In this article, we’ll dive into cheilitis, a condition that causes inflammation of the lips. Cheilitis can either be acute (short-lived) or chronic (persistent), and it can be a frustrating and challenging issue to diagnose and treat. There are a variety of causes for this condition, and understanding the type of cheilitis you're dealing with is key to finding the right treatment.
Let’s break down the different forms of cheilitis, how they occur, and the best ways to address them.
What is Cheilitis?
Cheilitis refers to the irritation or inflammation of the lips. While the causes can vary, the condition generally results in symptoms like redness, dryness, chapping, itching, burning, and sometimes painful cracks that may even bleed. These symptoms can be mild or severe, depending on the cause and how long the inflammation lasts.
Despite the common appearance of these symptoms, cheilitis can be caused by different factors, which makes diagnosis a bit tricky. We’ll go over some of the most common causes and treatments.
Types of Cheilitis and Their Causes
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Allergic Contact Cheilitis One of the most common causes of cheilitis is an allergic reaction, often triggered by a product applied directly to the lips, such as lip balm, lipstick, or lip gloss. Ingredients like fragrances or certain chemicals may cause an allergic response, even if you’ve been using the product for years without issue. In some cases, the allergy can develop gradually, and you might not realize it’s happening until your lips become red, irritated, or cracked. Treatment: The first step is to stop using the product that caused the allergy. Topical steroids are often effective in reducing the inflammation associated with allergic contact cheilitis. These medications help soothe the skin and reduce the allergic reaction.
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Irritant Contact Cheilitis Irritant contact cheilitis occurs when an agent damages the skin's barrier, leading to irritation. This can happen due to harsh lip products, over-exfoliating, or exposure to certain environmental irritants like wind or dry air. The symptoms—redness, pain, burning, and cracking—are very similar to allergic contact cheilitis, but the cause is not an allergy. Treatment: The key to managing irritant contact cheilitis is removing the irritating product or agent. Once the cause is withdrawn, you may need a topical steroid to reduce inflammation and allow the skin to heal. It’s also essential to avoid harsh scrubbing or exfoliation while your lips are healing.
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Candidiasis (Yeast Infection) Candidiasis is a yeast infection caused by an overgrowth of the fungus Candida on the lips. This can lead to severe inflammation and discomfort. Unlike allergic or irritant cheilitis, this condition does not respond to steroids but requires antifungal treatment. Treatment: For mild cases, topical antifungal creams like nystatin can be effective. For more severe infections, oral antifungal medications may be necessary. Once the infection clears up, a topical steroid may be used to address any residual inflammation.
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Actinic Cheilitis (Sun-Induced Inflammation) Actinic cheilitis is a form of chronic inflammation that occurs as a result of sun damage, particularly in areas of the lips that have been exposed to UV radiation. This condition is more common in older individuals who have had prolonged sun exposure over the years. In severe cases, actinic cheilitis can lead to the formation of actinic keratosis—precancerous growths that may develop into skin cancer (specifically squamous cell carcinoma) if left untreated. Treatment: Actinic cheilitis requires specialized treatment. In some cases, liquid nitrogen is used to freeze and remove damaged tissue. Other treatments, like photodynamic therapy (PDT), involve applying a photosensitizing agent to the affected area and then using light therapy to destroy damaged cells. Regular monitoring is important, as actinic cheilitis can lead to more serious conditions like skin cancer.
The Importance of Skin Barrier Protection
In all forms of cheilitis, maintaining the integrity of the skin barrier is crucial. Cheilitis disrupts the skin’s natural protective layer, which can slow healing and make the condition worse. Applying an occlusive layer, like white petroleum jelly or a soothing balm such as shea butter, can help restore the skin barrier. This can speed up recovery by preventing moisture loss and protecting the lips from further irritation.
Final Thoughts on Cheilitis
Cheilitis is a common but often misunderstood condition. Whether it’s triggered by an allergic reaction, irritants, a fungal infection, or sun damage, knowing the cause is key to finding the right treatment. By identifying the type of cheilitis you're experiencing, you can take steps to heal your lips effectively.
If you think you're dealing with cheilitis, it’s always a good idea to consult a dermatologist for an accurate diagnosis and treatment plan. In many cases, proper care and attention can restore your lips to health in no time.
If you found this helpful, subscribe to Dr. Bibi's Newsletter for cutting edge skincare and share this article. For further insights into skincare simplification, check out my book "Sick Skin - Skin Care Made Simple" on Amazon, now available in audio.
Thanks for reading and God bless.
Yuval Bibi, MD/PhD - Board Certified Dermatologist
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