What is an infection of the lips called?

Infection of the Lips: Types and Management

Infection of the lips is commonly called herpes labialis (cold sores) when caused by herpes simplex virus, or various forms of cheilitis when caused by other infectious or inflammatory processes.

Herpes Labialis (Cold Sores)

Herpes labialis is the most common infectious condition affecting the lips, primarily caused by HSV-1 virus 1.

Clinical Features:

• Prodromal symptoms: tingling, burning, or itching
• Progression to papules, vesicles, and ulcers
• Erythema, dryness, fissuring, peeling, cracking, and bleeding of the lips 1
• Typically appears on the vermillion border of the lips
• Lesions typically heal within 7-10 days

Treatment:

• Oral antiviral therapy is the recommended treatment for herpes labialis and should be started within 72 hours of symptom onset for maximum effectiveness 2
• FDA-approved options:
  • Valacyclovir: Indicated for treatment of cold sores in adults and pediatric patients ≥12 years 3
  • Acyclovir: Effective for initial and recurrent episodes 4
  • Famciclovir: Available as pharmacist-controlled medication in some countries 1
• Topical antivirals alone are not sufficient for herpetic stomatitis; oral antiviral therapy is necessary 2

Other Types of Lip Infections/Inflammation (Cheilitis)

Cheilitis refers to inflammation of the lips that may have infectious or non-infectious causes 5, 6.

Angular Cheilitis:

• Inflammation at the corners of the mouth
• Often has mixed bacterial and fungal etiology 7
• May be associated with:
  • Nutritional deficiencies (B vitamins, iron)
  • Mechanical factors (denture-related)
  • Saliva pooling at corners of mouth

Infectious Cheilitis:

• Can be caused by bacteria, fungi, or viruses
• May present with:
  • Erythema and swelling
  • Crusting and fissuring
  • Pain and tenderness

Other Forms of Cheilitis:

• Contact cheilitis: allergic or irritant reaction
• Actinic cheilitis: sun damage (premalignant)
• Exfoliative cheilitis: chronic peeling of lip surface
• Granulomatous cheilitis: persistent lip swelling
• Plasma cell cheilitis: dense plasma cell infiltration 6, 8

Diagnostic Approach

When evaluating lip infections, consider:

1. Duration of symptoms (acute vs. chronic)
2. Pattern of lesions (unilateral, bilateral, localized, diffuse)
3. Associated symptoms (pain, burning, itching)
4. History of recurrence
5. Triggering factors (sun exposure, new lip products)

For persistent or atypical lesions (>2 weeks duration), consider:

• Blood tests to rule out systemic conditions
• Biopsy for definitive diagnosis 1

Management Principles

1. For herpes labialis:

   • Oral antiviral therapy (valacyclovir, acyclovir, famciclovir)
   • Pain management with topical anesthetics or oral analgesics
   • Avoid triggers (sun exposure, stress)

2. For other forms of cheilitis:

   • Identify and address underlying cause
   • Maintain good oral hygiene
   • Use non-alcoholic mouthwashes
   • Consider dietary modifications (avoid irritating foods)
   • Topical corticosteroids for inflammatory conditions (limited to <2 weeks) 2

3. For angular cheilitis:

   • Antifungal treatment if Candida is present
   • Antibacterial treatment if bacterial infection is present
   • Address underlying factors (denture fit, nutritional deficiencies)

Prevention

• Regular oral hygiene practices
• Use of lip balm with sun protection
• Avoiding sharing personal items during active infection
• Regular dental check-ups every 6 months 2

For recurrent herpes labialis, consider suppressive antiviral therapy if episodes occur frequently (>6 episodes per year) 4.