Lips of patients with cheilitis appear dry and scaly and may have one or more fissures. Often the lips are painful, and there may or may not be associated edema and erythema.

Cheilitis is one of the more challenging oral problems to diagnose and treat. Many cases represent a factitial disorder related to lip-licking habits, and it can be difficult to convince patients that the vermilion zone of the lip should be dry (the "wet line" is the demarcation between the labial mucosa and vermilion zone).

Some cases of cheilitis are related to contact hypersensitivity reactions to compounds found in products that commonly come into contact with the vermilion zone of the lip, including cosmetics, lip balms, toothpastes, and sunscreens (oxybenzone [benzophenone-3]).

Other cases of cheilitis are due to candidal infection related to chronic lip-licking or to the use of petrolatum-based materials that are applied to the lips. The petrolatum seals in moisture, allowing the candidal organism to thrive in the moist keratin that results.

Retinoids (isotretinoin and acitretin) are also frequent causes for this problem. High doses of vitamin A, lithium, chemotherapeutic agents (busulfan and actinomycin), d-penicillamine, isoniazid, and phenothiazine have also been reported to cause cheilitis.

Related topics: actinic cheilitis, angular cheilitis, exfoliative cheilitis