Cheilitis Lip Inflammation Causes and Treatment (2024)

Cheilitis is a group of inflammatory conditions that cause the skin of the lips to become red, dry, scaling, and itchy. There are many possible causes of cheilitis, including infections, allergies, irritants, and even habitual behaviors like lip-licking.

Cheilitis can usually be diagnosed with a review of your medical history and an examination of your mouth and lips. Other tests like patch testing or a skin biopsy may be ordered if an allergy, inflammatory disease, or malignancy (cancer) is suspected. The treatment depends on the underlying cause.

Cheilitis Symptoms

There are several different types of cheilitis, but they share many of the same symptoms, including:

• Lip dryness
• Redness
• Swelling
• Scaling or peeling
• Cracking or splitting of the lip
• Tenderness
• Itching and burning sensations
  
• Crusting at the corners of the mouth
• Lip discoloration

If not appropriately treated, cheilitis can lead to secondary infection in which bacteria enter a crack or abrasion in the skin and establish an infection. This can result in permanent scarring, discoloration, and thickening of the lip.

Types and Causes of Cheilitis

Cheilitis is characterized by inflammation, the body's natural response to injury, infection, or disease. Inflammation causes the swelling of tissues along with pain, redness, and warmth.

Eczematous Cheilitis

Eczematous cheilitis is the most common form of cheilitis in which eczema (atopic dermatitis) develops on the lips. It is a non-contagious condition caused by an abnormal immune response.

Eczematous cheilitis is most common in people with other atopic (allergy-related) conditions like hay fever, food allergies, and asthma.

With eczematous cheilitis, symptoms occur when you are exposed to stimuli that trigger an allergy (called allergens) or irritate the skin (called irritants). Depending on the cause, symptoms may last for up to three weeks.

Possible triggers for eczematous cheilitis include:

• Lipstick or lip balms
• Toothpaste or mouthwash
• Food allergens
• Rubber or latex (such as caused by chewing on an eraser)
• Metals including nickel, cobalt, or gold
• Sunscreen
• Certain topical medications like bacitracin
• Food additives like propylene glycol
• Chronic lip-licking
• Cold, dry temperatures

Angular Cheilitis

Angular cheilitis is a form of cheilitis that affects the corners of the mouth. It occurs when saliva collects in crevasses and, in the process of evaporation, draws excess moisture from the skin, causing it to dry out and crack.

Secondary infection is common with angular cheilitis. This includes infection with the fungus Candida albicans (which causes oral thrush and yeast infections) or the bacteria Staphylococcus aureus (which causes staph infections).

Angular cheilitis often goes awaywithin two weeks when treated but can persist for weeks if left untreated.

Certain people are more prone to getting angular cheilitis, including those with diabetes, people with iron or vitamin B deficiency, and individuals who wear dentures. Medications that cause dryness, like isotretinoin, can also lead to angular cheilitis.

Children who drool, suck their thumbs, or lick their lips in the wintertime are also at risk.

Actinic Cheilitis

Actinic cheilitis is also called solar cheilitis because it is caused by long-term exposure to the sun. It is more common on the lower lip than the upper lip.

Actinic cheilitis is a form of precancer that on rare occasions can turn into a type of skin cancer called squamous cell carcinoma (SCC). It most commonly affects light-skinned people who spend too much time in the sun without the appropriate sun protection.

Actinic cheilitis also affects people who work outdoors for long hours, like fishing, forestry, or construction workers.

Rare Types of Cheilitis

There are other uncommon types of cheilitis, including:

• Exfoliative cheilitis: This is a rare condition mainly affecting younger adults that causes the continuous peeling of the lips. The cause is unclear but appears to be linked to repetitive behaviors like lip-sucking, lip-biting, or lip-licking.
• Glandular cheilitis: This is a rare condition mainly affecting older White adults in which the salivary gland produces thicker and more profuse amounts of saliva (particularly while a person is sleeping). It causes yellowish plaques or crusts on the skin of the lips.
• Cheilitis granulomatosa: Also known as granulomatous cheilitis, this is a condition that tends to affect young adults who develop persistent, painless swelling of the lips. The cause is unclear, although some suspect it may be a form of autoimmunity.

Diagnosis

When diagnosing cheilitis, your healthcare provider will review your medical history, including exposures to cosmetics, foods, allergens, or irritants. They will also perform a close-up examination of the mouth and lips.

Based on the initial findings, other tests may be ordered, such as:

• Patch testing: An adhesive patch infused with common allergens is placed on an unexposed area of the skin to see if you get an allergic reaction.
• Skin prick test: Tiny amounts of common allergens are embedded beneath an unexposed area of the skin to see if you get an allergic reaction.
• Lip swab: A cotton swab is swiped over affected skin to obtain fluid and skin cells for evaluation in a lab. The lab can check for infections using genetic-based PCR tests or bacterial or viral cultures.
• Punch biopsy: A tiny piece of tissue from your lip is removed with a springloaded punch. The lab can look for abnormalities such as cancer or precancer.

Cheilitis Treatment

Cheilitis can be cured in most cases, but the treatment depends on the underlying cause.

Eczematous Cheilitis

Topical corticosteroids (steroids) are commonly used to treat eczematous cheilitis. These are applied to the lips to bring down inflammation.

Lip balm or an emollient, like petroleum jelly, can keep the skin moisturized and reduce dryness. An over-the-counter antibiotic cream like Neosporin can help prevent infection.

If a specific allergen or irritant is identified, it is important to avoid them wherever possible. Behavioral changes, like avoiding lip-licking, should also be stressed.

Angular Cheilitis

For angular cheilitis, a topical antifungal may be prescribed to resolve the underlying yeast infection, while a topical antibiotic may be used to treat an underlying bacterial infection. A protective lip balm or barrier cream, like zinc oxide or petroleum jelly, can also help.

Improving oral hygiene, including the daily cleaning of dentures, is important. Vitamin B or iron supplements may be prescribed if an underlying deficiency has been found.

Actinic Cheilitis

There are several treatment options for actinic cheilitis, depending on its severity:

• Surgical excision; The removal of the skin lesion with a scalpel
• Cryotherapy: The removal of affected skin with sub-zero cold
• Laser ablation: The removal of affected skin with a laser
• Photodynamic therapy: Uses topical substances that react to ultraviolet (UV) light to reduce the lesion
• Topical chemotherapy: Uses cancer-fighting drugs like fluorouracil to kill the cells
• Topical immunotherapy: Uses drugs like imiquimod that stimulate the immune system to stop the growth of precancer cells
  

How to Prevent Cheilitis

Some measures you can take to prevent common causes of cheilitis include the following:

• Avoid known irritants or allergens.
• Don’t lick your lips.
• Protect lips with an emollient such as petroleum jelly or zinc oxide.
• Replace poorly fitting dentures or tooth implants, if either is a cause.
• Before bed, remove and soak dentures overnight in 10 drops of chlorhexidinegluconate or bleach diluted in water.
• Protect your lips from the sun by using sunscreen-containing lip balms.

It's also important to get treatment for any underlying conditions that can trigger cheilitis.

Summary

Cheilitis refers to a medical condition where the lips become inflamed, scaly, and cracked. Possible causes include irritants and allergens, atopic dermatitis, chronic sun exposure, and infection. A healthcare provider can diagnose the condition based on a visual examination of your lips (and surrounding skin) and testing if needed.

In many cases, you can treat chapped lips at home. However, some types of cheilitis—such as those caused by infection or another underlying condition—may require treatment from a medical professional.