How to treat cheilitis? Types, photos, preparations

01 June 2020

Cheilitis is an inflammatory process that affects the border, mucous membrane and skin of the lips. The disease has a long-term recurrent nature.

Cheilitis is an inflammatory process that affects the border, mucous membrane and skin of the lips. The disease has a long-term recurrent nature. In young people, the course is more favorable and self-healing is possible. In old age there is a risk of leukoplakia and malignancy.

Symptoms of cheilitis

The disease manifests itself in a variety of symptoms; common complaints include swelling, redness, peeling of the lips, the appearance of bleeding ulcers, purulent crusts, burning and pain when opening the mouth and eating.

There are several forms of this pathology:

• Catarrhal
• Glandular
• Exfoliative
• Eczematous
• Candida
• Allergic

The causes of catarrhal cheilitis are usually injuries, weather conditions, and chemical damage. This form of the disease manifests itself in the form of diffuse inflammation of the lips, swelling, redness, and peeling.

With glandular cheilitis, the mucous glands of the lips become inflamed. The disease can occur against the background of injuries with the addition of infection. The presence of bad habits can also contribute to the development of this form of cheilitis.

The disease manifests itself as enlarged glands, discharge of pus, and increased lip volume. Often, as a result of such an inflammatory process, the lips do not restore their previous shape, since changes in the form of cysts form in the labial glands.

Exfoliative cheilitis is divided into dry and exudative. Exfoliative cheilitis is more common in women. With dry exfoliative cheilitis, yellow scales appear on the lips and dryness is pronounced. In addition, the red border of the lips is affected by dyskeratosis.

The exudative form of exfoliative cheilitis is characterized by severe pain, swelling of the lip, and the presence of abundant crusts that make speech and eating difficult. Sometimes the crusts hang down in the form of an apron when the exudative phenomena are significant. Candidal cheilitis is provoked by the fungal infection Candida albicans, and this form of the disease is often combined with stomatitis.

Various allergens can cause another form of cheilitis - eczematous. This type of cheilitis occurs when there is an allergy to cosmetics, a lack of B vitamins in the body, or chronic injury to the lips. In addition, allergic (eczematous) cheilitis occurs due to increased sensitivity of the red border of the lips to chemicals (for example, dyes) included in toothpaste, lipstick, and dentures. It occurs with swelling and redness of the red border of the lips, then becomes covered with abundant scales and crusts, and painful cracks form in places.

Classification of cheilitis

Primary (independent)

• Glandular

This lip disease is caused by acquired or congenital enlargement of the minor salivary glands and their infection. Most often it affects people over 30 years of age. It is worth noting that the upper lip is affected 2 times less often than the lower lip. At the beginning of the development of the disease, patients are concerned about peeling and slight dryness of the lips. If left untreated, pain may occur due to cracks and erosion.

• Exfoliative

This disease affects only the red border of the lips and is accompanied by peeling.

In most cases, women suffer from this disease. In the dry form, scales form on the lips, a feeling of dryness and burning appears; in the exudative form, swelling and abundant crusts form, making it difficult to eat and speak.

• Contact allergic

This disease is caused by a delayed allergic reaction to various irritants upon contact with the red border of the lips. In most cases, this disease affects women over the age of 20. Signs include redness of the lips, swelling, burning and severe itching. With repeated contact with the irritant, the disease worsens. If treatment for cheilitis is not started in a timely manner, the lip becomes covered with small blisters, after which cracks and erosion appear.

• Meteorological

This disease is caused by increased sensitivity to ultraviolet radiation, wind or cold. In most cases, it affects men aged 20 to 60 years. The exudative form is characterized by itching, burning of the lips, and the appearance of erosion. Small bubbles may appear, after opening which crusts form. In the dry form, erythema of the lips is observed, small white-gray scales appear. If left untreated, abrasions and erosion may develop in the future.

