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CHEILITIS

What is cheilitis?


Cheilitis is a broad term which 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.


Risk factors

  • Cheilitis may occur in response to allergy from anything such as lipstick, cosmetics, drugs, toothpaste, rubbers, metals such as nickel.
  • It may occur due to excessive exposure to 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, or outdoors athletes, farmers, construction work, hikers 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 the thumb.
  • If any persons having sagging skin around your mouth from weight loss
  • If having a habit of licking the lips frequently
  • Unfit dentures cause repeated injury to lips or mouth can also lead the cheilitis.
  • Sometimes braces can cause it 
  • Some medical condition also triggered the condition such as anemia, cancers of 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 -it is three times more common in women than males 
  • In some people, the lips are more turned outward instead of inward. these people are more prone

Complication


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 


Symptoms and cause


  • The symptoms of the cheilitis are dependant 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 cause and symptoms 

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

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

Symptoms -this condition is characterised 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, sometimes crust may form around the corners of the mouth


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

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

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


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

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


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

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

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


Lichenoid cheilitis -this condition is found in person whos is already suffer from lichen planus ,lichen planus when 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 ofwhite patches in mouth or web like threads  ,it may be slightly raised but it is painless condition.in some cases may ulcer develop in mouth which causes difficulty in eating ,drinking and become painful


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


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


Eczematous cheilitis -this condition is associated with some allergens such as lipstick or other cosmetic item. If person having allergy from this article it lead to itching ,cracking and peeling of the skin of the lips .this condition is also related with atopic dermatitis


DIAGNOSIS & TREATMENT


Diagnosis of the cheilitis is made  by

  • Detailed history taking -this step include proper history of patient regarding the problem such as onset of the disease,all symptoms,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 potential to make the diagnosis of the condition ,findings during physical examination are -
  • Lab investigation include - two lab investigation include oral swab and biopsy .oral swab also called culture swabs -it is required to find out the cause of infection such as candida.blood test may require to rule out anemia or other immune deficiencies 
  • Biopsy- biopsy of the tissue of mouth help to rule out the lichen planus or any cancer condition of mouth .

Treatment


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

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

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


MANAGEMENT


  • Maintain oral hygiene 
  • Patients should use new toothbrush 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 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 prevent dryness of the lips .
  • Drink lots of water,keep body hydrated it reduce the chances of dryness of lips  
  • Take healthy diet 
  • Keep blood sugar in control level
  • Always wear proper fitting denture
  • Avoid licking or rubbing the corners of your mouth
  • Don't share your hankies to prevent the spread of infection

HOMEOPATHIC MANAGEMENT


Homeopathy give safe and effective treatment it cure the disease gently and permanently ,it strong the immune system and prevent the recurrence of infection , but never take homeopathic medicine without proper consultation from homeopathy registered practitioner 

Some homeopathic medicine are

 condurango,natrum mur,nitric acid ,sulphuric acid,petroleum,graphites


Do’s and don’ts


Do’s


  • Take healthy diet which 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 to become lips dry
  • Avoid to open mouth frequently 
  • Avoid to touch or harsh the lips
  • Avoid to share personal towels and hankies 

 

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