From the Guidelines
Treatment for cheilitis should prioritize lubrication with sterile vaseline or lip balm and maintaining good oral hygiene, as recommended by the most recent guidelines 1. The goal of treatment is to address the underlying cause and provide symptomatic relief, focusing on reducing morbidity, mortality, and improving quality of life.
Key Considerations
- Lubricate lips with sterile vaseline or lip balm to prevent dehydration and promote healing 1.
- Maintain good oral hygiene by inspecting the oral mucosa daily and eliminating sources of trauma 1.
- Drink ample amounts of fluids to keep the mouth moist 1.
- Consider using antifungal or antibacterial treatments if secondary infection is suspected, such as nystatin oral suspension or miconazole oral gel 1.
- Topical corticosteroids, such as betamethasone sodium phosphate or clobetasol propionate, may be used to reduce inflammation in severe cases 1.
Treatment Approach
- For angular cheilitis, apply an antifungal cream like clotrimazole 1% or miconazole 2% three times daily for 7-14 days 1.
- For exfoliative or contact cheilitis, eliminate irritants and apply petroleum jelly or a fragrance-free lip balm containing SPF several times daily 1.
- Hydrocortisone 1% cream can reduce inflammation for short periods (3-5 days) 1.
- Severe or persistent cases may require prescription-strength topical steroids like triamcinolone 0.1% or tacrolimus 0.1% ointment 1.
Additional Recommendations
- Avoid licking lips, stay hydrated, and use a humidifier in dry environments to maintain good lip hygiene 1.
- Nutritional deficiencies, particularly B vitamins, iron, and zinc, can contribute to cheilitis, so a balanced diet or supplements may help 1.
- If symptoms persist beyond 2-3 weeks despite treatment, consult a healthcare provider as this could indicate an underlying condition requiring different management 1.
From the Research
Treatment Options for Cheilitis
- The treatment of cheilitis depends on the underlying cause, with various options available including laser therapy, chemotherapy agents, surgical treatment, and application of anti-inflammatory agents 2, 3.
- For actinic cheilitis, a potentially malignant disorder caused by excessive sun exposure, treatments such as photodynamic therapy, imiquimod, and surgical approaches have been proposed 2, 3.
- Photodynamic therapy has shown positive results, with improvement in up to 100% of patients, while imiquimod has demonstrated clinical improvement in 80 to 100% of patients 2.
- Laser therapy appears to be the best option among nonsurgical approaches for actinic cheilitis, with partial surgery and laser therapy showing the highest complete response rates 3.
- The combination of photodynamic therapy with 5% imiquimod has also been shown to enhance efficacy 3.
Diagnostic Considerations
- Cheilitis can be caused by various factors, including irritants, allergic contact cheilitis, actinic cheilitis, infectious etiologies, nutritional deficiencies, and systemic conditions such as lichen planus and lupus 4, 5.
- A detailed anamnesis and patch testing are required to confirm the diagnosis of allergic contact cheilitis 4.
- Biopsies may be necessary to exclude severe dysplasia or carcinoma in cases of chronic actinic cheilitis 4.
- A diagnostic algorithm can assist clinicians in managing cheilitis by distinguishing among the various etiologies 5.