From the Guidelines
Cheilitis treatment should prioritize addressing the underlying cause and providing symptomatic relief, with ablative laser vermilionectomy being a valuable option for extensive actinic cheilitis, as suggested by the study published in the Journal of the National Comprehensive Cancer Network 1. When considering treatment options, it's essential to differentiate between various forms of cheilitis, such as actinic cheilitis, angular cheilitis, contact or irritant cheilitis, and others.
- For actinic cheilitis, which is a precursor to squamous cell carcinoma, treatment modalities like cryosurgery, topical 5-fluorouracil, topical imiquimod, photodynamic therapy, and curettage & electrodessication may be considered, as outlined in the study 1.
- In cases of extensive actinic cheilitis, ablative laser vermilionectomy may be of value, as mentioned in the study published in 2010 1. Key considerations in managing cheilitis include:
- Identifying and removing potential irritants
- Maintaining good oral hygiene
- Staying hydrated
- Using sun protection on lips
- Applying topical treatments as necessary, such as antifungal creams, hydrocortisone, or petroleum jelly It's crucial to note that the treatment approach may vary depending on the specific type and severity of cheilitis, and a thorough evaluation and diagnosis are necessary to determine the most effective treatment plan, with a focus on preventing recurrence and improving quality of life.
From the Research
Cheilitis Treatment Options
- The treatment of cheilitis depends on the underlying cause, with various options available, including topical treatments, oral medications, and surgical interventions 2, 3, 4, 5, 6.
- For angular cheilitis, a combination of 1% isoconazole nitrate and 0.1% diflucortolone valerate ointment has been found to be effective due to its broad spectrum of activity against dermatophytes and bacteria, as well as its anti-inflammatory properties 2.
- Actinic cheilitis, a premalignant condition, can be treated with carbon dioxide laser ablation, vermilionectomy, chemical peel, or photodynamic therapy, with the first two options showing the most favorable outcomes and fewest recurrences 5.
- In cases of cheilitis caused by irritants or allergens, identification and avoidance of the causative agent, as well as patch testing to confirm delayed hypersensitivity, are essential for effective management 6.
- Systemic conditions, such as lichen planus, lupus, atopic dermatitis, and nutritional deficiencies, may also require specific treatments, and cheilitis can be a symptom of these underlying conditions 3, 4, 6.
Diagnostic Approaches
- A diagnostic algorithm can assist clinicians in managing cheilitis by considering various types, including angular, contact, actinic, glandular, granulomatous, exfoliative, and plasma cell cheilitis 3, 4.
- Classification of cheilitis based on duration and etiology can help guide treatment decisions, with categories including mainly reversible, mainly irreversible, and cheilitis connected to dermatoses and systemic diseases 4.
- Biopsies may be necessary to exclude severe dysplasia or carcinoma in cases of chronic actinic cheilitis, and to confirm the diagnosis of granulomatous macrocheilitis 5, 6.