Actinic chelitis – sun-damaged lips

Author:By Dr. Davin S. Lim, Laser Dermatologist

20-30% of patients over the age of 40 residing in Brisbane will exhibit some form of solar or sun-damage on their lips. With regular sun protection, some of this sun-damage can be prevented or even reversed. Early forms of sun-damage on the lips can respond well to a high factor SPF 50+ balm, combined with Vitamin A creams. If sun damage on the lips is severe, skin cancers such as IEC or more serious SCCs can arise. Patients with moderate to severe damage should be seen by a laser dermatologist for consideration of laser surgery or Photodynamic Therapy. Early treatment is the key to managing sun damage on the lips.

Important facts on actinic chelitis

Solar or actinic chelits can present as dry, painful, stinging lips
Scaly and rough areas usually occur on the lower lip
White patches, or areas of non-healing skin can present as sun-damage on lower lips
This condition is more severe in smokers or in patients who have chronic sunexposure
The daily use of a lip balm can prevent or reverse mild changes
Moderate to severe lip chelitis should be treated by a Specialist using PDT or lip laser

How does sun damage on the lips look like?

Sun damage on the lips can present in several forms, including a blurred or ill-defined lip edge. They can also present as rough, dry scaly patches on the lips, or areas of whiteness called leukoplakia.

Sun damaged lips can cause symptoms such as burning, stinging or even bleeding.

In some cases, sun damage lips may present as a lump or ulcer- in this situation a biopsy is need to exclude skin cancers within the sun damage areas.

Why should actinic chelitis be treated?

Sun damage lips should always be treated, however not all forms need aggressive treatment such as lip laser. The reason why we should treat or prevent actinic chelitis is to reduce the chances of skin cancer within these areas.

Skin cancers such as IECs or Squamous Cell Cancers can result from sun-damage on the lips.

Read more about Mole Map – by Dermatologist

When should I consider treating sun-damage lips?

There are two reasons for which you should consider treatment for sun damage on your lips.

Firstly, if you suffer symptoms such as stinging, burning, bleeding, or just annoyed in regards to peeling, crusty skin on the lips. Cosmetically, sun-damage lips can either cause lipstick to run, or give the lip border a blurred edge. Young lips have a sharp well defined border, whilst sun-damaged lips have blunt edges.

Secondly, if your Specialist Skin Cancer Doctor or Dermatologist recommends treatment. This is important, as if left untreated moderate to severe sun-damage on the lips can lead to skin cancer. You will be guided in regards to the severity, timeline and treatment options available during your skin cancer screening consultation.

Can actinic chelitis be dangerous?

Yes. In some cases actinic chelitis, or sun damage to your lips can be dangerous. Sun spots, known as solar keratosis can occur on your lips. This may lead to IEC or intra epidermal Squamous cell skin cancers. These can transform to Squamous Cell Skin Cancers. SCCs on the lip are serious forms of skin cancers.

High risk patients for developing SCC skin cancers on the lips include-

High UV exposure and extensive sun-damaged lips
Smokers
Outdoor workers
Patients who have immune suppression

How can I minimize sun-damage to my lips?

Due to the intense amount of UV radiation, especially in Brisbane and other Queensland cities, lip balm with a high factor SPF should be worn on a daily basis.

Some tips to minimize sun damage to your lips include-

Use of SPF 30+ balm 4-5 times a day
Wearing broad brim hats
If you smoke, consider quitting- this can reduce the chances of lip cancer
Ask to see a Dermatologist for either lip laser, PDT or in mild cases a vitamin A cream

What treatment options are there for sun-damaged lips?

For mildly sun-damaged lips: Skin cancer doctors advise the use of high factor SPF 50+ applied 3-4 times a day, coupled with Vaseline at night. A prescription Vitamin A can help reverse mild sun damage and actinic keratosis on lips.

For moderately sun-damaged lips: Photodynamic therapy or laser resurfacing of the lower lip

More severely sun-damaged lips: PDT (2 treatments) or CO2 – Erbium Laser Resurfacing or lip surgery by a plastic surgeon.

My Skin Cancer Clinics doctors work closely with Specialist Laser Dermatologist in the treatment of moderate to severe sun-damage lips. The use of CO2 and Erbium lasers are conducted by Laser Specialists at Westside Laser Dermatology.

What does laser treatment of sun-damaged lips- leukoplakia or actinic chelitis involve?

This procedure is conducted in a laser operating theater by a Laser Dermatologist under partial sedation. It involves resurfacing your lip with either a CO2 Laser or an Erbium laser. Laser destroys the abnormal cells and sun-damage on your lips, and allows health, new cells to develop over weeks. This procedure is partially covered under Medicare.

Recovery following lip laser can take up to 2-3 weeks.