Secondary (symptomatic)

• Atopic

It is believed that this type of disease is one of the manifestations of atopic dermatitis. Patients complain of slight swelling of the red border of the lips, while adjacent areas of the skin are involved in the inflammatory process. Also, manifestations of the disease include damage to the corners of the mouth. When acute inflammation begins to subside, the lip begins to peel off. As a result of dryness in the corners of the mouth, cracks form. In the absence of comprehensive treatment, peeling of the facial skin is possible.

• Eczematous

This disease develops against the background of eczema, which results in inflammation of the surface layers of the skin. In the acute stage, patients complain of redness of the lips, burning and itching. In this case, each lip swells, erythema and pathological changes in the skin are observed. If there is no comprehensive treatment, the disease becomes chronic. In this case, acute inflammatory phenomena (hyperemia, edema) decrease, inflammatory infiltration develops, and nodules and scales may form.

• Hypovitaminosis

This disease in most cases develops against the background of hypo- or avitaminosis of group B. Symptoms of cheilitis include burning and dryness of the tongue, lips and oral mucosa. If the disease is not treated, vertical small cracks appear on the red border of the lips, which often bleed. The tongue may increase in size, and teeth marks are often visible on it.

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Prevention

As you know, prevention is cheaper than treatment. In addition, preventing a disease is much easier than curing it, although this will require regularly following some rules.

Pay more attention to oral hygiene. To prevent the formation of cracks, it is necessary to protect the skin and mucous membranes of the mouth from adverse effects: unlearn the habit of licking the lips and corners of the mouth, use medicinal cosmetics for dry skin (lipstick, balm, cream). To avoid infection of the skin of the lips from the oral cavity, it is necessary to regularly brush your teeth, see a dentist, and promptly treat caries and inflammatory gum diseases.

Follow the rules of nutrition. If cracks appear in the corners of the mouth, exclude from the diet spicy, sour and salty foods that irritate the mucous membrane and skin. Include less acidic fruits and vegetables in your daily diet, as well as foods containing iron and riboflavin (beef, liver, dairy products, cabbage, potatoes, peanuts, almonds and others).

Give up bad habits. Smoking is a provoking factor in the development of this disease.

Atopic

This disease is one of the symptomatic manifestations of atopic dermatitis. Characteristic signs are redness, slight swelling, itching, peeling of the skin in the red border area, as well as the spread of the inflammatory process to the corners of the lips, where cracks often form.

The cause is considered to be genetic abnormalities and poor heredity. By puberty, atopic cheilitis can heal itself or go into remission, but recurrent seasonal lesions cannot be ruled out. Allergens can be food, cosmetics, medications and many other factors.

Treatment of cheilitis

Treatment of the disease depends on the causes of its occurrence. For example, to treat allergic cheilitis, drugs are used that reduce the body’s sensitivity to allergens - antihistamines, as well as vitamins. Zinc ointment, anti-inflammatory creams containing glucocorticoids, salicylic acid, and sulfur are used externally. Avoid substances that irritate the mucous membrane of the mouth and lips. After eating, rinsing with chamomile infusion or soda is useful. To determine the allergen, it is necessary to conduct allergy tests.

For fungal cheilitis, antifungal drugs are prescribed in combination with vitamin B2 and ascorbic acid. An examination by a dentist and, if necessary, complete sanitation of the oral cavity and thorough treatment of problem areas with oil solutions of vitamins are recommended. To prevent relapses, a diet with limited carbohydrates is prescribed. In the treatment of exfoliative cheilitis, corticosteroid and photoprotective ointments, 2% boric salicylic acid ointment are widely used. In the presence of an exudative form of exfoliative cheilitis, Bucca radiation is effective.

Diagnosis of this disease is carried out by several doctors: a therapist, a dentist, an allergist. A combination of systemic (general) and topical (local) drug therapy produces a good effect.

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Reasons for development

In the clinical practice of most specialists, there are cases where cheilitis on the lips developed on its own or was a side effect of a serious disease of the internal organs or damage to the mucous membrane. Among the most likely causes of the development of the disease are:

• inflammation of the mucous membrane with dermatoses, erythematoses or lichen planus;
• infectious diseases: syphilis, tuberculosis, etc.;
• psoriasis and other skin problems.

