cheilitis

Cheilitis is inflammation of the lips, a broad term that describes several distinct conditions presenting with redness, cracking, scaling, crusting, or swelling of the lips and the surrounding skin. It can be acute or chronic and may involve one or both lips.

Common forms include angular cheilitis, which affects the corners of the mouth and is often caused by moisture, denture fit, and secondary infections with Candida or bacteria; actinic cheilitis, a sun-related condition that typically affects the lower lip and carries a risk of premalignant change; irritant or contact cheilitis from irritants such as lip licking, weather exposure, or certain cosmetics; and allergic contact cheilitis linked to fragrances, preservatives, metals, or flavorings. Infections, nutritional deficiencies (eg, iron or B vitamin deficiencies), and systemic conditions can also contribute.

Symptoms vary by form but typically include dry, cracked, or scaly lips, burning or stinging sensations, swelling, and crusting. Diagnosis is mainly clinical, based on history and exam. Additional testing may be used to identify infectious agents (cultures or microscopy), assess for nutritional deficiencies, or exclude actinic cheilitis/other premalignant changes. Patch testing may be helpful for suspected allergic cheilitis, and biopsy is considered when malignancy cannot be excluded.

Treatment focuses on the underlying cause and symptom relief. General measures include lip moisturizers and barrier creams, avoiding irritants, and good lip protection. Infections are treated with antifungals or antibiotics as indicated. Angular cheilitis may improve with denture adjustments and moisture control. Actinic cheilitis requires sun protection and may require topical therapies (eg, fluorouracil or diclofenac) or surgical management if dysplasia is present. Prevention emphasizes sun protection, minimizing lip licking, and avoiding known irritants.

Prognosis depends on the underlying cause; actinic cheilitis carries a risk of progression to skin cancer, underscoring the importance of monitoring and timely management.