Cheilitis on the lips - causes of the disease, treatment methods

Cheilitis is an inflammation of the red border, mucous membrane and skin of the lips. In common parlance, the disease is called jamming. The inflammatory process can be long-lasting and periodically worsen. In healthy young people it often goes away on its own, but in children, the elderly and people with chronic diseases it should be treated with medication. Elderly people have a high risk of leukoplakia and malignancy of the process.

Cheilitis is treated by a dentist, and if necessary, a therapist, pediatrician and other specialized specialists - an endocrinologist, an infectious disease specialist, etc. - are involved in drawing up a treatment plan.

Reasons for the development of cheilitis

The main causes of the disease include:

• Dermatoses seem to be the most common cause of cheilitis. Skin diseases such as psoriasis, lupus erythematosus, syphilis, tuberculosis, lichen, also often provoke inflammation of the red border of the lips.

• Thyroid diseases.

• Allergies to various kinds of external factors, professional activities.

• Adverse weather conditions.

• Hereditary predisposition.

• Decreased immunity, gastrointestinal diseases.

Stages

Currently, the generally accepted classification of lip cancer is TNM (T-size of the tumor, N-damage to the lymph nodes, M-metastases). Based on the size of the tumor, there are 4 stages of lip cancer.

Table 1. Stages of lip cancer

If on the affected side there are single enlarged lymph nodes, the size of which is less than 3 cm, this is stage N1 lip cancer. At stage N2, enlarged lymph nodes are detected on the affected side, the diameter of which is more than 3 cm. If the patient has single enlarged lymph nodes on the affected side measuring 3-6 cm in size, this is stage N2a of lip cancer. At stage N2, oncologists determine multiple metastases to the lymph nodes. Their size is equal to or greater than 6cm. In the presence of bilateral metastases in the lymph nodes measuring 6 centimeters, they speak of the N2c stage of lip cancer. If the diameter of the lymph nodes exceeds 6 cm, this is stage N3 of the disease.

In the absence of distant metastases, oncologists determine stage M0 of lip cancer, if there are distant metastases - M1, in the case of distant metastases that cannot be assessed - MX. The diagnosis of “early stage lip cancer” is made in the presence of a tumor less than or equal to 2 cm, the presence of single enlarged lymph nodes less than 3 cm on the affected side and the absence of distant metastases. This is T1 N1 M0.

Types of cheilitis

All types of cheilitis are divided into two groups:

• symptomatic (cheilitis, as a manifestation of the underlying disease);

• true (as an independent disease).

Types of symptomatic cheilitis and their clinical manifestations

The symptomatic group includes the following types of cheilitis:

• Eczematous - develops against the background of eczema, characterized by redness, swelling, burning and pathological changes in the skin of the lips. If left untreated, it becomes chronic.

• Macrocheilitis - this form of cheilitis is considered a component of Melkersson-Rossolimo-Rosenthal syndrome. There is severe itching and swelling of not only the lip, but also other parts of the face.

• Atopic - a predisposition to allergies to medications and food is a prerequisite for the development of inflammation. It manifests itself as peeling, redness, itching of the skin of the lips, and the formation of cracks in the corners of the mouth.

Possible complications

Failure to see a doctor in a timely manner often causes serious complications. The disease itself often does not pose a serious health risk. But only an experienced specialist can tell you how to treat cheilitis. Self-medication can lead to unpleasant consequences and provoke the occurrence of a chronic form of the disease. In addition, cheilitis is dangerous because its symptoms can mask malignant tumor processes. It is important to remember that some forms are prone to malignancy - cheilitis may be followed by precancerous conditions.

Types of true cheilitis

True cheilitis includes:

• Contact - manifests itself as a result of the body’s reaction to contact with an irritant: cosmetics (determined mainly in women), the bad habit of holding a pen or pencil in the mouth, professional activity (musicians due to prolonged use of the mouthpiece of a wind instrument) Characterized by redness, itching, feeling burning, swelling of the lips.

• Actinic - involves the development of an inflammatory process as a result of special sensitivity to natural phenomena: sunlight, wind, frost, radiation. It manifests itself as small blisters or erosion, swelling of the red border. This type of cheilitis is also called meteorological.

• Exfoliative - occurs mainly in women. The development of pathology occurs against the background of depression, anxiety, and various disorders of the nervous system. The main symptoms are dryness, severe, prolonged peeling of the lip border. Exfoliative cheilitis has two forms: dry and exudative. With exudative inflammation, crusts form, causing pain in the patient.

