What causes the inside of a baby’s lips to appear white, as if the skin is peeling?
Jan 22, 2022
Source: Cainiu Health
Dr. Ma Yan
Introduction
White patches appearing on the inner side of your baby’s lips may indicate oral thrush—a fungal infection caused by *Candida albicans*. It manifests as white, curd-like plaques on the oral mucosa and is most common in infants and young children. Oral thrush typically occurs in babies with poor oral hygiene or malnutrition. It commonly affects the buccal mucosa, tongue, soft palate, and inner lips. The white lesions cannot be easily wiped away with a cotton swab or moist gauze.
White, flaky patches resembling peeling skin on the inner surface of a baby’s lips may indicate one of two common conditions: oral ulcers or oral thrush (candidiasis). Below, we address this concern in detail.
What Causes White, Flaky Patches on the Inner Surface of a Baby’s Lips?
White patches on the inner lip may indicate oral thrush—a fungal infection caused by Candida albicans. It manifests as white, curd-like plaques adhering to the oral mucosa and is most commonly seen in infants and young children. Thrush typically occurs in babies with poor oral hygiene or underlying malnutrition. Lesions frequently appear on the cheeks, tongue, soft palate, and inner lips. These white plaques cannot be easily wiped away with a cotton swab or moist gauze.
Differentiation from residual milk residue is essential. Although milk residue may resemble thrush in appearance, it can be readily removed using warm water or a cotton swab. In contrast, thrush lesions resist removal; forcibly scraping them off reveals an underlying mucosa that appears erythematous and rough—sometimes with minor bleeding. Treatment includes rinsing the mouth with a weakly alkaline solution (e.g., 2–5% sodium bicarbonate) and applying nystatin suspension. Nutritional support—particularly supplementation with vitamin B2 (riboflavin) and vitamin C—is also recommended. Strict hygiene during breastfeeding helps prevent transmission.
Infants’ feeding utensils should be thoroughly cleaned and then sterilized by steaming for 10–15 minutes. Breastfeeding mothers should wash the areola and nipples with warm water before each feeding, bathe regularly, change undergarments frequently, trim fingernails regularly, and always wash hands before holding the baby.
Knowledge Extension: Common Causes of Lip Peeling in Infants
1. Oral Ulcers
Oral ulcers are often associated with “excess internal heat” (a traditional Chinese medicine concept), dietary imbalance, inadequate vitamin intake, or compromised immunity. Parents should ensure the infant consumes sufficient fresh fruits and vegetables and avoids spicy or irritating foods. If the baby is a picky eater, consider possible deficiencies in trace elements. Topical application of watermelon frost powder may help alleviate ulcer symptoms. Adjusting diet and enhancing immune function are key to management.
2. Oral Thrush
Oral thrush is a Candida albicans infection characterized by white, curd-like plaques on the oral mucosa. It is especially prevalent among newborns, infants, malnourished children, those with diarrhea, or those receiving prolonged broad-spectrum antibiotic therapy. Clinically, small white specks or confluent plaques appear on the oral mucosa; they are difficult to remove, and forced removal exposes an erythematous, rough, and sometimes bleeding mucosal surface. Systemic antifungal medication is usually unnecessary; instead, cleaning the oral cavity with a 2% sodium bicarbonate solution before and after breastfeeding is generally effective.
