The frost and the sun – a beautiful day… Unfortunately, not all citizens of our planet can enjoy such weather. Many chronic skin diseases can exacerbate in overcooling and overheating, meteorological cheilitis is among them.

The given type of cheilitis is a separate disease manifested by an inflammatory process affecting the skin and lip mucosa and is caused by various meteorological factors. The duration of such factors and individual peculiarities of the skin play an important role in the disease development. Cheilitis occurs most often in people with white and delicate skin or in those who have some skin diseases accompanied by excessive dryness (seborrhea, seborrheic eczema, atopic dermatitis and others).

There also exists actinic cheilitis, which is a variety of meteorological cheilitis. This is an inflammatory disease of the lips caused by an excessive sensitivity of the red lip rim to the ultraviolet (UV) radiation.

Cheilitis develops due to various unfavorable weather conditions, such as increased or decreased air humidity, high level of air dust, strong wind, low temperature and the sun rays.

The disease may develop in any season of the year. People working in the open air are most susceptible to the disease development. It is more prevalent in men, because the use of lipstick by women can have a protective function.

In order to suspect meteorological cheilitis, the doctor should know its main symptoms and peculiarities of the course of the disease. Meteorological cheilitis develops gradually depending on the period of time spent in the open air with unfavorable weather conditions.

The initial stage of the disease is characterized by mild peeling, dryness and disappearance of a clear-cut border between the red rim and the skin of the lip. When the unfavorable effect is prolonged, small dry whitish areas are formed on the lips. The skin on the lower lip thickens. The lip itself becomes swollen and gradually protrudes forward. Cracks may also appear at this stage.

If not treated, the process may become chronic, with the appearance of ulcers and crusts in the place of their healing. The ulcers themselves signal about the transformation of the inflammatory process to a malignant stage. 

Manifestations of actinic cheilitis differ insignificantly from meteorological cheilitis. There are 2 forms of actinic cheilitis: exudative and dry. Exudative form is a kind of acute allergic reaction with typical symptoms of contact dermatitis. It is characterized by the formation of small blisters, which rapidly break leaving noticeable defects. Patients with an exudative form often complain of a severe itching, burning and tenderness in the affected area. Dry actinic cheilitis is not accompanied by ulcers and blisters, though it is manifested by the formation of scales.

  When the disease is chronic, exacerbations usually occur from late spring to early autumn. The longer the disease lasts, the deeper skin affection is observed in the red rim area. With the appearance of deep cracks, knars and ulcers, the risk of cancer increases greatly.

Carefully taken anamnesis is most important for making a correct diagnosis, because there are no specific laboratory methods for detecting meteorological cheilitis. It is necessary to determine the relationship between the appearance    of the disease and the effect of unfavorable weather conditions. If the patient has been ill for several years, the diagnosis is obvious. But during the first examination, it may be difficult to establish a diagnosis, because the disease has similar manifestations with atopic cheiliitis and a dry form of actinic cheilitis. Nevertheless, there are some significant differences, which can help the doctor to identify the disease.

What is the difference between meteorological and actinic cheilitis and other inflammatory diseases of the lips?

Both actinic and meteorological cheilitis mostly affect the lower lip. When speaking with the patient, the doctor can ascertain that exacerbations are usually caused by unfavorable weather conditions.

Atopic cheilitis spreads both to the lower and upper lips, affecting the skin around the lip and the corners of the mouth. The disease is characterized by the periods of exacerbations and remissions.

Contact allergic cheilitis only develops following a contact with an allergen. When removing the causative agent, the manifestations of the disease disappear. In this case, the red lip rim and a small skin area around the mouth are usually affected.

  In exfoliative cheilitis (a dry form), the inflammation spreads from the red lip border with the mucous membrane to the middle of the red rim.

How to treat meteorological cheilitis?

The most important thing is to remove completely (or, at least, partially) the effect of unfavorable environmental factors on the skin. Sometimes, it is not easy to do. As for medicines, first of all, vitamins A, E, C, P and PP are usually administered. The patient should regularly use hygienic lipstick, especially when going out. At present, there is also a great choice of sun creams and ointments.

If the inflammation is severe and does not respond to treatment, a doctor-dermatologist can prescribe adrenal hormones locally.

The prognosis is usually positive. But at the advanced stage of the disease when the patient does not receive proper treatment and preventive therapy meteorological cheilitis can gradually lead to the development of the lower lip cancer.

K.A. Karapetova, doctor-dermatovenerologist