Winter, with its cold and dry air, is often responsible for the drying out of lips. These, particularly sensitive due to their thin skin, can crack and even become chapped. However, these cracks are areas prone to infections. So, how can one tell if a chapped lip is simply due to the cold or if it is infected? And why do some chapped lips become infected? Explore the answers to these questions here.
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- How to recognise infected chapped lips?
How to recognise infected chapped lips?
Why do chapped areas become infected?
The skin of the lips is approximately five times thinner than that of the rest of the body, making it particularly vulnerable to external aggressions such as cold, pollution or wind. This inherent fragility, coupled with a low production of sebum, promotes its dehydration and the formation of chaps. However, when a crack forms, it allows germs present in the mouth, such as bacteria, fungi or viruses, to colonise the damaged skin, which can lead to an infection.
The most common infections on chapped lips are caused by fungi, such as Candida albicans, bacteria, such as Staphylococcus aureus or those of the genus Streptococcus, or even viruses, like the herpes simplex virus. A well-known infection that affects the corners of the lips is angular cheilitis, a form of cheilitis that can be of fungal, bacterial or viral origin and usually follows persistent cracks.
What are the symptoms of infected chapped lips?
Lip infections can present in various forms, depending on their severity. Initially, an infected chapped lip appears as a simple localised redness. The skin of the lips becomes slightly swollen and can be painful. This discomfort can vary from person to person and sensitivity, ranging from a mild burning sensation to more pronounced pain, especially at the corners of the mouth. At this stage, the infection remains benign but it can progress more or less rapidly if not treated.
As the infection progresses, more visible signs begin to appear. Small whitish or greyish lesions, surrounded by a red mucous membrane, may form on the lips. The skin can also become papular, meaning it can present with small raised bumps, and may also become rougher, with deep fissures. The edges of the fissures are often red and surrounded by scaly patches. In the case of oral candidiasis, whitish lesions can be observed.
In severe cases, the crack on the lips can become deeper, to the point of bleeding. Depending on the intensity of the pain, speaking, eating or even yawning can become difficult. At this stage, the skin around the crack may exude a fluid and form crusts. If the infection is not properly managed, the blisters can burst and give way to painful ulcers. It can also spread, exceeding the corners of the lips to follow the folds around the mouth, thus creating relatively extensive lesions. Sometimes, additional oral symptoms may manifest, such as white patches on the tongue, redness on the oral mucosa or spots on the palate.
Chapped lips that are infected should not be ignored and are a sufficient reason to warrant a medical consultation.
How is the diagnosis of an infection determined?
When a lip infection is suspected, the diagnosis primarily relies on a clinical examination by a doctor. They assess the appearance of the lesions and associated symptoms to determine whether the infection is bacterial, fungal, or viral in origin. In certain cases, additional tests may be required to identify the pathogen. A sample of the lesions is then taken to examine the cells under a microscope, looking for Candida albicans or bacteria. If a viral infection is suspected, specific tests, such as a PCR to detect herpes simplex, may be carried out.
Sources
LUGOVIC-MIHIC L. & al. Differential Diagnosis of Cheilitis - How to Classify Cheilitis? Acta clinical Croatica (2018).
MRAVAC-STIPETIC M. & al. Diagnostic management of cheilitis: an approach based on a recent proposal for cheilitis classification. Acta Dermatovenerologica (2020).
VIJAYAN S. & al. Angular Cheilitis - An Updated Overview of the Etiology, Diagnosis, and Management. International Journal of Dentistry and Oral Science (IJDOS) (2021).
ZITO P. & al. Angular Chelitis. StatPearls (2023).
POPA C. & al. Angular cheilitis: a multidisciplinary approach to diagnosis and management. Romanian Journal of Medical and Dental Education (2023).
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