Actinic cheilitis is a precancerous condition located on the vermilion of the lips that can develop into cancer.

Etiologically, chronic exposure to sunlight is responsible for this condition, which in fact leads to genetic alterations of cells over time.

It mainly affects fair-skinned people, with blonde or red hair, and blue, green or gray eyes, who have less melanin and are therefore more sensitive if overexposed to the sun. There is a slight predilection of men because they tend to spend more time in the sun and use less sunscreen protection than women, and they may be more likely to work outdoors, which may be a determining factor.

Upon clinical examination, atrophy, red and white areas and sometimes erosions and ulcers are observed in the lip vermilion, while in more advanced cases demarcation of the sharp vermilion – skin border is reported.

Regarding treatment, a biopsy of the symptomatic area of the lip should take place, in order to document the presence of actinic cheilitis. Additionally a recommendation for the total removal of the affected area, usually using a laser, is made.

It is essential that patients with actinic cheilitis should use lip sunscreens with a high protection index and wear a hat during summer months in order to protect themselves as best as possible.


Frequently asked questions

Why should a biopsy come first, followed by lesion eradication? Can’t they be done at one stage simultaneously?

A partial biopsy is performed first to detect actinic cheilitis and at the same time to rule out the possibility of cancer. However, in the possibility of cancer, the appropriate treatment is more invasive and radical, so it is very important to know the nature of the lesion before intervening to eliminate it.

I have actinic cheilitis but a standard scalpel removal and not a laser was suggested. What is best?

The use of laser allows the removal of extensive areas in a bloodless manner and with an efficiency similar to a scalpel (see related section). In the case of standard scalpel surgery there are more profound complications such as paraesthesia, itching, intense scarring of the area and it is usually preferred as a treatment in recurring lesions.


Photographs

Actinic Cheilitis
Actinic Cheilitis
Actinic Cheilitis