamed, then I think leaving them alone might be a reasonable strategy.
If I misunderstood something about the leave alone method, let me know.
I understand the leave alone method to mean no use of moisturisers or any products and no manipulation of the lip skin. I don't think that EC patients should be doing any manipulation of the lip skin but I think moisturisers, if you need it and find it helps to an extent, is useful.