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Actinic Cheilitis – Pictures, Symptoms, Causes, Treatment

Actinic cheilitis refers to the condition wherein the lower lip appears crusty, scaly and even ulcerated. This usually occurs when spending lots of time under the sun for so many years. People affected by this condition will find some thickening of the skin and whitish discoloration between the skin and the red border of the lower lip. This condition is not only unpleasant but can be dangerous too because it could progress to cancer over time.

Treatment is always necessary for actinic cheilitis. There are several ways to treat the condition which may involve special medications, creams and surgery. Treatment will not only help patients deal with the unpleasant effects of the condition but prevent recurrence as well.

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Cause of Actinic Cheilitis

Actinic cheilitis comes from the words “actis” and “cheilitis”, which in Greek mean “sun’s rays” and “inflamed lip”, respectively. These aptly describe the exact cause of the condition – chronic exposure to sunlight. UV rays have damaging effects on the skin, including its DNA. UV causes the superficial dermal layer of the skin to thicken; results in the overproduction of keratin; and the formation of blue-gray elastic fibers. The condition develops the same way that actinic keratosis does and affects other sun-exposed areas like the face, arms and hands.

The odds of suffering from actinic cheilitis are high among people who are:

  • Light or fair skinned
  • 50 years of age and older
  • Male
  • Always spend long hours outdoors for many years

This skin condition is known for several names, such as actinic cheiolosis, farmer’s lips and sailor’s lips. It is relatively common among older people who are light or fair skinned because they produce lesser amount of melanin, the substance that determines the color pigmentation of the eyes, hair and skin.

Factors that aggravate actinic cheilitis

While overexposure to sunlight remains the prime culprit for actinic cheilitis, several things can aggravate the condition, and these include:

  • Tobacco use
  • Smoking
  • Ill-fitting dentures
  • Poor oral hygiene
  • Some lip balms
  • Mild trauma

It is very important to detect and treat the condition the earliest possible time due to the possibility of developing skin cancer. There is a 6% to 10% chance for actinic cheilitis to progress into cancer known as squamos cell carcinoma.

Appearance of actinic cheilitis  

People affected by actinic cheilitis are initially unaware of the condition because the symptoms are quite subtle and cause no pain, making it extremely difficult to notice any change. When the initial symptoms show up, the lower lip will appear:

  • Dry
  • White or pale
  • Cracked
  • Scaly
  • Red
  • Discolored vermillion (red border)
  • Puffy

Over time, crusty bumps form causing the lower lip to appear wrinkled. They are, however, painless but stay there for months to years. Due to the risk of aggravating into cancer, affected individuals shouldn’t wait any longer than two months to have it checked by the doctor. Those who persistently experience scaly lips should visit the doctor as well. The doctor will conduct a skin biopsy to find out whether the bump is malignant or not.

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Actinic Cheilitis  Treatment

Treatment should start as soon as actinic cheilitis is diagnosed. The most apt treatment method will depend on the severity of the condition.

The disease can be treated with the use of:

  • 5-fluoroucil

This had been proven effective in treating mild actinic cheilitis by stopping DNA synthesis. The patient will initially notice some inflammation, erosion, smoldering and redness of the lower lip and would see the results after one month.

  • Imioquimod cream

This cream also gives impressive results in treating inflamed lips. Imioquimod cream is an immuno-modulator that presses on the immune response that will cause erosion and death of epidermal growth. It also helps in preventing future recurrence of lesions.

  • Cryosurgery

This method involves spraying liquid nitrogen to the lesions to destroy the diseased cells. The good thing about cryosurgery is that it removes the lesions with just a little scarring. The success rate of this treatment method is so high, making it the prime choice for actinic cheilitis treatment. However, cryosurgery could be very painful if the entire lower lip is treated.

  • Laser therapy

Laser therapy effectively removes diseased cells with little scarring and fast recovery. It does not cause lip deformation or loss of sensation.

  • Electrocautery

This method involves killing and removing diseased cells using a voltage electrified device or probe. The patient is treated under local anesthesia and some scars will be evident on the treated area.

  • Photo dynamic therapy

This procedure involves putting a light-sensitive agent on the lip and exposing it to a special lamp or laser. The laser will activate the light-sensitive agent which will kill the cells. This procedure causes little scarring but is only done if the lesions have only affected the surface of the lower lip.

  • Scalpel vermilionectomy

This method involves shaving the affected area with carbon dioxide laser. This results in scarring and possible secondary infection.

Actinic cheilitis needs close monitoring even after treatment and the doctor’s advice on proper lip care should be religiously followed to prevent degeneration.

Actinic Cheilitis Pictures


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