WHAT IS CHEILITIS?

Cheilitis is a broad term that is used to describe the inflammatory condition of the lips, cheilitis also called chapped lips 

Cheilitis can occur in perioral skin(the skin around the mouth), vermilion border (the junction of the lips and skin), or labial mucosa (the mucous membrane lining the inner aspect of the lips.

WHAT ARE THE RISK FACTORS FOR CHEILITIS?

• Cheilitis may occur in response to allergy to anything such as lipstick, cosmetics, drugs, toothpaste, rubbers, and metals such as nickel.

 

• It may occur due to excessive exposure to the sun, dry heat, or cold weather.

 

• Some internal reasons may trigger conditions such as autoimmune disorder, oral infection 

 

• It is age-related, it is common in adults due to sagging of the skin

 

• People with weak immune systems are more prone to developing cheilitis.

 

• Generally, this condition is found in those people who spend more time outside such as landscapers, fishermen, outdoors athletes, farmers, construction workers, hikers, and sailors.

 

• People who have light skin tone also prone to develop actinic cheilitis 

 

• Lack of nutrients in the diet such as vitamin B or iron can trigger the condition 

 

• Smoking, chewing tobacco, and alcohol  

 

• Children who are having a habit of sucking their thumb.

 

• If any person has sagging skin around their mouth from weight loss

 

• If having a habit of licking your lips frequently

 

• Unfit dentures cause repeated injury to lips or mouth and can also lead the cheilitis.

 

• Sometimes braces can cause it 

 

• Some medical conditions also triggered the condition such as anemia, cancers of the blood, diabetes, down syndrome, cancer of the kidney, liver, lung, or pancreatic cancer.

 

• Chronic sun exposure or severe sunburn can damage the skin cells and increase the chances of cellular mutations

 

• Sex - The condition is three times more common in women than in males 

 

• In some people, the lips are more turned outward instead of inward. these people are more prone

WHAT ARE THE COMPLICATIONS OF CHEILITIS?

Oral thrush -if the infection becomes untreated it may spread to the mouth and cause ulceration of the mouth called oral thrush 

Cancer- sometimes this condition is developed into skin cancer but it rare condition 

WHAT ARE THE SYMPTOMS OF CHEILITIS?

• The symptoms of the cheilitis are dependent upon the underlying cause 

 

• The main common symptoms of cheilitis

 

• Dryness Of the lips

 

• Cracking due to dryness

 

• Bleeding

 

• Pain in the mouth while talking, eating drinking 

 

• Swelling of lips 

 

• Scaling 

 

• Sometimes fever, headache, and malaise may occur 

Different types of cheilitis with underlying causes and symptoms 

1. Angular cheilitis - In this cheilitis, the affection occurs at the corners of the mouth, maybe one corner or both corners will be affected.

Cause -it is mainly found in children and elderly people because it occurs due to excess drooling of saliva, and the collection of excessive saliva around the corners of the mouth leads to a favorable environment for the development of the microorganism, such as yeast called candida, it is the most common cause 

Symptoms -this condition is characterized by cracks and fissures at the corners of the mouth, the formation of blisters, redness, and bleeding of the corners of the mouth, itching, scaly lips, and sometimes crust may form around the corners of the mouth

 

2. Actinic cheilitis -this is an inflammation of the lips but usually it appears on the lower lip, it is caused by damage to the lip epithelium, it is the outermost layer of the lips. It is a painless condition, but it may lead to squamous cell carcinoma.

Cause -it is caused by long-term exposure to sunlight, and also it is found in people who live in damp areas.

Symptoms-the initial symptoms of this type are dry and cracking of the lips, as the condition develops there is the formation of a white scaly patch(leukokeratosis) on the lip with a red and swollen lip, it generally occurs on lower lips. Tightness and wrinkles of the skin, tenderness, soreness, loss of demarcation between the lower lip and surrounding skin

3. Granulomatous cheilitis-this condition is related to underlying diseases such as Crohn's disease, sarcoids,  allergy, infection, or cancer.

