Actinic cheilitis is a precancerous lesion on the lip caused by chronic exposure to ultraviolet (UV) rays. It’s common in people who spend a great deal of time outdoors. For that reason, it’s sometimes called sailor’s lip or farmer’s lip.
You might mistake the symptoms, which include rough or swollen lips with whitish patches, for garden-variety chapped lips. But actinic cheilitis can progress to squamous cell carcinoma if left untreated. Squamous cell carcinoma can spread to the mouth and other parts of the body.
What Causes Actinic Cheilitis?
Actinic cheilitis can develop when long-term exposure to the sun or other forms of UV radiation, such as tanning beds, damages a gene responsible for preventing tumors. This allows defective cells in the skin of the lip to multiply.
The lips are especially vulnerable to UV rays for two reasons:
- They get more sun exposure because they protrude from the face. The lower lip typically protrudes further than the upper lip, so most actinic keratosis lesions form there.
- The skin of the lips is thinner than that of other parts of the body. It also has fewer sebaceous (oil) glands and less melanin, the pigment produced by skin to protect it from UV rays.
Who Gets Actinic Cheilitis?
You are more likely to develop actinic cheilitis if you:
- Are over the age of 60
- Are male
- Have fair skin that burns or freckles easily
- Have worked outdoors for more than 25 years
- Have a history of nonmelanoma skin cancer
- Have a weakened immune system
There is also evidence that suggests smoking and drinking alcohol increase the risk of actinic cheilitis.
Actinic Cheilitis Symptoms
The condition doesn’t look exactly the same in everyone. Common signs include:
- Scaly whitish patches on the lip
- Dryness or peeling that won’t heal
- A rough, sandpapery texture
- Blurring of the border between the lip and the adjacent skin
- Loss of color in the skin of the lip
- Swelling or redness of the lip
Actinic cheilitis is usually painless, though it may cause burning or numbness. In severe cases, the area can become hardened and develop a sore.
A dermatologist can often diagnose actinic cheilitis based on visible signs. If the doctor isn’t certain whether a lip lesion is actinic cheilitis (precancer) or cancer, a biopsy may be performed. The dermatologist may also run tests to rule out other potential causes, such as a vitamin deficiency, infection or contact dermatitis.
Actinic Cheilitis Treatment
Actinic cheilitis is treated with either an in-office surgery or topical medicine. The best treatment depends on the severity of the condition, how much area of the lip is involved and the location.
Surgical options include:
- Cryotherapy (freezing the lesion to remove it)
- Electrocautery (using an electric current to burn off the lesion), sometimes coupled with curettage to scrape it off
- CO2, pulsed dye or erbium laser treatment
- Vermilionectomy (surgery to cut out the lesion)
Topical treatments are typically used when the affected area is large. They include:
- Fluorouracil cream, also known as 5FU
- Imiquimod cream
- Ingenol mebutate gel
- Trichloroacetic acid, a type of chemical peel
- Diclofenac gel, a topical nonsteroidal anti-inflammatory drug
Preventing Actinic Cheilitis
The most effective way to protect your lips from precancerous or cancerous lesions is to shield them from the sun whenever you’re outside, even on cloudy days and in the winter. Use a lip balm with SPF 30 or higher and apply it frequently. Wear a wide-brimmed hat that shades the front of your face, including your lips.
If you notice any changes to your lips that don’t resolve on their own, see a dermatologist promptly.