Precancerous Actinic Cheilitis on Lips

<p>Luis Alvarez / Getty Images</p>

Luis Alvarez / Getty Images

Medically reviewed by William Truswell, MD

Actinic cheilitis (AC), sometimes referred to as farmer’s lip, sailor’s lip, solar cheilitis, and solar cheilosis, is a variant of actinic keratosis (AK), which is a precancerous lip lesion. Lips may become very dry, or sandpapery, and present with inflammation and white patches. Actinic cheilitis is caused by excessive ultraviolet (UV) light exposure from the sun or indoor tanning beds.

In this article, you’ll learn the signs of actinic cheilitis and what the difference is between chapped lips and actinic cheilitis lip symptoms. The article will also cover diagnosis, risk factors, causes, treatment, and prognosis of actinic cheilitis on the lips.

<p>Luis Alvarez / Getty Images</p>

Luis Alvarez / Getty Images

Actinic Cheilitis Lip Symptoms: How to Tell

There are some defining features of actinic cheilitis. These signs can help you determine whether you have actinic cheilitis lip symptoms or dry or chapped lips for another reason. A key characteristic is that the lower lip is more commonly affected as it has greater exposure to the sun.

Symptoms of actinic cheilitis include:

  • Dry, scaly lips that won’t heal or lips that keep getting chapped again

  • White patches on lips

  • Discoloration or color loss on lips

  • Sandpapery feeling and look

  • Tenderness and pain when touched (usually painless otherwise)

  • Thin or more fragile lips without a clear lip line

Related:Actinic Keratosis

Getting a Timely Actinic Cheilitis Diagnosis

If you think you have signs and symptoms of actinic cheilitis, consulting with a dermatologist for a timely diagnosis is the next step. Getting a timely actinic cheilitis diagnosis or getting a timely assessment for unknown lip skin changes is important for your health. Left untreated, actinic cheilitis can progress to skin cancer, including squamous cell carcinoma of the skin.

While this may sound alarming, bear in mind skin cancer is highly treatable, especially when found in its early stages.

Related:Skin Cancer Facts and Statistics: What You Need to Know

Risk Factors for Actinic Cheilitis

Risk factors for actinic cheilitis include excessive exposure to UV light from the sun or from indoor tanning beds. The American Academy of Dermatology says most people who get AKs have spent much of their time outdoors and perhaps without sun protection.

The lip is more vulnerable to this type of sun damage because the skin in thin here and has less pigment to protect it against the sun’s rays.

Actinic cheilitis is directly caused by:

  • UV exposure from the sun

  • Frequent tanning bed exposure

  • Frequent sunlamp exposure

Prevention measures include:

Related:Understanding Sun Protection Factor

Other factors that contribute to a person’s likelihood of developing this type of AK include:

  • Being an outdoor worker or athlete who spends a lot of time in the sun (especially without wearing SPF lip protection)

  • Having fair skin or skin with no pigment (albinism) and burning easily, rarely tanning

  • Having naturally red or blond hair and light-colored eyes

  • Being 40 years of age or older

  • Being an organ transplant recipient (medications required can reduce immune system functioning)

  • Having a compromised immune system

  • Living closer to the equator or where the sun’s UV rays are stronger

  • Having Xeroderma pigmentosum, Rothmund-Thomson syndrome, or Bloom syndrome

Related:The 3 Skin Signs for Evaluating Patients

Treatment for Actinic Cheilitis Lip Symptoms

Treatment for actinic cheilitis lip symptoms includes using creams and other forms of therapeutic intervention. You may need one form of treatment or a combination of treatments, depending on the severity of your symptoms and whether AC has progressed from precancerous to cancerous.

Treatments ror actinic cheilitis lip symptoms include:

  • Antitumor creams, including 5-fluorouracil (5-FU) or imiquimod

  • Laser removal

  • Cryotherapy or cold laser therapy to freeze and destroy abnormal cell growth

  • Electrocautery (electric current therapy or heat blast therapy), which uses the power of electrical current to destroy abnormal cells

  • Photodynamic therapy or light-based therapy, which uses light to destroy abnormal cells

  • Vermilionectomy, which is a surgery to remove part of the lower-lip border commonly affected by abnormal cell growth in AC

According to the Skin Cancer Foundation, 5-FU is not a safe or suitable treatment option for someone who is pregnant because this medication can cross the placenta, causing harm to the fetus.

Related:Adrucil (Fluorouracil) for Chemotherapy

Can You Treat AC at Home?

The creams used to treat AC can be purchased over the counter and used at home.

However, if you have AC, a combination of approaches may be the most effective. One study from 2021, for example, found that the combination of antitumor creams imiquimod, 5-fluorouracil, and tretinoin with cryotherapy or cold laser therapy had high clearance rates (in which the abnormal cells did not return by study end) and was the most effective treatment.

How Quickly Does Actinic Cheilitis Progress?

According to the Skin Cancer Foundation, AK is the most common type of precancer that forms on skin damaged by chronic exposure to UV rays from the sun and/or indoor tanning. Paying attention to early warning signs can help prevent AC from progression to skin cancer. 

The 10-year rate of malignant transformation of AK estimates range from 6% to 10% (the likelihood that the lesions become cancerous), with approximately 60% of squamous cell carcinomas arising from actinic keratosis.

Skin color changes or early signs of sun damage can indicate a decline in your skin’s health. Losing firmness in your lips is another potential early warning sign.

AC will not go away on its own. While it may not look like much in its very early stages, it is serious and requires diagnosis and treatment because it can progress to squamous cell carcinoma. If you think you may have AC the next step is to see a healthcare provider or dermatologist for assessment.

Related:How Skin Cancer Is Treated


Actinic cheilitis is a form of actinic keratosis, or a precancerous skin lesion. It presents as dry, chapped, scaly lips with white patches or discoloration. People who are frequently exposed to UV rays from the sun or tanning beds are at greater risk, especially when sun protection is not involved. Other risk factors include age and declined  immune system functioning.

AC is serious, and when left untreated, it can progress to skin cancer. Treatments include medicated creams, various laser therapies, and surgical removal of any scaly patches or lesions (in more severe cases or where the AC has progressed to skin cancer). Skin cancer treatment in early stages is highly effective.

Read Next:Skin Cancer Treatment