Cheilitis Lip Inflammation Causes and Treatment (2024)

Cheilitis is a group of inflammatory conditions that cause the skin of the lips to become red, dry, scaling, and itchy. There are many possible causes of cheilitis, including infections, allergies, irritants, and even habitual behaviors like lip-licking.

Cheilitis can usually be diagnosed with a review of your medical history and an examination of your mouth and lips. Other tests like patch testing or a skin biopsy may be ordered if an allergy, inflammatory disease, or malignancy (cancer) is suspected. The treatment depends on the underlying cause.

This article explains the various causes, types, and symptoms of cheilitis, including how this common inflammatory condition is diagnosed and treated.

Cheilitis Symptoms

There are several different types of cheilitis, but they share many of the same symptoms, including:

  • Lip dryness
  • Redness
  • Swelling
  • Scaling or peeling
  • Cracking or splitting of the lip
  • Tenderness
  • Itching and burning sensations
  • Crusting at the corners of the mouth
  • Lip discoloration

If not appropriately treated, cheilitis can lead to secondary infection in which bacteria enter a crack or abrasion in the skin and establish an infection. This can result in permanent scarring, discoloration, and thickening of the lip.

This photo contains content that some people may find graphic or disturbing.

Cheilitis Lip Inflammation Causes and Treatment (1)

How to Get Rid of Chapped Lips

Types and Causes of Cheilitis

Cheilitis is characterized by inflammation, the body's natural response to injury, infection, or disease. Inflammation causes the swelling of tissues along with pain, redness, and warmth.

Eczematous Cheilitis

Eczematous cheilitis is the most common form of cheilitis in which eczema (atopic dermatitis) develops on the lips. It is a non-contagious condition caused by an abnormal immune response.

Eczematous cheilitis is most common in people with other atopic (allergy-related) conditions like hay fever, food allergies, and asthma.

With eczematous cheilitis, symptoms occur when you are exposed to stimuli that trigger an allergy (called allergens) or irritate the skin (called irritants). Depending on the cause, symptoms may last for up to three weeks.

Possible triggers for eczematous cheilitis include:

  • Lipstick or lip balms
  • Toothpaste or mouthwash
  • Food allergens
  • Rubber or latex (such as caused by chewing on an eraser)
  • Metals including nickel, cobalt, or gold
  • Sunscreen
  • Certain topical medications like bacitracin
  • Food additives like propylene glycol
  • Chronic lip-licking
  • Cold, dry temperatures

Angular Cheilitis

Angular cheilitis is a form of cheilitis that affects the corners of the mouth. It occurs when saliva collects in crevasses and, in the process of evaporation, draws excess moisture from the skin, causing it to dry out and crack.

Secondary infection is common with angular cheilitis. This includes infection with the fungus Candida albicans (which causes oral thrush and yeast infections) or the bacteria Staphylococcus aureus (which causes staph infections).

Angular cheilitis often goes awaywithin two weeks when treated but can persist for weeks if left untreated.

Certain people are more prone to getting angular cheilitis, including those with diabetes, people with iron or vitamin B deficiency, and individuals who wear dentures. Medications that cause dryness, like isotretinoin, can also lead to angular cheilitis.

Children who drool, suck their thumbs, or lick their lips in the wintertime are also at risk.

Actinic Cheilitis

Actinic cheilitis is also called solar cheilitis because it is caused by long-term exposure to the sun. It is more common on the lower lip than the upper lip.

Actinic cheilitis is a form of precancer that on rare occasions can turn into a type of skin cancer called squamous cell carcinoma (SCC). It most commonly affects light-skinned people who spend too much time in the sun without the appropriate sun protection.

Actinic cheilitis also affects people who work outdoors for long hours, like fishing, forestry, or construction workers.

Rare Types of Cheilitis

There are other uncommon types of cheilitis, including:

  • Exfoliative cheilitis: This is a rare condition mainly affecting younger adults that causes the continuous peeling of the lips. The cause is unclear but appears to be linked to repetitive behaviors like lip-sucking, lip-biting, or lip-licking.
  • Glandular cheilitis: This is a rare condition mainly affecting older White adults in which the salivary gland produces thicker and more profuse amounts of saliva (particularly while a person is sleeping). It causes yellowish plaques or crusts on the skin of the lips.
  • Cheilitis granulomatosa: Also known as granulomatous cheilitis, this is a condition that tends to affect young adults who develop persistent, painless swelling of the lips. The cause is unclear, although some suspect it may be a form of autoimmunity.

Diagnosis

When diagnosing cheilitis, your healthcare provider will review your medical history, including exposures to cosmetics, foods, allergens, or irritants. They will also perform a close-up examination of the mouth and lips.

Based on the initial findings, other tests may be ordered, such as:

  • Patch testing: An adhesive patch infused with common allergens is placed on an unexposed area of the skin to see if you get an allergic reaction.
  • Skin prick test: Tiny amounts of common allergens are embedded beneath an unexposed area of the skin to see if you get an allergic reaction.
  • Lip swab: A cotton swab is swiped over affected skin to obtain fluid and skin cells for evaluation in a lab. The lab can check for infections using genetic-based PCR tests or bacterial or viral cultures.
  • Punch biopsy: A tiny piece of tissue from your lip is removed with a springloaded punch. The lab can look for abnormalities such as cancer or precancer.

Cheilitis Treatment

Cheilitis can be cured in most cases, but the treatment depends on the underlying cause.

