Good Question, I'm not 100% sure. I think I picked my lips without me even knowing. I saw an old picture of myself and I noticed that the top of my lower lip had been picked because it was red. So it could have been that or also since I was in Boxing there was a time that I would TAKE ALOT Of Vitamins and suppliments. I stopped and like 3 months later I had EC. Also during the time I got EC I was obssesd with my lips and it could have been a mental reaction.