What is Cheilitis and how to Recognize It

Cheilitis is a medical condition characterized by inflammation of the lips that could be either acute or chronic depending on its onset and course. There are different forms of cheilitis reported in medical literature such as:

 
· Herpes simplex
· Angular cheilitis
· Granulomatous cheilitis
· Orofacial granulomatosis
· Crohn skin disease
· Actinic cheilitis
· Exfoliative cheilitis
· Glandular cheilitis

We will discuss the most common types as well as explain their cause and offer treatment solutions. Cheilitis is mostly caused by sun exposure, lip biting/sucking or allergies. The most common forms of cheilitis are:

 
- Cheilitis exfoliativa sicca (cracked and chapped lips, fissures or desquamation of the lips, usually of the lower lip)
- Cheilitis exfoliativa exudative (crusted and painful lips)

 
What is the most common cause of cheilitis?

 
One of the main causes for this inflammation is the climate conditions especially at this time of the year. The sun rays and wind exposure followed by bad habits such as lip biting or licking but also the lack of certain vitamins or hormonal imbalance further exacerbate the inflammation.
How can you identify this condition?
If you have red, dry and scaling itchy lips, then it is best to see your doctor for further examination and have your medical history taken. In addition, the most common symptoms connected with cheilitis are:

 
· Dryness
· Redness
· Scaling or fissuring
· Tenderness
· Cracking or peeling
· Swelling (edema)
· Itching and burning sensation
· Crusting at the corners of the mouth (angular cheilitis)
· Brown-black discoloration of the lips (seen with certain types of irritant contact cheilitis)

 
Angular cheilitis

Angular cheilitis, as the name itself implies, causes inflammation of the skin located at the sides or "angles" of the mouth. Initially, saliva collects at the angles of the mouth and leads to dryness and cracking of the skin when it dries up. Secondary infection with the fungus, Candida albicans ("Yeast"), or less commonly the bacteria, Staphylococcus aureus ("Staph"), may then develop.Certain people are more prone to developing angular cheilitis, such as:

 
· Diabetic persons
· Elder people wearing dentures
· People that take medications that cause skin dryness (Isotretinoin – formerly known as Accutane)
· People suffering from anemia

 
It is important to note that angular cheilitis does not only affect adults. Children who drool, suck their thumbs, or lick their lips in the wintertime are also at a greater risk for developing this condition.

 
Actinic Cheilitis

Actinic or solar cheilitis is caused by long-term sun exposure and is more common on the lower lip than the upper lip. It is a pre-cancerous condition of the lip that most commonly occurs in light-skinned individuals and in people who live in hot, dry climates and/or work outdoors, for instance - construction workers.

 
Treatment

Depending on the cheilitis form, different treatment methods are used. For instance, angular cheilitis demands vitamin B and iron supplements. In addition, if yeast or staph infection occurs, then antibiotics or topical antifungal ointment should be applied. On the other hand, for cheilitis caused by allergy it is crucial to detect and remove the irritant/allergen.

 
What is our advice?

 
We believe that it is essential to discover the root of the problem first and then take the right multidisciplinary approach i.e determine the right form of cheilitis and treat it accordingly. Use protective sunscreen balms, avoid licking/sucking your lips or tearing the skin flakes. Depending on its nature, ask your doctor or dentist to help you out.