Eczematous Cheilitis

Topical corticosteroids (steroids) are commonly used to treat eczematous cheilitis. These are applied to the lips to bring down inflammation.

Lip balm or an emollient, like petroleum jelly, can keep the skin moisturized and reduce dryness. An over-the-counter antibiotic cream like Neosporin can help prevent infection.

If a specific allergen or irritant is identified, it is important to avoid them wherever possible. Behavioral changes, like avoiding lip-licking, should also be stressed.

How to Safely Use Topical Steroids

Angular Cheilitis

For angular cheilitis, a topical antifungal may be prescribed to resolve the underlying yeast infection, while a topical antibiotic may be used to treat an underlying bacterial infection. A protective lip balm or barrier cream, like zinc oxide or petroleum jelly, can also help.

Improving oral hygiene, including the daily cleaning of dentures, is important. Vitamin B or iron supplements may be prescribed if an underlying deficiency has been found.

Actinic Cheilitis

There are several treatment options for actinic cheilitis, depending on its severity:

  • Surgical excision; The removal of the skin lesion with a scalpel
  • Cryotherapy: The removal of affected skin with sub-zero cold
  • Laser ablation: The removal of affected skin with a laser
  • Photodynamic therapy: Uses topical substances that react to ultraviolet (UV) light to reduce the lesion
  • Topical chemotherapy: Uses cancer-fighting drugs like fluorouracil to kill the cells
  • Topical immunotherapy: Uses drugs like imiquimod that stimulate the immune system to stop the growth of precancer cells

Frequently Asked Questions

  • Is it possible to get angular cheilitis from someone else?

    Angular cheilitis is not contagious. Although it may involve a fungal or staph infection, it isn’t passed from one person to another through kissing or sharing utensils like cold sores can be.

    Learn MoreCold Sore Outbreak Overview

  • Can any foods make angular cheilitis worse?

    No, but nutritional deficiencies have been associated with some cases of angular cheilitis—specifically, deficiencies of iron, zinc, and B vitamins, particularly riboflavin (vitamin B2) and cobalamin (B12).

    Learn MoreThe Best B-Complex Supplements, According to a Dietitian

  • What is the best way to prevent cheilitis?

    Some measures you can take to avoid angular cheilitis include:

    • Don’t lick your lips.
    • Protect lips with an emollient such as petroleum jelly or zinc oxide.
    • Replace poorly fitting dentures or tooth implants, if either is a cause.
    • Before bed, remove and soak dentures overnight in 10 drops of chlorhexidinegluconate or bleach diluted in water.

9 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Blagec T, Glavina A, Spiljak B, et al. Cheilitis: a cross-sectional study-multiple factors involved in the aetiology and clinical features, Oral Dis.2022 Aug 24 [online ahead of print].doi:10.1111/odi.14359

  2. Lugovic-Mihic L, Pilipovic K, Cmaric I, Situm M, Duvancic T. Differential diagnosis of cheilitis - how to classify cheilitis? Acta Clin Croat. 2018;57(2):342-351. doi:10.20471/acc.2018.57.02.16

  3. Ayesh MH. Angular cheilitis induced by iron deficiency anemia. Cleve Clin J Med. 2018;85(8):581-582. doi:10.3949/ccjm.85a.17109

  4. Lai M, Pampena R, Cornacchia L, Pellacani G, Peris K, Longo C. Treatments of actinic cheilitis: a systematic review of the literature. J Am Acad Dermatol. 2020 Sep;83(3):876-87.doi:10.1016/j.jaad.2019.07.106

  5. Almazrooa SA, Woo SB, Mawardi H, Treister N. Characterization and management of exfoliative cheilitis: a single-center experience. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;116(6):e485-e489. doi:10.1016/j.oooo.2013.08.016

  6. Miest R, Bruce A, Rogers RS. Orofacial granulomatosis. Clin Dermatol. 2016;34(4):505-513. doi:10.1016/j.clindermatol.2016.02.024

  7. Oza N, Doshi JJ. Angular cheilitis: a clinical and microbial study.Indian J Dent Res. 2017;28(6):661-665. doi:10.4103/ijdr.IJDR_668_16

  8. Griffith RS. A triad of dermatologic dilemmas.Mo Med. 2016;113(4):288-292.

  9. Merck Manual Professional Version. Lip sores and inflammation.

Additional Reading

Cheilitis Lip Inflammation Causes and Treatment (2)

By Colleen Doherty, MD
Dr. Doherty is a board-certified internist and writer living with multiple sclerosis. She is based in Chicago.

See Our Editorial Process

Meet Our Medical Expert Board

Was this page helpful?

Thanks for your feedback!

What is your feedback?

Cheilitis Lip Inflammation Causes and Treatment (2024)
Top Articles
Latest Posts
Recommended Articles
Article information

Author: Barbera Armstrong

Last Updated:

Views: 5528

Rating: 4.9 / 5 (79 voted)

Reviews: 94% of readers found this page helpful

Author information

Name: Barbera Armstrong

Birthday: 1992-09-12

Address: Suite 993 99852 Daugherty Causeway, Ritchiehaven, VT 49630

Phone: +5026838435397

Job: National Engineer

Hobby: Listening to music, Board games, Photography, Ice skating, LARPing, Kite flying, Rugby

Introduction: My name is Barbera Armstrong, I am a lovely, delightful, cooperative, funny, enchanting, vivacious, tender person who loves writing and wants to share my knowledge and understanding with you.