What causes cheilitis and vesicles on the lip?

From the Guidelines

Cheilitis and bubbles on the lip are most commonly caused by Herpes Simplex Virus (HSV-1), which leads to the formation of fluid-filled blisters or bubbles, known as cold sores or fever blisters. According to a study published in the Journal of Clinical Virology 1, HSV-1 is the primary cause of herpes labialis, a condition characterized by recurrent episodes of painful and disfiguring lesions on the lips. The study highlights that primary HSV-1 infection can be either asymptomatic or cause self-limiting gingivostomatitis in the immunocompetent host, and that reactivation stimuli include exposure to ultraviolet light, fever, psychological stress, and menstruation.

Some key points to consider in the diagnosis and management of cheilitis and bubbles on the lip include:

• The epidemiology of HSV-1 has changed dramatically in recent decades, with the virus becoming the most common cause of primary genital HSV infections 1
• Reactivation of HSV-1 can be triggered by various factors, including ultraviolet light, fever, psychological stress, and menstruation 1
• Antiviral therapy, such as famciclovir, aciclovir, or valaciclovir, can be effective in shortening the duration of symptoms and accelerating the resolution of lesions 1
• Treatment should be initiated as soon as possible to ensure an optimal therapeutic beneficial effect, as peak viral titres occur in the first 24 h after lesion onset 1

It is essential to note that other conditions, such as angular cheilitis, contact cheilitis, actinic cheilitis, and irritant cheilitis, can also cause cheilitis and bubbles on the lip. However, based on the most recent and highest quality study available 1, HSV-1 is the primary cause of herpes labialis, and antiviral therapy is the most effective treatment option.

From the Research

Causes of Cheilitis

• Cheilitis, or inflammation of the lips, can be caused by various factors, including irritant and allergic contact dermatitis, atopic cheilitis, actinic cheilitis, infectious etiologies, nutritional deficiencies, and drug-induced cheilitis 2
• Other rare etiologies of cheilitis include granulomatous cheilitis, cheilitis glandularis, plasma cell cheilitis, lupus cheilitis, and exfoliative cheilitis 2
• Irritants, such as climatic, mechanical, or caustic agents, are the main aetiological factors of cheilitis 3
• Allergic contact cheilitis can be caused by various substances and should be investigated with a detailed anamnesis and patch testing to confirm the diagnosis of delayed hypersensitivity 3, 4

Bubbles on the Lip

• There is no direct evidence in the provided studies that specifically addresses the cause of bubbles on the lip
• However, some studies mention that cheilitis can present with erythema, superficial desquamation of mucosal skin, dryness, redness, irritation, burning, fissuring, and itch, which may be related to the formation of bubbles or blisters on the lip 2, 3
• Angular cheilitis, a type of cheilitis, can cause erythema, moist maceration, ulceration, and crusting at the corners of the mouth, which may be accompanied by bubbles or blisters 5, 6

Systemic and Nutritional Factors

• Cheilitis can be associated with various systemic conditions, such as lichen planus, lupus, atopic dermatitis, and nutritional deficiencies 3
• Nutritional deficiencies, such as vitamin deficiencies, can contribute to the development of cheilitis 5
• Systemic immune suppression, local irritation, and moisture can also precipitate cheilitis 3