• Glandular - occurs against the background of hypertrophy of the minor salivary glands. This phenomenon can be congenital (appears after puberty) or acquired as a result of chronic inflammation. There is a risk of suffering from glandular cheilitis in people with periodontal disease, numerous carious cavities, after lupus erythematosus, and leukoplakia. It is initially characterized by increased dryness, which does not disappear with the use of hygiene products. Later - the presence of cracks due to the constant exposure of saliva to the red border of the lips. 20-30% of patients with glandular cheilitis develop squamous cell carcinoma. It is necessary to take a responsible approach to the treatment of this disease and seek qualified help from doctors in a timely manner - surgical intervention may be required.

Prognosis and prevention

With timely treatment and the absence of malignancy processes, the prognosis is almost always favorable. If the therapy has caused noticeable cosmetic defects, you can resort to methods for correcting the appearance of the lips.

To prevent complications, it is important to understand whether you are at risk. The presence of allergic diseases and dermatoses, chronic endocrine diseases, and wearing dentures increase the risk of developing pathology. To prevent the appearance of cheilitis, it is important to adhere to several rules:

• regularly visit the dentist, sanitize the oral cavity, remove tartar;
• promptly replace outdated fillings and orthopedic structures, contact after chipped teeth and injuries to prevent lip injury from the sharp edges of fillings and enamel;
• For the manufacture of prostheses, contact only professionals;
• eat properly and nutritiously to prevent hypovitaminosis;
• try to avoid prolonged exposure to the sun and use products with SPF, including for lips;
• be attentive to your health and promptly treat diseases of the gastrointestinal tract, endocrine, nervous system, and internal organs.

Treatment of cheilitis

This disease requires special treatment, depending on the cause, type and degree of the inflammatory process. The main methods of treating cheilitis:

• local treatment of the surface of the skin of the lips with disinfectant solutions, ointments, vitamin oil solutions;

• physiotherapeutic methods: Bucca radiation, ultrasound, laser therapy;

• a course of vitamin therapy;

• rinsing the mouth with decoctions of medicinal herbs.

If necessary, to eliminate the causes of the disease, specialized specialists may be involved: a dermatologist, an allergist, an infectious disease specialist.

Diagnostic features

If inflammation appears on the lip, it is advisable to visit a therapist, for children a pediatrician, if indicated, an infectious disease specialist, a dentist, or other specialized specialists. Diagnosing cheilitis is usually not difficult - a specialist will conduct an examination, listen to complaints and prescribe a series of tests. If the allergic nature of the disease is suspected, allergy tests may be recommended, and if plaque appears, it is advisable to take a scraping. To detect endocrine and other disorders that may cause the disease, biochemical blood tests and other diagnostic methods are often prescribed. In rare cases, a biopsy is required to differentiate cheilitis from other pathologies. This will help to exclude the malignant or precancerous nature of inflammatory formations and prescribe the correct treatment.

Allergic cheilitis

A disease that develops in allergy sufferers upon contact with an allergen and affects the surface of the lips. Typical manifestations of this type of cheilitis are a feeling of itching and burning on the lips, dryness and significant discomfort. The lips begin to dry and peel, and the scales of dead epithelium begin to flake off.

The main cause of this disease is the patient’s increased sensitivity to external irritants, in particular to allergens. Allergic, or, as it is also called, contact cheilitis can develop gradually.

It all depends on the patient’s personal sensitivity to allergens, and it can develop over several weeks, months and even years. The duration of this process is determined by the peculiarities of the endocrine system, as well as the degree of manifestation of allergic reactions.

This disease practically does not appear in children. According to statistics, most patients with allergic cheilitis are women over twenty years of age.

Causes of the disease

In most cases, allergic cheilitis is caused by contact allergic irritants. Among the most common allergens that cause cheilitis is lipstick. It is not the lipstick itself that is dangerous, but the substances it contains - rhodamine, eosin and others. Provoking factors also include low-quality dental implants and plastic dentures.

Allergic manifestations may appear after contact with citrus fruits, as well as in patients who have the habit of chewing pencils or pens. The disease is also common for those whose work involves playing wind instruments or hazardous chemical production.

