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Cheilitis is inflammation of the lip. There are several different forms of the disease:

  • Cheilitis granulomatosa produces a mass of malformed tissue (sometimes black, sometimes not) after the immune system is activated. Allergies to gold,mercury, and cobalt can trigger an outbreak, as can exposure to certain chemical additives in food, such as benzoate preservatives or even plain old ordinary cinnamon. It can be a reaction to Lyme disease, tuberculosis, or bacteria closely related to tuberculosis. It can also occur with the immune system changes associated with sarcoidosis and Crohn's disease. This form of cheilitis causes attacks that come on suddenly and resolve after a few hours, at least at first. As there are more and more attacks of swelling, changes in the lip become permanent. There can also be fever, headaches, and paralysis of the facial muscles.
  • Cheilitis glandularis only affects the lower lip. It involves the salivary glands, and it can be caused by excessive exposure to sunlight, use of chewing tobacco or betel nut, or as a result to HIV infection. It causes the lip to jut outward. There's usually burning, oozing, and crusting on the lip. 
  • Angular cheilitis is a painful condition of inflammation that occurs at the corners of the mouth. A surprisingly large number of cases involve toothpaste or mouthwash that contains the ingredient sodium lauryl sulfate (SLS), known in Commonwealth countries as sodium dodecyl sulphate.

With granulomatous cheilitis the most important thing you can do is to avoid cinnamon and foods (especially baked goods) that contain the preservatives BHT or BHA. Dietary changes alone are successful in 54 to 78 percent of cases. It also helps to avoid putting anything with a scent or flavor on your lips, whether lipstick or chap stick. Doctors can do patch tests that identify inflammation triggers you can avoid. When avoidance of inflammatory compounds does not work, the next thing the doctor will try is steroids, which may have to be injected into the lip. When swelling has become permanent, a plastic surgeon can do lip reduction surgery.

In cheilitis glandularis, the most important thing you can do is to avoid new bacterial infections. If you also tend to get hives, it may help to avoid Aspirin. Aspirin makes the linings of blood vessels in the lips (and all over the body) more susceptible to histamine, the chemical the immune system generates that causes hives and other allergic reactions. If you have a problem with a specific food, it will be worse when you take Aspirin. You may also need to experiment to see whether your symptoms get worse when you eat cheese, chocolate, eggs, milk, pineapple, shellfish, or strawberries. If they do, you need to avoid these foods.

Angular cheilitis usually can be tracked to a specific inflammatory substance. By far the most common problem chemical is the previously mentioned sodium lauryl sulfate. You might be able to get relief just by switching to an SLS-free brand of toothpaste or mouthwash. It can also help to avoid Aspirin. Aspirin makes the linings of blood vessels in the lips (and elsewhere in the body) more permeable to histamine. This is the chemical the immune system generates to cause allergic inflammation. The more Aspirin you take, the more sensitive you are to allergy-provoking substances.

Many people who have angular cheilitis are allergic to a food dye called yellow dye #5 or tatrazine. It's in almost all packaged foods. If you have angular cheilitis, making your food from scratch or buying organic can make a huge difference in your symptoms.

No matter what kind of cheilitis you have, you can get short-term relief from pain by placing an ice pack (not ice itself) on your lips. Just don't add frostbite your problems. Make sure the ice is wrapped in a cloth or ice bag, and don't use for more than 15 minutes at a time.

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