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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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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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