While basic dryness and chapping are the most common lip complaints, a variety of other conditions can affect the lips—some minor, others requiring medical attention. Being able to recognise these conditions helps you determine when simple home care is sufficient and when professional evaluation is warranted. This guide covers the most common lip conditions, their causes, symptoms, and appropriate treatment approaches.
⚠️ Medical Disclaimer
This article is for educational purposes only and does not constitute medical advice. If you have concerns about a lip condition, please consult a healthcare professional for proper diagnosis and treatment.
Angular Cheilitis
Angular cheilitis, also known as perleche or angular stomatitis, is characterised by painful cracks, redness, and sometimes crusting at the corners of the mouth. It's one of the most common lip-adjacent conditions and often mistaken for simple chapping.
Causes
- Saliva accumulation at mouth corners (common in denture wearers or those with drooping mouth corners)
- Fungal infection (Candida)
- Bacterial infection (Staphylococcus)
- Nutritional deficiencies (iron, zinc, B vitamins)
- Allergic reactions to dental materials or lip products
Symptoms
Red, swollen patches at mouth corners that may crack, bleed, or develop a crusty texture. Pain when opening the mouth wide, eating, or speaking. The condition typically affects both corners and can persist for weeks if untreated.
Treatment
Treatment depends on the underlying cause. Fungal cases respond to antifungal creams, while bacterial infections may require antibiotic ointments. Keeping the area dry and protected with a barrier cream (like petroleum jelly) can help. Persistent cases warrant medical evaluation to identify underlying causes such as nutritional deficiencies.
Cold Sores (Herpes Labialis)
Cold sores are caused by the herpes simplex virus (HSV-1) and affect a significant portion of the Australian population. Once infected, the virus remains dormant in nerve cells and can reactivate periodically, causing outbreaks.
Causes and Triggers
- Initial infection through contact with infected saliva or skin
- Reactivation triggers: stress, fatigue, sun exposure, fever, hormonal changes, or immune suppression
Symptoms
Outbreaks typically begin with tingling, itching, or burning at the site (the prodrome stage), followed by the development of fluid-filled blisters. These blisters eventually break, crust over, and heal within one to two weeks. Cold sores most commonly appear on the lip border but can occur elsewhere on the face.
Treatment
Antiviral medications (acyclovir, valacyclovir) can shorten outbreaks if taken early, ideally during the prodrome stage. Over-the-counter creams containing docosanol may provide modest benefit. Keep the area clean and avoid touching or picking at sores to prevent spread and secondary infection. Sun protection is important as UV exposure is a common trigger.
đź’ˇ Cold Sore Prevention
If you experience frequent outbreaks, daily SPF lip protection may help reduce recurrences triggered by sun exposure. Some individuals benefit from daily suppressive antiviral therapy—discuss with your doctor if you have more than six outbreaks per year.
Actinic Cheilitis
Actinic cheilitis is a precancerous condition caused by chronic sun damage to the lips. It's particularly concerning in Australia, where intense UV exposure makes this condition more prevalent than in many other countries.
Causes
Cumulative sun exposure over years or decades. The lower lip is most commonly affected due to its greater exposure to direct sunlight. Risk factors include fair skin, outdoor occupation, male gender, and age over 50.
Symptoms
- Persistent dryness and roughness of the lips
- Pale or grayish discolouration
- Loss of the clear border between lip and skin
- Scaly patches that may be white, red, or brown
- Thickening or hardening of lip tissue
Treatment
This condition requires medical evaluation. Treatment options include topical chemotherapy creams (5-fluorouracil), cryotherapy, laser treatment, or surgical excision in severe cases. Regular monitoring is essential as actinic cheilitis can progress to squamous cell carcinoma.
🚨 When to See a Doctor Immediately
- Any lump, bump, or thickened area on the lip
- Sores or ulcers that don't heal within three weeks
- Bleeding without obvious cause
- Significant changes in lip colour or texture
- Numbness or tingling in the lip area
Contact Cheilitis (Allergic Lip Reactions)
Contact cheilitis occurs when the lips react to a substance they've come into contact with. This can be an allergic reaction (allergic contact cheilitis) or an irritant reaction (irritant contact cheilitis).
Common Culprits
- Lip care products (particularly those with fragrances, dyes, or flavouring)
- Toothpaste ingredients (especially cinnamic aldehyde and peppermint)
- Lipsticks and lip glosses
- Foods (mangoes, citrus, cinnamon)
- Dental materials
- Musical instruments (particularly brass and woodwinds)
Symptoms
Redness, swelling, itching, burning, and sometimes blistering of the lips. Symptoms may appear immediately after contact or develop over several days of repeated exposure. The reaction is usually limited to areas that contacted the irritant.
Treatment
Identify and eliminate the triggering substance. Use only bland, fragrance-free lip products. In severe cases, short-term topical corticosteroids may be prescribed. Patch testing can help identify specific allergens if the trigger isn't obvious.
Exfoliative Cheilitis
This condition involves continuous peeling or flaking of the lip surface. While it can be a normal response to mild irritation, persistent exfoliative cheilitis may have underlying causes.
Causes
- Habitual lip licking or picking
- Anxiety-related behaviours
- Allergic reactions
- Certain medications
- In rare cases, factitious (self-induced) injury
Treatment
Address any behavioural components such as lip licking habits. Use emollient lip products consistently. For persistent cases, medical evaluation may uncover underlying causes or reveal a need for psychological support if the behaviour is anxiety-related.
âś… Breaking the Licking Habit
If habitual lip licking is causing problems, try keeping lip balm constantly accessible so you can apply it whenever you feel the urge to lick. Some people find that using flavoured balms helps redirect the oral fixation into a healthier habit.
Cheilitis Glandularis
This rare inflammatory condition affects the minor salivary glands of the lips, causing swelling, usually of the lower lip. It's more common in middle-aged men and is associated with increased risk of squamous cell carcinoma.
Symptoms
Swelling and enlargement of the lower lip, particularly the central portion. Enlarged salivary gland openings may be visible as small dots on the lip surface. In advanced cases, the lip may become firm and everted.
Treatment
Medical management may include corticosteroid injections or surgery in severe cases. Regular monitoring for malignant changes is essential. Consult a dermatologist or oral surgeon for proper evaluation.
Nutritional Deficiencies and Lip Health
Several nutritional deficiencies can manifest as lip problems:
- Iron deficiency: Can cause angular cheilitis and pale lips
- Vitamin B2 (riboflavin) deficiency: Associated with cracks at mouth corners and lip inflammation
- Vitamin B3 (niacin) deficiency: Can cause lip redness and inflammation
- Vitamin B6 deficiency: May contribute to angular cheilitis
- Zinc deficiency: Associated with various lip and mouth problems
If lip problems persist despite good care practices, or if you have other symptoms of nutritional deficiency (fatigue, weakness, hair loss), blood tests can identify specific deficiencies for targeted supplementation.
When to Seek Medical Help
While many lip conditions improve with simple home care, certain situations require professional evaluation:
- Any lip condition that doesn't improve after two weeks of appropriate home care
- Recurring problems that keep coming back despite treatment
- Signs of infection: increasing pain, spreading redness, pus, or fever
- Any growth, lump, or persistent change in lip appearance
- Sores or ulcers that don't heal normally
- Lip problems accompanied by other symptoms (joint pain, rashes, fatigue)
Early evaluation often leads to simpler, more effective treatment. Don't hesitate to consult a GP, dermatologist, or oral medicine specialist if you're concerned about a lip condition.
For general lip care advice, see our beginner's guide to lip care and how to heal chapped lips.