Actinic cheilitis is a precancerous condition of the lips (see also actinic keratosis) that develops after years of sun exposure. The lower lip is the most often lip involved. The lip becomes dry, rough, scales or flakes and sometimes cracks and bleeds. It is seen most often in white, fair-skinned men over 50 years of age. Those with significant long-term sun exposure are at highest risk for developing this condition. Untreated, actinic cheilitis may progress to squamous cell carcinoma, see images below.
Squamous Cell Carcinoma
There are many treatment options available for actinic keratoses, most commonly liquid nitrogen administered from a canister or a Q-tip. Liquid nitrogen has a temperature of -196° and freezes the cells, causing cell death. The area treated scabs up and crusts off in about a week or two. New skin cells are generated, which replace the dead skin cells. Other options include, topical creams such as, 5-fluorouracil (Efudex®, Fluoroplex® and Carac®), Aldara®, Solaraze® and Picato®. Actinic cheilitis can be prevented with the use of sunscreen, sun avoidance and protective clothing. When applying your sunscreen don't forget to include your lips. Several companies now sell lip balm's with SPF built into it.
Wearing a wide-brimmed hat and limiting sun exposure will help prevent the development of actinic cheilitis.
Follow David Robles, MD, PhD
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