Severe solar cheilitis is a condition caused by constant exposure to sunlight. The thin skin of the lips can only withstand so much sunlight exposure before the top layers start to become damaged. The injured area can’t shed properly and so the skin builds up. This will lead to a constant chapped look of the lips.

The lower lip is almost universally involved. The upper lip is protected by shadow.

Prevention is the best treatment for actinic cheilitis. There are many lip balms available that contain sunscreen. A sun protection factor of 30 or higher would be recommended.

If the damaged area is very small, local destructive techniques such as liquid nitrogen cryotherapy can be useful. Multiple treatments may be indicated. If an area fails to improve, it may be necessary to biopsy.

If the whole lower lip is involved, it may need to be resurfaced. This can be done with liquid nitrogen, light dermabrasion, or laser therapy. Imiquimod or a 5-fluorouracil can be applied topically to the surface on a regular basis. Periodic monitoring will be mandatory to ensure that the treatment is effective. Rarely, it’s necessary to physically remove the surface of the lip and have a surgical repair performed.

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