What is Actinic Cheilitis?
This is a condition which is commonly known as “sailor’s lips” or “farmers’ lips” because this is a condition affecting the lower lips of an individual. It is really a form of actinic keratosis where rashes which are small, very often with scaly surfaces develop on the lower lips of people.
Usually this kind of problem is seen in those people who spend a lot of time outdoors in the sun and have done this for many years. It is also called accumulative sun damage for this nature.
Those with this condition frequently show other effects of skin which is damaged by the sun, for instance precancerous lesions as well as wide wrinkling. A type of cancer of the skin known as squamous cell carcinoma matures in approximately 6% to 10% of the cases of actinic cheilitis.
Actinic Cheilitis Symptoms
Symptoms and signs named in a variety of sources on actinic cheilitis include the ones listed below:
- Lips are dry
- Lips are cracked
- Lips are scaly
- Lips are pale
- Lips are white
- Bumps that are scaly on lip
- Crusty bumps on lip
- Lips are red
- Lips are discolored
- Wrinkled lips with painless lesions
- Lip puffiness
Actinic Cheilitis Causes
Normally the individuals who get actinic cheilitis are those individuals who are above the age of 50 and individuals who are fair skinned. Some causes of this ailment include:
- UV rays of sun
- Long term use of tobacco
- Smoking
- Poor oral hygiene
- Ill-fitting dentures
This ailment is normally due to chronic and excessive exposure to ultra-violet radiations. This is the main reason why fair skinned individuals are most susceptible to this condition, as these individuals have lesser melanin. It is also most commonly seen in older fair-skinned men.
There has been some speculation that there are other causes which may play a role in furthering the progression of this ailment. As mentioned above, the use of tobacco is one cause as well as irritation of the lips because of chemical or physical factors such as using lip balm containing allergen. Other causes can include poor oral hygiene as well as ill-fitting dentures and prostheses seem to be responsible for further aggravating this problem.
A major risk of actinic cheilitis is that it is a precancerous condition. Actinic cheilitis has a 10% chance of turning to squamous cell carcinoma or cancer of the lip. Because it has not been identified as which kind of actinic cheilitis will develop into cancer, the standard of care is to treat all lesions properly.
Actinic Cheilitis Treatment
Treatment of actinic cheilitis includes the use of medication such as 5-fluoroucil. This medication is helpful for minor actinic cheilitis. This medication works by blocking DNA synthesis. Treatment with this medication normally takes up to a month to yield any type of results which are visible. Initially with treatment there will be inflammation with redness, erosion and burning of lesions. Approximately 50% of individuals do respond well to this management and are reported to have gone into total remission.
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Another medication which is reported to have good results is imioquimod cream. This medication is an immune response modifier and therefore promotes an immune response in the skin that leads to the erosion as well as the death of the epidermal growth and remission of the rash on lips. It also aids in preventing any recurrence of the lesions.
However, there are many cases that do not adequately respond to medications. In these cases, other options include procedures such as:
- Cryosurgery
- Electrosurgery
These treatments are the standard of care for small lesions of actinic cheilitis.
Cryosurgery is the application of liquid nitrogen as an open spray. Local anesthesia is not necessary but if there is need of treating the entire lip, then this process could end up being very painful. This treatment is reported to have a very high rate of success and therefore is the treatment of choice for focal areas of actinic cheilitis.
Electrosurgery also referred to as electrodesiccation is a treatment alternative that needs local anesthesia. Both of these techniques lead to tissue which is adjacent to be damaged and can therefore delay healing as well as leading to the formation of scars.
There is also a technique of facial sanding known as dermabrasion.
There is a fairly new procedure for dealing with this ailment that involves using carbon dioxide laser to ablate or shave the vermillion border. This procedure is known as vermilionectory. But this process can also run the risk of causing secondary infections and scarring. Another option is chemical peeling using 50% trichloroacetic acid except results have not been very satisfactory,
Actinic Cheilitis Pictures
Actinic Cheilitis in women