Among the unfavorable external factors, it is worth noting an excessive amount of ultraviolet radiation, strong wind, flows of cold or hot air from climate control equipment or ventilation in industrial premises. Signs of cheilitis are often observed in people who work in open areas in direct sunlight.

A separate group includes manifestations of allergic cheilitis, which developed after contact of the lip mucosa with aggressive chemicals or prolonged exposure to ultraviolet radiation. Sometimes doctors observe the clinical picture of secondary cheilitis, when the development of the disease is caused by eczema, neuritis of the facial nerve, pathologies of the muscles and tissues of the facial part of the skull.

Allergic

Allergic cheilitis most often occurs in women after twenty years of age and is characterized by swelling, severe burning, itching and redness of the lips. Sometimes, with a severe allergic reaction, small blisters form on the skin, which burst, leaving behind cracks and erosions.

The reason is a tendency to allergic reactions and direct multiple contact with the allergen. Allergic contact dermatitis can be caused by any substance: lanolin from lipstick, components of toothpastes and dentures, paint from foreign objects, metal and anything that touches the lips. When allergic cheilitis occurs, treatment consists of identifying the allergen and eliminating it.

Reasons for education

The causes of damage to the mucous membrane of the lips are the harmful effects of the environment, sudden changes in temperature in winter and summer, leading to chapping, drying out and the formation of cracks. Excessive intake of spicy, hot, salty and sour foods can also cause inflammation. In addition, the following reasons contribute to the formation of cheilitis:

1. Clogging of pores with lanolin (animal wool wax found in lipsticks), leading to flaking, irritation and allergic reactions.
2. Contact allergies and dermatoses that occur when lips come into contact with harmful chemical compounds (at work or just in everyday life).
3. Systemic diseases of the endocrine system, congenital and acquired immunodeficiencies.
4. Lip lesions can also be caused by such serious diseases as skin tuberculosis, lichen, and syphilis.
5. Diseases that arise from the nervous system, such as psoriasis and eczema, can also cause complications in the lip area.
6. There are also possible genetic causes of cheilitis, for example, with ichthyosis.
7. Diseases of internal organs can affect the development of the inflammatory process. There are frequent cases of lip damage due to the liver or disruptions in the gastrointestinal tract.
8. A sharp decrease in the level of body resistance due to cancer or its treatment (during chemotherapy) also leads to a disruption of the natural protection of the lip area.

How to treat cheilitis on the lips?

To identify the disease and determine its cause and type diagnosis ; the clinic usually carries out:

• skin tests and smears;
• Ultrasound of internal organs (thyroid, pancreas, liver, etc.);
• blood tests (general, biochemistry, antibodies, allergens, etc.) and urine;
• biopsy and histology of epithelial cells.

Treatment is selected according to the diagnosis:

1. General strengthening measures:

• systematic oral and facial hygiene;
• sanitation of the lip mucosa with aseptic solutions;
• getting rid of irritants (nicotine, alcoholic beverages, the habit of biting or licking lips, hypersalivation, contact with allergens, solar radiation, etc.);

2. Drug therapy

• local treatment, antibacterial or glucocorticosteroid ointment (as indicated);
• taking antihistamines;
• pain relief for severe pain;
• a course of antibiotics, antiviral, immunostimulating agents (depending on the type of cheilitis).

3. Physiotherapy:

• ultrasound;
• UHF;
• electrophoresis.

4. Surgical treatment:

• electrocoagulation;
• laser cauterization;
• cryodestruction.

Drugs

Medicines traditionally used in the treatment of cheilitis:

• Prednisolone;
• Erythromycin;

• Doxycycline;
• Diphenhydramine;
• Suprastin;

• Infliximab;
• Methotrexate;
• Zinc;
• Boric acid;

• vitamin A, vitamin B, PP, etc.;
• Roxithromycin;
• Peridoxin;
• Sulfasalazine;
• Kenalog 40;
• Tacrolimus-teva;
• salicylic acid;
• sulfur;
• Bromine, Valerian, Motherwort;
• Elenium, Oxilidine, Seduxen.

