Overview
Actinic Cheilitis (also known as solar cheilitis) is a precancerous condition affecting the lips, caused by long-term sun exposure. It typically appears on the lower lip as dryness, scaling, thickening, or whitish discoloration. Although not cancer itself, it has the potential to develop into squamous cell carcinoma, a type of skin cancer.
Early recognition and treatment of actinic cheilitis are crucial to prevent progression to cancer. It is most common in fair-skinned individuals, older adults, and people who work outdoors.
What is Actinic Cheilitis?
Actinic cheilitis is a form of actinic keratosis (sun-damaged skin) that specifically affects the lips. Chronic ultraviolet (UV) radiation from the sun damages the lip tissue, especially the vermilion border (the margin between the lip and skin), leading to cellular changes that may become cancerous if left untreated.
Symptoms
Signs and symptoms of actinic cheilitis usually develop slowly and may include:
- Dry, cracked lips that don’t heal
- Scaly, crusted patches on the lower lip
- Persistent lip roughness or sandpaper-like texture
- Discoloration (whitish, pale, or red areas)
- Lip swelling or loss of clear border between the lip and skin
- Burning or tingling sensation
- Ulceration (in more advanced cases)
Causes
The primary cause of actinic cheilitis is:
- Chronic exposure to ultraviolet (UV) radiation, especially from sunlight
Other contributing factors may include:
- Tanning beds
- Smoking or tobacco use
- Poor lip protection outdoors
Risk Factors
Several factors increase the risk of developing actinic cheilitis:
- Fair skin, blue eyes, and light-colored hair
- Chronic sun exposure, especially for outdoor workers (e.g., farmers, fishermen, construction workers)
- Older age (usually over 50)
- Male gender (more common in men)
- History of frequent sunburns
- Weakened immune system
Complications
If left untreated, actinic cheilitis can progress to:
- Squamous Cell Carcinoma (SCC) of the lip
This is a serious form of skin cancer that can metastasize if not caught early. About 10–20% of actinic cheilitis cases may evolve into SCC over time.
Other complications include:
- Cosmetic disfigurement
- Chronic lip discomfort
- Difficulty eating or speaking in severe cases
Prevention
Preventive measures can greatly reduce the risk of actinic cheilitis:
- Use lip balm with SPF 30 or higher daily, even on cloudy days
- Wear a wide-brimmed hat when outdoors
- Avoid tanning beds
- Seek shade during peak sunlight hours (10 a.m. to 4 p.m.)
- Stop smoking or using tobacco products
- Perform regular self-checks of the lips for changes
- Routine dermatological exams, especially if you are at high risk
Treatment Options Korea
1. Sun Protection
- Essential first step in all cases
- Use of broad-spectrum lip balms with SPF 30+
- Patient education on UV avoidance and protective hats/masks
2. Topical Therapies
- 5-Fluorouracil (5-FU) cream – most commonly used topical agent
- Imiquimod cream – boosts local immune response
- Often applied over 2–4 weeks under dermatologist supervision
3. Cryotherapy
- Liquid nitrogen applied to the lesion
- Quick outpatient procedure
- May cause temporary pain, swelling, or scarring
4. Laser Therapy
- CO₂ or Er:YAG lasers used to ablate affected tissue
- Available in dermatology clinics and cosmetic centers in Korea
- Effective for moderate to severe cases
5. Surgical Options
- Vermilionectomy (removal of the lip border) for persistent or severe dysplasia
- Considered when there’s high suspicion of progression to squamous cell carcinoma
6. Regular Monitoring
- Ongoing follow-up to check for malignant transformation
- Biopsies performed if lesions do not respond or worsen
