Too much sun exposure can lead to swollen, puffy, inflamed lips. This is known as actinic cheilitis, which may turn into skin cancer. But treatment options like fluorouracil or cryotherapy can help treat this lip condition.

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While more than 1 in 3 people in the United States report getting sunburn every year, the lips are one part of the body that many don’t think about being at risk of sunburns. But your lips are susceptible to ultraviolet (UV) rays, and this lip inflammation can possibly lead to skin cancer.

Long-term exposure to the sun can lead to rough, scaly, discolored patches on the lips known as actinic cheilitis. If you have actinic cheilitis, you may be curious about what treatment options are available.

This article provides more information you can discuss with your healthcare team about safely and effectively treating actinic cheilitis.

Actinic cheilitis is a lip inflammation from long-term exposure to sunlight. It frequently appears as white, scaly, chapped lips.

Actinic cheilitis is often more common in males than females. It is also more common in people more than 40 years old or who spend significant amounts of time outside in the sun. People with lighter skin tones and weakened immune systems can be more likely to develop actinic cheilitis.

Although actinic cheilitis is frequently painless, it can potentially become squamous cell carcinoma. So, it’s important to consult your doctor and make sure you get treatment when you notice it.

Treatment for actinic cheilitis can involve medication and in-office procedures. Your doctor will consider your health history, the extent of your actinic cheilitis, and even your personal preferences when making a treatment recommendation.

Medications

You can apply medications directly to the skin to kill the affected cells. The most common side effect includes irritated skin. Some common medications doctors use to treat actinic cheilitis include:

  • 5-fluorouracil (5-FU) cream: People usually apply this cream on their skin one or two times a day, and doctors prescribe it for 2 to 3 weeks. Pregnant people must avoid using this cream to prevent harm to the unborn baby. While the success rate of 5-FU at 1 week is only 69%, it increases to 91% at 4 weeks.
  • Imiquimod cream: Sometimes, people apply this cream only once or twice a week for 12 to 16 weeks. This can help minimize skin reactions. Alternatively, your doctor might suggest using it every night for 2 weeks, taking 2 weeks off, and then using it again every night for 2 weeks.

Medical procedures

There are also various in-office procedures that doctors perform to remove actinic cheilitis.

  • Cryotherapy: In this procedure, the doctor coats the actinic cheilitis in liquid nitrogen. This causes the affected skin to blister and peel off. It may take one or two office visits for this to be effective.
  • Laser treatment: The use of laser treatment has an efficacy of 93% and a low amount of recurrences associated with it. The biggest drawbacks are the potential for scarring and pain.
  • Curettage: For thicker actinic cheilitis cases, a doctor may first scrape the actinic cheilitis, and then frequently use another measure to destroy any remaining cells.
  • Vermilionectomy: In some cases, experts recommend removing part of the lip. While this has an efficacy rate nearly 100% and low recurrence rates, it will leave an open wound and can change the lip form.
  • Photodynamic therapy: Experts use special drugs and light to kill the cells in this treatment. While this has a lower efficacy rate of 68% and a 12% rate of recurrences, when they use it with other treatments, these numbers increase. Swelling, itching, and burning are potential side effects of this procedure.

If you have several areas of actinic cheilitis or areas that you can feel but not see, your doctor may prescribe medication to apply to your lips at home. They may also suggest applying medication at home and getting a surgical procedure in the office.

This can be an effective way to treat actinic cheilitis, but you’ll need to follow the exact treatment plan your doctor describes. The medication may cause a skin reaction, but you’ll usually need to keep applying the treatment.

While applying medication at home, you’ll need to avoid hydrocortisone and other corticosteroid medications, as they can prevent the actinic cheilitis treatment from working properly. You’ll also want to stay out of the sun.

Actinic cheilitis can develop into a type of skin cancer called squamous cell carcinoma in about 6% to 10% of cases. However, there’s currently no way to know which cases of actinic cheilitis will turn into skin cancer.

Research looking at cases of actinic cheilitis in Brazil showed that the majority of cases presented some epithelial dysplasia or harmful changes in the cells. This lends support for treating all cases of actinic cheilitis as potentially cancerous, even if only a small percentage actually become so.

If a case of actinic cheilitis becomes squamous cell carcinoma, the outlook is generally good, especially if doctors treat it early on, since it typically progresses slowly.

Tips and tricks for preventing sunburn on your lips

Staying out of the sun is the best way to prevent actinic cheilitis. When that’s not possible, it’s important to take protective measures. You can:

  • Wear a wide brimmed hat that shades your face.
  • Apply a lip balm with an SPF of at least 15. Don’t forget to reapply it often, too!
  • Avoid being outside during the harshest midday sun.

It’s important to remember that UV rays can harm the body throughout the year and not just in the summer. Sun protection is always important no matter the season.

There’s no way to know for sure which cases of actinic cheilitis will turn into cancer, so it’s important to talk with your doctor about treatment options when you notice discolored, rough areas on your lips. Common treatments for actinic cheilitis include applying medications to the area and getting procedures.