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Cheilitis – Causes, Symptoms & Treatment

Cheilitis is an inflammation of the lips characterized by redness, swelling, scaling, or cracking. It has various causes and is generally well treatable.

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Things worth knowing about "Cheilitis"

Cheilitis is an inflammation of the lips characterized by redness, swelling, scaling, or cracking. It has various causes and is generally well treatable.

What is Cheilitis?

Cheilitis refers to inflammation of the lips or the lip border. The term derives from the Greek word cheilos, meaning lip. It is a common condition that can affect people of all ages and may present in either an acute or chronic form.

Types of Cheilitis

Cheilitis simplex: The most common form, usually caused by dryness or mechanical irritation.
Angular cheilitis (cheilitis angularis): Inflammation of the corners of the mouth, often associated with fungal infection or nutritional deficiency.
Actinic cheilitis: Triggered by chronic sun exposure and considered a precancerous lesion that requires close monitoring.
Glandular cheilitis: Involves the mucous glands of the lips, leading to thickening and crusting.
Allergic contact cheilitis: An allergic reaction to lip care products, toothpaste, or certain foods.
Exfoliative cheilitis: A chronic form with persistent scaling and crusting, most common in adolescents.

Causes

The causes of cheilitis vary depending on the type:

Lip dryness caused by cold weather, dry air, or habitual lip licking
Allergic reactions to cosmetics, lip balms, or food products
Infections caused by bacteria, viruses (e.g., herpes simplex virus), or fungi (e.g., Candida albicans)
Chronic UV exposure (actinic cheilitis)
Nutritional deficiencies, particularly vitamin B2 (riboflavin), vitamin B12, iron, or zinc
Systemic conditions such as Crohn's disease or Melkersson-Rosenthal syndrome
Medication side effects (e.g., isotretinoin or chemotherapy agents)

Symptoms

Common symptoms of cheilitis include:

Redness, swelling, and a feeling of tightness in the lips
Scaling, crusting, or flaking of the lip surface
Painful cracks or fissures
Burning sensation or itching
Painful splits at the corners of the mouth in angular cheilitis
In severe cases: bleeding or ulcerations

Diagnosis

Diagnosis is typically made clinically based on the appearance of the lips. Depending on the suspected cause, additional investigations may include:

Patch testing: To identify contact allergies
Swab and microbiological culture: If a fungal or bacterial infection is suspected
Blood tests: To rule out nutritional deficiencies or systemic diseases
Biopsy: Recommended when actinic cheilitis or malignant changes are suspected

Treatment

Treatment depends on the underlying cause of cheilitis:

Moisturizing care: Regular use of protective and hydrating lip balms (e.g., based on petrolatum or lanolin)
Topical corticosteroids: To reduce inflammation in allergic or inflammatory forms
Antifungal agents: For fungal infections (e.g., clotrimazole cream)
Antibiotics: For bacterial infections
Antiviral medications: For herpes infections (e.g., aciclovir)
Sun protection: Consistent use of UV-protective lip balm for actinic cheilitis
Nutritional supplementation: To correct deficiencies in B vitamins, iron, or zinc
Allergen avoidance: Identifying and avoiding triggering substances in allergic contact cheilitis

When to See a Doctor

Medical advice should be sought if lip symptoms persist, recur frequently, or worsen over time. It is especially important to have any white patches, thickening, or hardening of the lip evaluated promptly, as these may indicate actinic cheilitis or a precancerous lesion.

References

Lugovic-Mihic L. et al. - Differential Diagnosis of Cheilitis - How to Classify Cheilitis? Acta Clinica Croatica, 2018.
Leducq S. et al. - Cheilitis: Diagnosis and Treatment in 2021. Journal of the European Academy of Dermatology and Venereology, 2021.
Neville B. W. et al. - Oral and Maxillofacial Pathology. 4th Edition. Elsevier, 2015.

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