Cheilitis: symptoms, causes, diagnosis and treatment

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Cheilitis or "lip inflammation" is a condition that manifests as redness, dryness, scaling, and itching of the lips. Many factors can cause cheilitis, such as infection, chronic lip licking, or exposure to an allergen or irritant, such as sun damage, lip cosmetics, oral hygiene products, fragrances, certain foods, and certain medications.

Healthcare providers diagnose cheilitis by looking at a person's medical history and examining the mouth, lips, and skin. Sometimes other tests, such as a patch test or a biopsy, are done to determine the underlying cause of the inflammation.

Cheilitis treatment depends on the underlying cause, for example treating an infection or removing an irritant. Also, a dermal medicine called a topical ("on the skin") corticosteroid is often recommended to soothe sore lips.

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Symptoms

The most common lip symptoms associated with cheilitis include:

  • Dryness
  • Redness
  • Flakes or cracks
  • Sensitivity
  • Cracking or peeling
  • Swelling (edema)
  • Itching and burning
  • Scabs at the corners of the mouth (angular cheilitis)
  • A brownish-black discoloration of the lips (seen with some types of irritant contact cheilitis)

Rarer symptoms may include thick keratin scales on the lips (seen with exfoliative cheilitis). In glandular cheilitis, a thickening of the lower lip is seen, along with small holes (orifices) through which saliva can flow.

Causes

There are different types of cheilitis, depending on the cause.

Eczematous cheilitis

The most common type of cheilitis is eczematous cheilitis, which can be associated with an atopic condition (eczema, hay fever, and asthma) or caused by exposure to an allergen or irritant.

Atopic cheilitis is commonly seen in people with eczema , but is often indistinguishable from irritant or allergic contact cheilitis.

Allergic or irritant contact cheilitis is caused by a reaction to an irritant or allergen that touches the lips, for example:

  • Lipstick or lip balms
  • Oral hygiene products such as toothpaste or mouthwash.
  • Fragrances (for example, balsam of Peru)
  • Rubber or latex products
  • Substances in nail polish (for example, formaldehyde)
  • Metals (such as nickel, cobalt, or gold)
  • Certain foods (such as mango or cinnamon)
  • Certain medications (such as neomycin or bacitracin)
  • Propylene glycol
  • Chronic lip licking
  • Weather-related factors (such as cold or wind)
  • Sunscreen

Angular cheilitis

Angular cheilitis causes inflammation of the skin along the sides or corners of the mouth. Most of the saliva collects in the corners of the mouth, eventually leading to dryness and cracking of the skin as the saliva dries up. Then a secondary infection with Candida albicans ("yeast") or, less commonly, Staphylococcus aureus ("Staph") bacteria can develop.

Some people are more likely to develop angular cheilitis, such as people with diabetes or older people who wear dentures. This condition can develop in people taking medications that cause dryness, such as isotretinoin (formerly Accutane) for acne. People who are deficient in vitamin B or iron are also more prone to this.

It is important to note that angular cheilitis is not limited to adults. Babies who drool, thumb suck, or lick their lips in winter are also at higher risk of developing this condition.

Actinic cheilitis

Actinic cheilitis is also called solar cheilitis because it is caused by prolonged exposure to the sun. This is a precancerous condition ( squamous cell carcinoma of the lip) that is more common in fair-skinned people and in people who live in hot, dry climates and / or work outdoors, such as construction workers. Actinic cheilitis: it is more common on the lower lip than on the upper lip.

Rare types of cheilitis

Other rare types of cheilitis include:

  • Exfoliative cheilitis – possibly associated with chronic lip licking or biting
  • Glandular cheilitis – Possibly associated with sun exposure, lip biting, and smoking.
  • Granulomatous cheilitis (also called Mischer cheilitis) – can affect young adults and experts suspect it is caused by a combination of factors including genes, infections, and food allergies.

Diagnostics

When diagnosing cheilitis, your healthcare provider will write a detailed medical history that looks at potential effects (such as cosmetics or food). They will also examine the skin, including the mouth and lips.

Other tests may be done depending on your primary care provider, such as:

  • Patch test (used to diagnose allergic contact cheilitis)
  • Lip swab to check for infection
  • Biopsy (when a small piece of tissue is removed from your lip and examined under a microscope)

Watch out

Cheilitis treatment depends on the underlying cause.

Eczematous cheilitis

For all forms of eczematous cheilitis, topical corticosteroids, along with a lip balm or an emollient such as petroleum jelly, can help soothe the lips and relieve itching.

In the case of irritant or allergic contact cheilitis, it is key to remove the irritant / irritant allergen, for example not using a certain lip balm or toothpaste.

Angular cheilitis

For angular cheilitis (also known as perleche), it is important to treat the underlying infection. This involves applying a topical antifungal (for yeast infection) or antibiotic (for bacterial infection) ointment to the sides of the mouth and then applying a protective lip balm or protective cream such as zinc oxide or petroleum jelly after the infection is gone. . until.

It is also important to pay attention to the root of the problem. This could mean improving the fit of your dentures or taking vitamins or iron supplements.

Actinic cheilitis

There are several possible treatment options for actinic cheilitis, depending on the severity, for example:

  • Cryotherapy (freezing)
  • Topical treatments (such as fluorouracil or imiquimod)
  • Photodynamic therapy (light therapy)
  • Surgical excision (removal) of part of the lip
  • Laser ablation

Get the word of drug information

Cheilitis is a common inflammatory skin disease. While this can be cosmetically inconvenient and unattractive, the good news is that, in the vast majority of cases, it can be treated with simple and straightforward measures.

If you suspect you have cheilitis or notice any new changes to your lips or the skin around your lips, be sure to make an appointment with your doctor.

Frequently asked questions

  • Angular cheilitis is not contagious. While it may be a fungal or staph infection, it is not spread from person to person by kissing or sharing utensils or drinks, such as herpes .

  • No, but there are several nutritional deficiencies associated with some cases of angular cheilitis, notably deficiencies of iron, zinc, and B vitamins. in particular riboflavin (vitamin B2) and cobalamin (B12) .

  • Some steps you can take to prevent angular cheilitis include:

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