Eczematous

This type of cheilitis is a symptomatic manifestation of eczema, an inflammatory process on the surface layers of the epithelium caused by stress or allergic reactions. In the acute stage, eczematous cheilitis is accompanied by redness, burning, itching, swelling and pain in the lips. In addition, the acute course of the disease is often accompanied by the formation of vesicles, weeping blisters and crusts. When transitioning to the chronic form, swelling and hyperemia decrease, but infiltration increases, scales and nodules form. The main treatment for eczematous cheilitis is to take sedatives and antihistamines.

Glandular

The main difference between glandular cheilitis is the presence of small red dots (enlarged hypertrophied salivary glands) on the red border of the lips. Droplets of salivary fluid are constantly released from these channels, which irritate the skin and provoke an inflammatory process, as well as drying out of the epithelium, the formation of cracks and erosions.

The disease itself appears as a result of gene abnormalities, or against the background of serious diseases. Treatment with drugs rarely gives a positive result, so most often the hypertrophied glands are removed surgically.

Chronic

The presence of chronic cheilitis in a patient indicates that at one time, due attention was not paid to the treatment of the acute form. The development of this form can also be caused by previous infectious diseases caused by yeast infections, streptococci and staphylococci, as well as injuries or hormonal imbalances.

Treatment of the chronic form of the disease is determined based on the cause of its formation. Types such as Miescher granulomatous cheilitis, streptococcal, glandular and meteorological cheilitis can become chronic.

Signs, types and methods of treating cheilitis on the lips

• Causes
• Symptoms
• Kinds
• Treatment

Redness, dryness, and cracks on the lips are familiar to many. These are pronounced symptoms of cheilitis, popularly called “jams”, an inflammatory lesion of the red border and nearby areas of the skin. Almost every person in the world has experienced symptoms of cheilitis, but not everyone turns to specialists with this problem.

Doctors rarely use the term “cheilitis” to describe a specific disease; usually this word refers to an inflammatory process. However, cheilitis in any form is a disease that requires specialist consultation and appropriate treatment.

Cheilitis does not have a permanent place of residence; it can be diagnosed by almost any doctor, since there are many reasons for the appearance of the disease. But most often, dermatologists and dentists are involved in its diagnosis and treatment.

Causes

The causes of inflammation on the lips may be the following factors:

• Dysfunction of the nervous system;
• Genetic predisposition;
• Decreased immunity, allergic reactions;
• Ultraviolet irradiation;
• Exposure to extreme weather factors - cold, wind, dry air;
• The presence of chronic foci of infection in the oral cavity, such as caries, pulpitis, periodontitis;
• Traumatic damage to the red border.1

Symptoms

The picture of the disease depends on the type of inflammatory process and its causes. Common symptoms include:

• Redness and swelling of the red border of the lips;
• Excessive thickening of the skin;
• Pain in the area of ​​inflammation, especially during eating;

• Dry skin and the formation of cracks and erosions on it;
• A sharp change in the color of the damaged mucous membrane.

Types of cheilitis

According to the modern classification of cheilitis, diseases include two main groups: independent inflammatory processes (granular, allergic, meteorological, contact, etc.) and symptomatic lesions (eczematous, atopic and others). The division into such types is based on the causes and characteristics of the clinical course of the disease2.

Glandular cheilitis

The disease is characterized by an inflammatory process in the small salivary glands located on the border of the red border of the lips. The inflammatory process is located in the area of ​​the lower lip. This disease is a consequence of the abnormal structure of the lower lip. The disease has a characteristic clinical picture and begins with the appearance of bright red dots filled with saliva on the mucous membrane of the lips and red border. Even if you blot your lips, droplets of saliva appear again after a while.

Glandular cheilitis includes three subtypes:

• Simple, in which the lower lip is slightly enlarged in size, and small nodules covered with saliva are visible on the mucous membrane.
• Secondary, which develops due to chronic diseases (systemic lupus erythematosus, rheumatoid arthritis, etc.).

• Purulent - a rare type, which is characterized by infection of the ducts of the salivary glands with subsequent release of pus.