Symptoms of the disease

The disease manifests itself as hyperemia and swelling of the lips, as well as a sensation of itching and burning, accompanied by the formation of erythema. Small painful blisters appear and burst on the affected areas of the lips. If the pathogenic process is prolonged, over time, small scars and scars will form in their place on the lips. Dry lips only increase over time.

Inflammation almost never extends beyond the red border around the lips. In rare cases, it may spread to adjacent skin. Sometimes the inflammatory process moves to the oral mucosa. This form of allergic cheilitis is characterized by hyperemia (significant redness of the tissues), the appearance of noticeable swelling of the tissues, and when trying to palpate, pain occurs.

Diagnosis and treatment

Diagnosis of the disease is carried out by a dentist together with an allergist. To determine the allergen, it is necessary to conduct allergy tests.

When making a diagnosis, it is important to distinguish allergic and atopic cheilitis, as well as exclude exfoliative and actinic cheilitis. Treatment of this disease includes the mandatory elimination of the irritant or allergen that caused it.

Systemic (general) and topical (local) drug therapy is used. General therapy refers to the use of medications taken orally. To relieve allergy symptoms, a course of antihistamines is used. If the case is sufficiently complex, the use of corticosteroids may be indicated. In addition, calcium supplements may be prescribed.

Local treatment of allergic cheilitis includes the use of a variety of emollient oils, ointments and balms based on sea buckthorn, vitamin E and others. To avoid the recurrence of the pathology, it is necessary to take an allergy test in order to eliminate any contact with the allergen in the future. It is also advisable to reconsider your diet and carefully consider the choice of cosmetics.

How to treat lips with cheilitis

The most important thing in treating cheilitis is to identify its cause, which is difficult to do without professional help. You'll have to contact a specialist. First, it is better to go to a therapist, and he will then refer you to a specialist doctor.

Typically, treatment for diseases of the lips and skin around the mouth is based on eliminating not the symptoms, but the root cause. It includes lifestyle changes, proper nutrition, and medication.

If the cause of inflammation is an infectious or fungal infection, local drugs are included in the therapy. Typically, patients are prescribed various medicinal ointments for external use, which must be applied to damaged skin several times a day:

• anti-inflammatory – Tetracycline, Erythromycin;
• antifungal – Clotrimazole;
• hormonal – Prednisolone.

To cure lips, you need to influence them not only from the outside, but also from the inside. The skin around the mouth often suffers from a lack of B vitamins, so they are often prescribed in the treatment of lips.

Folk remedies

If the pathology is not of a serious nature, then traditional medicine can be used to eliminate it. Below are some home remedy recipes that will help eliminate inflammation on the lips.

Calendula decoction recipe

Ingredients:

• dry calendula - 1 tbsp;
• water - 200 ml.

Preparation: Boil water. Pour the calendula into a jar, pour boiling water over it, and close the lid well. Let the broth brew.

Usage: Perform the procedure before going to bed. Soak a clean cloth in the warm broth and apply it to your lips for a quarter of an hour. Pat your lips dry with a towel.

Chamomile infusion recipe

Ingredients:

• dry chamomile - 1 tbsp;
• water - 100 ml.

Preparation: Boil water. Pour boiling water over the herb and let the broth brew.

Usage: Soak gauze in a warm broth, apply it to the sore lips, wait a quarter of an hour.

Result: Chamomile eliminates inflammation and itching, relieves redness, softens hard crusts.

Recipe with oak bark

Ingredients:

• crushed oak bark - 1 tbsp;
• water - 100 ml.

Preparation: Boil water. Pour boiling water over the bark, then place the mixture in a water bath for 30 minutes.

Usage: Soak gauze in warm broth. Apply it to your lips for ten minutes. Dry your lips with a towel and lubricate them with oil.

Other folk remedies:

• If large cracks appear in the corners of your lips, lubricate them with soft beeswax. Perform this procedure every 3 hours, and after a few days you will notice how the crack begins to heal. But remember, it is forbidden to open your mouth too much while eating or talking.
• Kalanchoe, like aloe, neutralizes minor inflammation and tightens cracks in the corners of the lips. For treatment, use a large cut leaf of the plant. Apply the cut to the inflamed area and secure with a bandage. After 2 hours, remove the patch; do not drink or eat while wearing it.
• Oil masks will help fill the lack of vitamin E and collagen. If your lips are dry, lubricate them with olive, linseed or any other vegetable oil. These foods contain large amounts of vitamin E.