Summary about Disease
Cheilitis refers to inflammation of the lips. It can present in various forms, ranging from mild dryness and cracking to severe swelling, bleeding, and crusting. It can affect one or both lips and may be acute (short-term) or chronic (long-term).
Symptoms
Common symptoms include:
Dry, cracked, or scaling lips
Redness and inflammation
Itching or burning sensation
Pain or tenderness
Crusting or ulceration
Swelling
Peeling of the lips
Causes
The causes of cheilitis are varied and can include:
Irritant Contact Dermatitis: Exposure to irritants like lip cosmetics, toothpaste, foods, or allergens.
Allergic Contact Dermatitis: Allergic reaction to substances contacting the lips.
Infections: Bacterial, fungal (e.g., Candida), or viral infections (e.g., herpes simplex).
Nutritional Deficiencies: Vitamin deficiencies (e.g., B vitamins, iron).
Medications: Certain medications can cause cheilitis as a side effect (e.g., retinoids).
Systemic Diseases: Conditions like Crohn's disease, lupus, or Sjogren's syndrome.
Actinic Cheilitis: Chronic sun exposure leading to precancerous changes.
Angular Cheilitis: Often caused by fungal infection (Candida) at the corners of the mouth, exacerbated by saliva accumulation.
Habitual lip licking: Repeated licking dries the lips out.
Medicine Used
Treatment depends on the underlying cause:
Emollients/Moisturizers: Petrolatum-based products, lip balms, and ointments to keep lips hydrated.
Topical Corticosteroids: To reduce inflammation (e.g., hydrocortisone cream). Use sparingly and as directed by a doctor.
Antifungal Creams: For angular cheilitis caused by Candida (e.g., nystatin, clotrimazole).
Antibiotics: For bacterial infections (topical or oral).
Antiviral Medications: For herpes simplex infections (e.g., acyclovir).
Barrier Creams: Zinc oxide or titanium dioxide-based creams to protect lips from irritants.
Prescription Medications: For severe or chronic cases, a dermatologist may prescribe stronger topical or oral medications.
Is Communicable
Whether cheilitis is communicable depends on the cause.
Cheilitis caused by infections (e.g., herpes simplex) is communicable through direct contact.
Cheilitis caused by irritants, allergies, nutritional deficiencies, or systemic diseases is not communicable.
Angular cheilitis can sometimes be caused by bacteria and spread.
Precautions
Avoid Irritants: Identify and eliminate potential irritants and allergens.
Protect from Sun: Use lip balms with SPF 30 or higher.
Stay Hydrated: Drink plenty of water.
Avoid Licking Lips: This can worsen dryness.
Gentle Cleansing: Cleanse lips gently with mild, fragrance-free cleansers.
Good Oral Hygiene: Maintain good oral hygiene to prevent infections.
Avoid sharing personal items: Avoid sharing lip balm or utensils to minimize the risk of spreading any infection.
Diet: If a nutritional deficiency is suspected, follow a balanced diet and consider supplementation as advised by a healthcare professional.
How long does an outbreak last?
The duration of a cheilitis outbreak varies widely depending on the cause and treatment:
Mild cases due to dryness or irritation: May resolve in a few days with proper hydration and lip care.
Allergic reactions: May last a few days to weeks until the allergen is identified and avoided.
Infections (e.g., herpes simplex): May last 1-2 weeks.
Chronic cases: Can persist for weeks, months, or even years if the underlying cause is not addressed.
Angular cheilitis: Can last for several weeks if not properly treated with antifungals or antibiotics.
How is it diagnosed?
Diagnosis typically involves:
Physical Examination: A doctor will examine the lips and surrounding skin.
Medical History: The doctor will ask about symptoms, potential irritants, allergies, medications, and underlying medical conditions.
Allergy Testing: Patch testing may be performed to identify potential allergens.
Swab Culture: A swab of the affected area may be taken to check for bacterial or fungal infections.
Biopsy: In rare cases, a biopsy may be performed to rule out other conditions or confirm a diagnosis.
Timeline of Symptoms
The timeline of symptoms varies based on the cause:
Irritant Contact Dermatitis: Symptoms appear quickly (within hours to days) after exposure to the irritant.
Allergic Contact Dermatitis: Symptoms may appear 12-48 hours after exposure.
Infections: Gradual onset of symptoms over a few days, often with redness, swelling, and/or crusting.
Actinic Cheilitis: Develops slowly over years of sun exposure.
Angular Cheilitis: Gradual onset, usually starting with dryness and cracking at the corners of the mouth.
Important Considerations
Chronic Cheilitis: If cheilitis is persistent or recurrent, it's essential to see a doctor or dermatologist to identify and address the underlying cause.
Secondary Infections: Cracks and fissures in the lips can increase the risk of secondary bacterial or fungal infections.
Actinic Cheilitis: This condition is precancerous and requires prompt treatment.
Medication Side Effects: If cheilitis develops after starting a new medication, discuss it with your doctor.
Differential Diagnosis: Cheilitis can sometimes resemble other conditions, such as herpes labialis (cold sores) or impetigo, so accurate diagnosis is important.