Glandular cheilitis is treated with antibacterial agents, corticosteroid ointments and drugs to simulate epithelialization. Doctors additionally prescribe the patient vitamins A and B. If conservative treatment is unsuccessful, dentists resort to plastic surgery3.

Atopic cheilitis

This pathological condition is a separate manifestation of dermatitis, neurodermatitis and mainly affects people aged 7-17 years. A key risk factor is a genetic predisposition to an allergic reaction.

Symptoms of the atopic type are itching, redness, and slight swelling of the red border in the corners of the mouth. Often this inflammatory process spreads to the skin. The patient gradually develops dryness, cracks and crusts at the site of scratching. As the acute phase subsides, increased peeling of the skin of the lips is observed, and small cracks form in the corners of the mouth.

Treatment of the atopic form consists of systemic administration of antihistamines, vitamins, sedatives, and local treatment with corticosteroid ointments.

Macrocheilitis

The disease refers to pathologies associated with impaired lymph outflow. A symptom of macrocheilitis is painless lip enlargement. The disease occurs in a chronic form, with constant alternation of stages of exacerbation and remission. Diagnosis is made by visual confirmation of edema and fibrous inflammation.

Treatment of macrocheilitis in the early stages is medicinal and therapeutic. Doctors recommend the patient thermal baths, massaging the damaged area of ​​the red border, paraffin therapy, sclerosing therapy. When the disease develops, experts advise radical intervention.

Meteorological cheilitis

Adverse weather conditions can cause inflammatory lesions of the red border. Symptoms of the meteorological type are infiltration and hyperemia of the lips. In this case, the outer layer becomes covered with scales, and increased dryness of the red border is noted. Patients complain of dryness, a feeling of “tightness” of the lips, and increased peeling.

Treatment of the meteorological form is aimed at eliminating the effect of the irritating factor. In such cases, experts advise taking nicotinic acid and B vitamins. Local treatment is carried out with hygienic lipstick and photoprotective cream.

Exfoliative cheilitis

This is an isolated disease of the red border, manifested by peeling of the epithelium and disruption of its keratinization processes. The main factors are genetic predisposition and lack of immunity.

Symptoms of the exfoliative type depend on the clinical form of the disease:

• 1 The dry type of inflammation is characterized by the formation of a thin strip of scales between the red border and the mucous membrane. After their removal, the hyperemic surface of the lip is exposed, which is soon re-covered with the same scales. These cycles can repeat for decades.

• 2 In the exudative form, patients complain of a layer of yellow-brown crusts in the area of ​​the lower lip. After removing such growths, a bright red surface covered with white exudate is noticeable. In such cases, the crusts tend to be constantly restored, which causes the cyclical nature of the pathology.

Treatment of exfoliative cheilitis in the dry form involves lubrication with moisturizing ointments, lipsticks, and at the exudative stage, patients undergo complex therapy using immunostimulants.

Actinic cheilitis

Chronic inflammation of the skin of the lips, which forms due to exposure to ultraviolet rays, develops mainly in spring and summer.

Actinic type symptoms are determined depending on the form of the disease:

• 1 The dry stage is manifested by a swollen red border covered with whitish scales.

• 2 With the exudative form, bubbles appear, which, when cracking, form cracks and erosions.

Treatment of such cheilitis consists of protecting the lips from direct sunlight, moisturizing the surface of the lips and treating it with products with protective UV filters. In severe cases, specialists resort to the use of corticosteroid ointments.

Eczematous cheilitis

Chronic allergic inflammation can occur on its own or be a symptom of facial eczema. Allergens can be different - germs, cosmetics, medications, certain foods, toothpaste and much more.

The symptoms of such cheilitis are very diverse. First, bubbles appear against the background of a bright red lip. These elements gradually merge, crack, and become wet. Over time, the surface becomes covered with scales. Patients are bothered by itching, burning, difficulty speaking and opening their mouth.

Treatment is carried out at two levels: systemic (antihistamines and vitamin preparations) and local (corticosteroid cream and antiseptics).

