Actinic Cheilitis

What is actinic cheilitis?

Actinic cheilitis is a precancerous condition that can create rough, scaly, discolored patches on your lips. Prolonged sun exposure causes it, and usually affects your lower lip.

It’s also called:

• Actinic cheilosis.
• Farmer’s lip.
• Sailor’s lip.
• Solar cheilitis.
• Solar cheilosis.

Cheilitis means “inflamed lips.” Actinic cheilitis is a form of actinic keratosis, which are precancerous macules or papules that may occur anywhere on the body. Being precancerous, actinic keratosis can eventually turn into squamous cell carcinoma (SCC), a type of skin cancer.

Who might get actinic cheilitis?

Anyone can develop actinic cheilitis, but it’s more common in:

• Fair-skinned people.
• Men, because they’re more likely to be outdoor laborers who are frequently exposed to the sun and less likely to use sun-protective lip coatings.
• People over the age of 65, who may have had more exposure to the sun over the years.
• Outdoor workers, such as sailors, farmers, lifeguards and construction workers.
• People who live closer to the equator or at higher altitudes, where the sun is stronger.
• Those with abnormal pigmentation of the skin, such as albinism.

What causes actinic cheilitis?

Genetic damage to skin cells by ultraviolet light (UV) rays causes actinic cheilitis. Your lips are more vulnerable to the sun’s rays than other areas of skin. The skin on your lips is thinner and contains less pigment to protect cells from the sun’s damaging rays.

Repeated, long-term exposure of your lips to solar ultraviolet radiation causes actinic cheilitis.

What are the symptoms of actinic cheilitis?

With actinic cheilitis, your skin on one or both lips may look or feel:

• Chapped all the time.
• Cracked.
• Crusty.
• Discolored (such as white or yellow patches, or lips that are redder than normal).
• Dry.
• Folded in spots.
• Like sandpaper.
• Scaly.
• Swollen.
• Thin or fragile.

Also, the vermilion border (the reddish-colored line that separates the lips from other skin) may blur. Women sometimes describe difficulty applying lipstick because the lip line is less defined.

Actinic cheilitis is usually painless, but you might experience:

• Burning.
• Numbness.
• Pain.
• Soreness.
• Tenderness.

How is actinic cheilitis diagnosed?

If you have symptoms of actinic cheilitis, talk to your healthcare provider. They’ll examine you to determine whether you have:

• Cheilitis (simple inflammation that’s not precancerous).
• Actinic cheilitis.
• Squamous cell carcinoma.
• Another condition.

Your healthcare provider may diagnose actinic cheilitis based on:

• Physical examination of your lips.
• Questions about your life, such as the amount of time spent outdoors, use of sun protection and history of cancer.
• Skin biopsy, which is a sample of skin taken to review microscopically in more detail.

How is actinic cheilitis treated?

Actinic cheilitis can turn into cancer, so you should talk to your healthcare provider about treatment options. They’ll recommend strategies depending on how severe the condition is and your overall health.

The goal of treatment is to reduce the risk that the condition will turn into SCC. Treatment options may include:

• Creams, such as retinoids, 5-fluorouracil or imiquimod.
• Cryotherapy, which uses extremely cold temperatures to freeze and destroy abnormal cells.
• Electrocautery, which uses heat from an electric current to destroy abnormal tissue.
• Laser ablation, which uses a laser to destroy abnormal cells.
• Photodynamic therapy, a procedure that uses light to kill harmful cells.
• Vermilionectomy, a surgical procedure that removes part or all of your lower lip border.

How can I prevent solar cheilitis and SCC?

The best way to prevent actinic cheilitis and SCC is to protect your lips from the sun’s harmful rays year-round:

• Apply lip balm that contains sunscreen regularly.
• Limit time in the sun, especially when it’s at peak solar strength.
• Wear a hat with a brim that shades your lips.

People with actinic cheilitis should have routine checkups to detect any changes that could be early warning signs of cancer. Most healthcare providers recommend yearly skin checks by a dermatologist (skin doctor) for such individuals.

In addition, smokers should quit smoking. Ask your healthcare provider for help with quitting.

What is the outlook for people with actinic cheilitis?

You can improve the outlook for actinic cheilitis by protecting your lips from the sun.

Continued sun exposure will increase the risk of SCC, which can be life-threatening. Actinic cheilitis progresses to SCC in 6% to 10% of cases. And SCC that starts on your lips is more likely to spread to other areas of your body than SCC that starts elsewhere on your skin.

When should I seek medical care after being diagnosed with actinic cheilitis?

If you’ve been diagnosed with and treated for actinic cheilitis, you should have routine checkups every six months to a year.

A note from Cleveland Clinic

Chronic sun exposure causes actinic cheilitis, a precancerous condition on your lips. The rough, scaly patches usually develop on your lower lip. If you have any changes on your skin or lips, talk to your healthcare provider. It’s important to get an accurate diagnosis and take steps to prevent the condition from progressing to skin cancer.