Symptoms-cracking of lips, headache, fever, and maybe mild lymph node becomes enlarged 

 

4. Exfoliative cheilitis-it is a rare reactive condition and it manifests as continuous peeling of lips.

Cause-it occurs due to poor oral hygiene, bad habits such as constant picking or biting of the lips, and sometimes HIV may be associated 

Symptoms -initially there is the formation of thickened surface layer, there is peeling of the lips and lips look red, the condition may become painful, causing difficulty in eating, and speaking, the hemorrhagic crust may form after bleeding from lips dryness of lips, tingling sensation and maybe sometimes itching of the lips

 

5. Lichenoid cheilitis -this condition is found in a person who already suffers from lichen planus that affects the lips or skin around the lips.

Cause- the exact cause is unknown but it may be triggered after some medications such as beta-blockers and nonsteroidal anti-inflammatory drugs, and it is also genetic and weak immune system.

Symptoms-appearance white patches in the mouth or web-like threads, it may be slightly raised but it is a painless condition. In some cases may ulcer develop in the mouth which causes difficulty in eating, and drinking and become painful

 

6. Cutaneous lupus erythematosus-this type is associated with systemic lupus erythematosus, the main symptom of SLE is butterfly rash if these rashes spread to the mouth it cause scaling and formation of plaques on the lips.

 

7. Cheilitis glandularis- in this condition there is a progressive enlargement of the lower lip, this condition is also associated with long-term exposure to sun rays, smoking, and repeated lip biting, due to this activity the delicate labial mucosa of the lower lip becomes swollen and tenderness.

 

8. Eczematous cheilitis - this condition is associated with some allergens such as lipstick or another cosmetic item. If a person has an allergy to this article it leads to itching, cracking, and peeling of the skin of the lips. This condition is also related to atopic dermatitis.

 

DIAGNOSIS OF CHEILITIS

Diagnosis of the cheilitis is made  by

• Detailed history taking -this step include the proper history of the patient regarding the problem such as the onset of the disease, all symptoms, a question about denture history, oral care, any medical history or any skin condition, any habit of smoking, bowel movement.
• Physical examination-physical examination of the mouth is important to make the diagnosis of the condition
• Lab investigation includes - two lab investigations including oral swabs and biopsy.
• oral swab also called culture swabs -is required to find out the cause of infection such as candida. A blood test may require to rule out anemia or other immune deficiencies 
• Biopsy- biopsy of the tissue of the mouth help to rule out the lichen planus or any cancer condition of the mouth.

TREATMENT OF CHEILITIS

The main aim of the treatment of this condition is to remove the present infection in the body and keep the area dry to prevent the regrowth of the infection 

The conventional treatment is antifungal cream, ointments are available if the infection is caused by bacteria then the doctor prescribes antibacterial cream.

All these treatments are not safe and permanent is just only remove the superficial; symptoms but in homeopathy, this condition is treated from the root and gives a permanent cure.

MANAGEMENT OF CHEILITIS

• Maintain oral hygiene 
• Patients should use new toothbrushes during infection
• Change the cosmetic item within six month 
• Always use high-quality makeup but avoid as much as possible 
• Use herbal products or try to avoid chemicals during infection
• Don't try to itch or scratch
• Try to open your mouth less frequently because it may lead to further cracks 
• Try to find out the allergens and avoid it 
• Stop taking alcohol and smoking 
• Stop chew tobacco
• Use petroleum jelly frequently it prevents dryness of the lips.
• Drink lots of water, and keep your body hydrated it reduces the chances of dryness of lips  
• Take healthy diet 
• Keep blood sugar in control level
• Always wear a proper fitting dentures
• Avoid licking or rubbing the corners of your mouth
• Don't share your hankies to prevent the spread of infection

HOMEOPATHIC MANAGEMENT OF CHEILITIS

Homeopathy gives safe and effective treatment it cures the disease gently and permanently, strengthens the immune system, and prevents the recurrence of infection, but never take homeopathic medicine without proper consultation from a homeopathy registered practitioner 

Some homeopathic medicines are condurango,natrum mur, nitric acid ,sulphuric acid,petroleum,graphites

Do’s and don’ts

Do’s

• Take a healthy diet that is rich in vitamins and minerals 
• Take sugar level in control level 
• Do exercise daily 
• Maintain oral hygiene
• Keep hydrated 
• Use herbals product 
• Use lip balm frequently 
• Change the brush

Don’ts

• Avoid alcohol 
• Avoid tobacco 
• Avoid spicy and oily foods
• Avoid making the lips dry
• Avoid to open mouth frequently 
• Avoid touching the lips
• Avoid sharing personal towels and hankies