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Did you know that leprosy can cause lip discoloration? Tuberculosis? Brain tumors? In very, very rare cases, deadly diseases reveal themselves in discoloration of lips. Most of the time, however, a much simpler condition interferes with beautiful lips.

Most of us have a good idea of what to do about chapped lips. Discoloration of the lips, on the other hand, sometimes suggests some kind of scary cause. Fortunately, most of the time strange lip color does not mean you have a horrible disease.

Dangerous Diseases That Cause Changes in Lip Color

Your chances are literally less than one in one million that any of these dread diseases is behind any strange discoloration of your lips.

  • Brain tumors. A brain tumor can change lip color, but it would also change the movement or the lip, or cause a permanent distortion of the lip.
  • Histoplasmosis. This sometimes-brain parasite would also cause changes in mood and behavior.
  • Leprosy. This ancient dread disease still exists. It attacks the fingers and toes as well as the lips and nose [1].

These serious but treatable diseases are a little more common, and do cause changes in lip color, but aren't the first thing your doctor would look for:

  • Leishmaniasis. Caused by a parasite transmitted by sand flies, this disease is especially common in Iraq [2].
  • Sarcoidosis. This condition of short-term to life-long inflammation also strikes the lungs and lymph nodes.
  • Tuberculosis. When TB is "hibernating," pale skin and lip color may be the only obvious symptom, but when it is active, it will also cause coughing, fatigue, fever, loss of appetite, and sometimes dramatic loss of weight.

Many doctors actually will consider Crohn's disease, a condition of chronic intestinal inflammation, when they see small white and red bumps on the lips that burst and form oozy, bloody, red, painful patches. They look like a cut skin that has begun to heal only there is no cut. When the breakouts on the lip and face only mean that Crohn's disease hasn't developed in the intestines yet, the condition is known as orofacial granulomatosis [3]. A variation of this autoimmune disease called Melkersson-Rosenthal syndrome will also cause fissures in the tongue and paralysis (palsy) on one or both sides of the face [4].

Most of the time the problem that is visible on the lip is limited to the lip. Here are some much more common and much more easily treatable possibilities.

Pale Lips

The most common cause of pale lips is anemia, a deficiency in the red blood cell count that results in less blood delivery to the lips. The pallor of the lips is more noticeable in cold weather, and particularly low red blood cell counts will result in a bluish tint. Anemia is not something you really ought to try to treat on your own, because there are multiple, entirely different nutritional causes of anemia that can manifest themselves in the lips but require totally different treatments [5]. Get a blood test. Don't guess what your body needs.

Dark Lips

The most common cause of dark lips is long-term exposure to noxious chemicals from tobacco, betel nut, or street drugs like crack cocaine or crystal meth. Smoking causes a condition called smoker's melanosis [6]. There will be increased pigmentation of the lips and mouth that goes away when you stop smoking. Betel nut causes unusually red lips at first, but after years of use there will be a kind of brown discoloration that also can go away when the practice is discontinued. Smoking cocaine or meth causes more discoloration than other ways of using the drugs; both doctors and police check lips as a sign of drug use. However, stopping the drugs leads to eventual restoration of normal lip color.

Brown or Black Flat Spots on the Lips

A flat brown to black spot on the lips is usually a solar lentigo (also known as an actinic lentigo or a liver spot), a sign of sun damage. It is possible to develop very similar discoloration without sun exposure; this condition is known as Peutz-Jeghers syndrome. Peutz-Jeghers causes tiny brown spots on the lips and around the mouth, but larger dark brown blotches on the gums. People who have this condition are about 15 times more likely than normal to develop colon cancer [7]. In relatively rare cases brown or black flat spots on the lips may be malignant (lentigo maligna). The only way to know for sure is for the doctor to do a biopsy [8].

If you have a solar lentigo, you can cover up with the right lipstick, but it may take several years of using lipstick or chapstick with sunscreen for your lips to return to normal. Malignancies have to be surgically removed. Peutz-Jeghers shows up before the age of 20, and at least one parent also has the condition. Cosmetic coverups are possible, as is removal of the brown or black spots with laser [9],but lifetime monitoring for colon cancer is essential.

Yellow Lips

Yellow lips are most often a manifestation of jaundice, which in turn is caused by liver disease. The yellowing will be more obvious in the sclera (whites) of the eyes. Treating liver disease stops the jaundice, but in the process of breaking down the pigments that cause jaundice the lips may turn green. Green lips are a sign of recovery.

Purple Lips

Purple lips may be caused by simple bruising injuries to the lips. However, women who have golden, Asian skin tones who use lightening agents that contain the chemical hydroquinone sometimes may develop a condition of purple lips and purple blotches on the skin called ochronosis because they lack an enzyme for breaking down the lightening agent  [10]. They should use "natural" skin lighgteners that contain a plant-derived ingredient called kojic acid. Whenever chapped lips turn purple, there is a possibility of lip cancer.

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