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Solar Chelitis | Creams, Surgery or Laser Treatment for Sun Damaged Lips

Solar cheilitis (also known as actinic cheilitis or cheilosis) is a degenerative condition of the lips caused by exposure to ultraviolet light. Solar cheilitis is a precancerous condition, so it is essential to treat this and ensure regular skin cancer checks if you have it. Treatment for sun-damaged lips included laser, topical prescription creams or surgery. A skin cancer check before treatment is essential as solar cheilitis can progress to cancer.

Solar Cheilitis or Sun Damaged Lips Presentation.

Sun-damaged changes to the lips develop slowly over years of sun exposure. Because the skin of the lips is thinner than other areas, it is particularly prone to damage. A healthy lip has a homogeneous pink colour and a distinct lip border.   Whereas sun-damaged lips present as non-homogeneous white/grey, pink, and red areas, the skin border becomes less precise.

  • Solar cheilitis is more common on the lower lip as it protrudes more. It is more visible,
  • In the early stages, there are colour changes and blurring of the lip border, but as sun damage to the lips progresses, they appear cracked with scaling. These can progress to ulcerations or crusting.
  • Firmness or a non-healing ulcer may indicate the presence of early cancer and should be examined by a skin cancer doctor immediately.

Sun Damaged Lips Progress to SCC

Chronic UV light exposure can cause DNA damage in the cells, eventually leading to precancerous changes and, in some cases, cancer known as squamous cell carcinoma.

  • With suspicious changes, a biopsy of the suspect area, followed by a microscopic examination, is advised.

Treatment for  Sun Damaged Lips

You cannot reverse sun-damaged lip changes. However, some treatments can restore a healthy appearance and prevent progression to SCC.

    • Sun protection can prevent further damage at any stage, and if you have sun damage on your lower lips, start the twice-daily application of sunscreen designed for lips, wear a broad-brimmed hat or umbrella in the sun and avoid sun exposure entirely when the UV index is high.
    • Assessment with a skin cancer check is an essential first step.
    • Smaller premalignant solar cheilitis can be treated with laser resurfacing or creams designed to treat sun-damaged lips.
    • In more widespread lesions, a “lip shave” procedure may be performed to remove the covering of the lip.
    • If detected early, squamous cell carcinoma of the lip has a good prognosis.
    • Once you have solar cheilitis or SCC, lips should be followed up regularly to look for new changes or recurrences.

Who is at Risk of Solar Cheilitis?

  • The risk increases with age.
  • Men are more commonly affected than women.
  • People with fair skin have a higher rate of solar cheilitis and sun damage to the skin.
  • Outdoor workers are especially vulnerable.
  • People who do not observe sun protection.

Laser Treatment for Sun-Damaged Lips

Lasers are an effective treatment for moderately to severely sun-damaged lips. They allow for the precise removal of the sun-damaged lip’s surface layers. Correction of solar cheilitis may prevent the development of lip cancer at a later stage. However, this needs to be monitored with regular checks.

  • Laser Treatment for sun-damaged lips aids in the reduction of  peeling, cracking, lip discomfort,
  • A skin cancer doctor must examine lips and biopsy performed before laser treatment for sun-damaged lips. Your lips will be photographed both before and after treatment.
  • If you have a history of cold sores, you should take prophylactic treatment to prevent occurrence after treatment.
  • The laser treatment itself only takes a few minutes.
  • After treatment, except for significant pain, which will require pain relief and healing, it can take up to 2 weeks, but sensitivity can persist for longer.
  • Recurrence is possible. After the lip has healed, you must apply lip sunscreen at least twice a day all year to help prevent any recurrence and regularly have checkups.
  • Scarring can occur at the biopsy site or in areas of lips treated with laser.

Sun Damage Lips Treatment with Creams

Topical options for sun damage include creams Fluorouracil, Aldara and compounded fluorouracil and calcipotriol. Alternatively, photodynamic therapy (PDT), such as Metvix, is activated by light.

  • Treats isolated actinic keratoses of the lips and diffuse actinic damage of the lower lip.
  • This causes significant temporary discomfort, but the results can be excellent.
  • Recurrences can occur, and once you are diagnosed with solar cheilitis, it is essential to have regular skin cancer checks.
  • As with laser for sun-damaged lips, a biopsy of suspicious areas is required is essential before treatment to exclude SCC.,
  • In patients with severe diffuse sun damage lip damage, topical fluorouracil is an alternative to surgical excision of the vermilion border of the lip.

Surgery for Solar Cheilitis

Surgery is generally applied once a lip SCC is diagnosed. However, a lip shave can be performed to remove the lip sun damage. Vermilionectomy is a surgery where all or part of the lower red lip is removed.