Contact allergic cheilitis

The disease occurs after frequent contact of the skin of the lips with chemicals that cause an allergic reaction. Swelling of the lips can spread to the mucous membrane and skin. After some time, individual areas of peeling, blisters, and erosions are noticeable.

Treatment of the contact allergic form involves eliminating contact with the chemical factor. Patients also use corticosteroid ointments and systemic antihistamines.

Chronic cracked lip

Inflammation of the deep layers of the skin of the lips provokes the formation of cracks. The causes of the disease may be climate change or trauma to the red border.

Treatment of cracks is carried out after identifying the cause of the damage. Local hormonal ointments, painkillers and agents for restoring the mucous membrane are used.

Hypovitaminous cheilitis

The main reason for this inflammation is insufficient intake of vitamins A, E, B into the body. Symptoms include chronic fissure, burning sensation and dryness in the red border area.

Treatment includes taking vitamin preparations and local treatment of the inflammation with antiseptics3.

How to treat cheilitis on the lips?

Treatment of cheilitis depends on the type and extent of the disease. In most cases, therapy is complex. At the systemic level, doctors recommend getting rid of the causative factor, prescribing antibacterial medications and immunostimulants.

Local manifestations are treated with hormonal ointments and antiseptics. During recovery, it is advisable to lubricate your lips with a drug that stimulates the immune system.

With reduced local immunity, inflammation often occurs not only on the lips, but also in the oral cavity and its mucous membranes. The drug Imudon® will help strengthen local immunity. This is a local drug for the treatment and prevention of infectious and inflammatory diseases of the oral cavity and pharynx4. Imudon® interacts with the mucous membrane directly at the site of the disease, providing protection against bacterial, fungal and viral pathogens. Lactobacilli contained in the drug relieve inflammation and promote healing and restoration of the oral mucosa5.

Treatment of cheilitis on the lips in children is carried out by a pediatric dentist or dermatologist using broad-spectrum antibacterial medications and natural-based restoratives.

The article was prepared based on materials:

1. Lutskaya I.K. Diseases of the lips - cheilitis / I.K. Lutskaya // Consilium Medicum. Dermatology (Add.). – 2016. – No. 1. – 58-62 s. 2. Borovsky E. V. Diseases of the mucous membrane of the mouth and lips. / E. V. Borovsky, A. L. Mashkilleyson. – M.: Medicine, 1984. – 116-129 p. 3. Lutskaya I.K. Clinical manifestations of independent lip diseases / I.K. Lutskaya // Medical news. – 2011 – No. 11. – 4-8 s. 4. INSTRUCTIONS FOR MEDICAL USE OF THE MEDICINE Imudon® dated 07/02/2018. 5. Shumsky A.V. Imudon in the treatment of infectious and inflammatory diseases of the oral mucosa. Scientific and practical journal “Dentistry”, 2000, No. 6, volume 79, p. 53-54.

The material was developed with the support of Abbott to improve patient health awareness. The information in the material does not replace the advice of a healthcare professional. Contact your doctor.

RUIMD192468 from 08/16/2019

To learn more

Herpetic

It is necessary to distinguish the manifestations of herpetic cheilitis from lip cancer. Despite the fact that in both diseases ulcerative lesions and dark brown crusts appear, the removal of which leads to bleeding, in the first case a striking distinctive feature is the formation of small blisters, after opening which erosions form. The appearance of blisters is accompanied by increased itching and burning in the area of ​​inflammation. If left untreated, acute herpetic cheilitis can become chronic with frequent exacerbations.

Causes of cheilitis

• adverse weather conditions
• allergies
• lack of vitamins
• bad habits (licking and biting lips, habit of chewing pens)
• bad habits (licking and biting lips, habit of chewing pens)
• anomaly of the lip structure
• emotional and physical overload
• infections

Cheilitis often occurs against the background of diseases of the digestive, endocrine, nervous and immune systems. An important role is played by poor oral hygiene and multiple caries, since in this situation the number of microorganisms in the mouth increases.2 Cheilitis is often found in children with bronchial asthma and diabetes.3