It could be none of those things. I often wonder if this is related to my stomach or if it's fungus or bacteria on my lips, but it could be none which makes it all so confusing. It seems rare that this condition develops at middle age since most of the members got it near their twenties (23 for me). I have the classic symptoms like dhammaboy, alesiom, and uklad and since we all have the same symptoms the cause and cure must be the same. For most of us it was self-inflicted but for some it isn't. I think I may actually have had EC before I started rubbing my lips real hard like a maniac which just made them worse so the root cause may not be self-induced permanent damage because I had chapped lips for months that wouldn't go away but it was never this bad. I think it could possibly be bacteria since the "wound" is so susceptible but it could be that it's not a wound but rather the form it has adapted into from all the damage I inflicted on it. I'm very hesitant to try anything new because i'm so skeptical that anything will work. I think because me and dhammaboys lips look the same I will try epiceram once I can find a piece of shit doctor who will prescribe it for me.