Merck Manual

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Lip Ulcers and Inflammation

By

Bernard J. Hennessy

, DDS, Texas A&M University, College of Dentistry

Last full review/revision May 2022| Content last modified May 2022
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Lip inflammation may be generalized, or localized to one or more ulcers or lesions. Although some swelling may be present, the main manifestation is discomfort. Lip swelling Lip Swelling Spontaneous (ie, nontraumatic) lip swelling is usually painless. Itching may or may not be present. Cheilitis sometimes causes lip swelling, but patients typically present because of the painful... read more Lip Swelling with little or no discomfort is discussed elsewhere.

Lip ulcers and other changes

A number of infectious, neoplastic, or other disorders can cause lip ulcers, growths, and other changes:

Cheilitis (lip inflammation)

Cheilitis is acute or chronic inflammation of the lips. It may be caused by infection, sun damage, drugs or irritants, allergy, or underlying disease. Inflammation primarily affects the vermilion and vermilion border. Swelling Lip Swelling Spontaneous (ie, nontraumatic) lip swelling is usually painless. Itching may or may not be present. Cheilitis sometimes causes lip swelling, but patients typically present because of the painful... read more Lip Swelling , redness, and pain of the lips occurs; other changes may include cracks, fissures, erosions, crusts, and scale.

Angular cheilitis (angular stomatitis) is the most common form; inflammation, crusting, painful fissures, and often maceration develop in the corners of the mouth. Typical causes include

Treatment of angular cheilitis may involve replacing dentures or restoring proper tooth size with partial dentures, crowns, or implants, which helps reduce the folds at the corners of the mouth, and using antifungals (eg, clotrimazole cream), antibiotics (eg, mupirocin ointment), or iron or vitamin B supplementation as needed.

Other causes of cheilitis include

Rare types of cheilitis include cheilitis glandularis, cheilitis granulomatosa, and plasma cell cheilitis. Children with Kawasaki disease Kawasaki Disease Kawasaki disease is a vasculitis, sometimes involving the coronary arteries, that tends to occur in infants and children between the ages of 1 year and 8 years. It is characterized by prolonged... read more Kawasaki Disease may develop erythematous, dry, swollen, and cracked lips, along with strawberry tongue.

Diagnosis is usually based on history and inspection. Actinic cheilitis with signs of progression (induration, ulceration, thickening) should be biopsied to rule out carcinoma.

Treatment includes petrolatum or other emollients, as well as elimination or treatment of specific causes. For severe nonmalignant actinic cheilitis, vermilionectomy (lip shave) or CO2 laser ablation may be considered. Sun damage to the lips can be minimized through the use of protective coverings such as a wide-brimmed hat and lip balm containing topical sunscreen.

Drugs Mentioned In This Article

Drug Name Select Trade
No US brand name
VALTREX
ZOVIRAX
DENAVIR
ABREVA
No US brand name
MYCELEX
BACTROBAN
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NOTE: This is the Professional Version. CONSUMERS: Click here for the Consumer Version
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