Actinic Cheilitis

Actinic cheilitis is a type of cheilitis, that is inflammation of the lips. This is the counterpart of actinic keratosis that is a skin disorder. In actinic cheilitis, there is thickening of the skin of the lip and there is whitish discoloration of the vermilion border of the lip (the junction of red of the lip and skin). Thus, one of the most prominent symptoms includes the loss of the sharp border of the red of lip and skin. The lip may also become slightly scaly in appearance. In later stages, there may also be induration. These lesions are generally painless in nature. Given below are the various causes and treatment alternatives for this condition.

Actinic Cheilitis Causes
Actinic cheilitis is caused due to excessive and chronic exposure to ultra-violet radiations. This is the reason why fair-skinned people are more susceptible to suffer from this condition, as they have lesser melanin. This is also more commonly seen in older fair-skinned males. There has been speculation that other factors may play a vital role in furthering the progression of this condition. These factors include the usage of tobacco, irritation to the lips due to physical or chemical factors (like by using a lip balm that has allergens in it), etc. Sometimes, very poor oral hygiene and ill-fitting dentures and prostheses may also be responsible for aggravating this condition.

Actinic Cheilitis Treatment
The treatment for this condition includes using medications like 5-fluoroucil. This is helpful for diffuse but minor actinic cheilitis. This drugs mechanism of action is that it blocks DNA synthesis. This treatment usually takes around a fortnight to a month to produce any kind of visible results. Initially there will be inflammation with redness, burning and erosion of lesions. Around half of patients respond very well to this therapy and are said to have gone into complete remission. Another drug that is said to have very good effects is imioquimod. This is an immune response modifier and hence, it promotes an immune response in the skin, which leads to death and erosion of the epidermal growth and remission of the rash on lips. Thus, it also helps to prevent any recurrence of the lesions.

There are, however, many cases which do not respond adequately to medications. In such cases, other options include procedures such a cryosurgery and electrosurgery. This is especially the treatment of choice for small lesions of actinic cheilitis. Cryosurgery involves the application of liquid nitrogen as an open spray. Local anesthesia is not required as such but if there is need for treatment of the entire lip, then the procedure could end up being quite painful. However, this treatment is said to have a very high success rate and so is the treatment of choice for focal areas of actinic cheilitis. Electrosurgery is an alternate treatment which requires local anesthesia. However, both these techniques can lead to adjacent tissue damage and thus, can delay healing and lead to scar formation.

A relatively newer procedure of dealing with this condition involves the use of carbon dioxide laser to ablate the vermilion border. However, this procedure also runs the risk of resultant secondary infection and scarring. Chemical peeling is another option that people can opt for, using 50% trichloroacetic acid although the results have not been satisfactory.

This is a serious condition that needs to be dealt with. Since the lesions are normally asymptomatic, people tend to defer getting the condition diagnosed and treated. However, one needs to understand that this is a premalignant condition, that is, if left untreated for long, it could progress into oral squamous cell carcinoma. Thus, actinic cheilitis needs to be diagnosed and treated on a priority basis, as it is a dangerous cutaneous condition.