What is actinic cheilitis?
In actinic cheilitis there is scaling and crusting of the lips as a result of sun damage. It is essentially a variant of actinic keratosis, but located on the lips. Actinic cheilitis is fairly common and is regarded as a precursor of squamous cell carcinoma. It is sometimes also referred to by the (strictly speaking incorrect) term actinic cheilosis.
How does actinic cheilitis develop?
Actinic cheilitis develops in people who have been exposed to the sun unprotected for many years. People of middle age and older who have had an outdoor occupation are especially at increased risk. Unfortunately there is a trend for ever younger people to develop actinic cheilitis, probably as a result of extensive sun exposure in childhood. Actinic cheilitis is often seen in the context of chronic actinic (sun) damage to the skin.
How is it treated?
Very localised actinic cheilitis can be treated by dabbing with liquid nitrogen (cryotherapy). For more extensive forms, the dermatologist will usually choose treatment with 5-fluorouracil cream. Treatment with photodynamic therapy is also possible.
What is the outlook?
These treatments often give a good result. When the spots have not healed well after treatment, or return quickly, you should always contact your GP or dermatologist again. The reason is that with recurring actinic damage on the lips, the possibility of developing squamous cell carcinoma must always be considered. Particularly when the spots are painful or thickened, the suspicion is greater and the dermatologist will usually take a tissue biopsy for further examination by a pathologist.
When to see a doctor
See your GP or dermatologist if you have persistent scaling, crusting, cracking or a sore on the lip (especially the lower lip) that does not heal, or a spot that becomes painful, thickened, firm or ulcerated. Because actinic cheilitis is a precursor of skin cancer, prompt assessment and treatment are important, and protecting the lips from the sun with a lip balm containing a sunscreen helps prevent it.