Lip pain

Lip pain is observed in various types of cheilitis, herpes, traumatic injuries, atypical form of lichen planus of the oral cavity, trigeminal neuralgia, lip cancer. In the absence of significant skin defects, it is often burning, often combined with itching, with the appearance of cracks – itching, with neurological pathology – extremely intense, shooting. The reason is established on the basis of inspection data, instrumental and laboratory techniques. Treatment includes anti-inflammatory, anti-allergic, antipruritic local remedies, immunomodulators, regeneration stimulants, other general-acting drugs, physiotherapy techniques. Sometimes operations are recommended.

Why does the lip hurt
Heilit
Herpes
Red lichen planus of the oral cavity
Traumatic injuries
Trigeminal neuralgia
Lip cancer
Diagnostics
Treatment
Conservative therapy
Surgical treatment
Prices for treatment
Why does the lip hurt
Heilit
Cheilitis is an extensive group of inflammatory diseases of the mucous membrane and skin of the lips. They arise primarily or develop against the background of other pathologies. Typical signs are pain and burning in the lips when eating, opening the mouth, peeling, hyperemia, the appearance of cracks, crusts, bleeding ulcers. The symptom can be provoked by the following types of cheilitis:

Exfoliative. It is formed against the background of neurotic disorders, it is more often detected in women. It affects the red border without involving the mucous membrane, corners of the mouth, areas adjacent to the skin of the chin and nasolabial triangle. It is manifested by burning, dry lips, the formation of scales. The pain is more pronounced in the exudative form, also accompanied by swelling of the lips.
Glandular. It is diagnosed in people with malformations and acquired diseases of the small salivary glands, caries, periodontal diseases. The lower lip suffers more often. Initially, a slight dryness is detected, which is subsequently replaced by painful erosions, deep bleeding and wet cracks.
Contact allergic. It is potentiated by cosmetics, formed with the habit of holding various objects in the mouth, develops in people of some professions (for example, musicians playing wind instruments). Severe itching, redness, swelling of the lips prevail. The resulting bubbles are opened with the formation of painful erosions and cracks.
Meteorological. Occurs under the influence of sunlight, less often – wind and cold. The exudative form is accompanied by burning, itching, the appearance of small bubbles, in place of which painful erosions remain. For the dry form, the presence of erosive defects is uncharacteristic, pain appears against the background of burning, dry lips. There is a risk of developing precancerous diseases, malignancy.
Atopic. It is diagnosed in patients with neurodermatitis and atopic dermatitis. They are worried about hyperemia, peeling, itching. Pain occurs when cracks form in the corners of the mouth. These manifestations are complemented by peeling, dryness of the face.
Hypovitaminous. It is provoked by a lack of B vitamins, especially B2. The skin of the lips is dry, hyperemic, covered with small vertical cracks that hurt and bleed. The mucosa is reddened, slightly edematous. The tongue is enlarged.
Herpes
The red border of the lips and the corners of the mouth are the favorite localizations of herpes simplex. The patient feels burning, tingling, bursting. In the affected area, rashes are formed, which are a cluster of small bubbles. As the changes progress, unpleasant symptoms increase, and pain syndrome joins them. Then the bubbles are opened individually or having previously merged into one or more multi-chamber bubbles. In their place, erosions of irregular shape appear, painful when touched, lip movements.

Red lichen planus of the oral cavity
Involvement of the lip (mainly the upper lip) is characteristic of a rare atypical form of the disease. Papules, plaques or ulcers, erosive defects of irregular configuration, covered with fibrinous plaque are found on the skin and mucous membrane. Pain syndrome is most pronounced in the presence of ulcers, accompanied by burning sensation. Several forms of lichen planus often combine with each other or transform into one another, so the affected areas may be present not only on the lips, but also on the gums, tongue, and oral mucosa.

Lip pain
Lip pain
Traumatic injuries
Acute damage to the mucous membrane or skin of the lip occurs as a result of injury by foreign objects, biting. It is quite rare. It is manifested by the formation of a hematoma or erosive defect. The pain persists for 1-3 days. With secondary infection, erosion transforms into an ulcer, the surrounding tissues swell, and soreness increases.

Chronic traumatization is possible if the sharp edges of the anterior carious teeth are damaged. It proceeds with swelling, slight soreness, a feeling of discomfort. With prolonged injury, an ulcer forms. It is possible to develop a local or widespread inflammatory process with increased pain, swelling, and the appearance of purulent discharge.

Bruises of the lip, as a rule, are the result of fights. Children often develop as a result of falls. They are characterized by rapidly increasing edema, may be accompanied by abrasions of the mucous membrane due to sharp contact with the teeth. Pain is pronounced in the first minutes after the injury, then gradually subside. Recovery occurs after 1-2 weeks. Wounds of the lips are more often torn, manifested by acute stinging pain, bleeding.

Trigeminal neuralgia
Multiple shooting intense pain impulses, resembling an electric shock, are noted when 2 branches of the trigeminal nerve are involved. The pain spreads to the upper lip, upper cheek, upper jaw. When the 3 branches are affected, similar sensations occur in the area of the lower lip, chin, lower jaw, lower cheek. The duration of a neuralgia attack ranges from a few seconds to 2 minutes.

Lip cancer
At the initial stage of lip cancer, there is no symptom. A painless, sometimes itchy ulcer or a compaction area forms on the lip (more often the lower one). Pain appears when nearby tissues germinate. It becomes constant, progresses, reaches a significant intensity. Upon examination, an ulcer with uneven edges or a node in the form of a wart or a cauliflower inflorescence covered with cracks and ulcers are revealed.

Diagnostics
The cause of the symptom is determined by a dentist or a maxillofacial surgeon. With the neuropathic nature of the pain, a neurologist’s consultation is required, if malignant neoplasia is suspected, an oncologist’s examination is required. With cheilitis, herpes simplex and traumatic injuries, complaints and examination data form the basis of diagnosis, additional studies are not prescribed or are carried out to a minimum. Neuralgia is confirmed on the basis of the clinical picture, the results of palpation of trigger points. Taking into account the nature of the disease, the examination plan includes:

Cytological or histological examination. It is a basic way to verify the diagnosis of lip cancer, lichen planus. For patients with cheilitis, according to indications, it is performed to differentiate with other pathologies. With herpes simplex, it is carried out if necessary to detect the virus.
Other laboratory tests. Patients with cheilitis are prescribed a biochemical blood test to detect metabolic disorders and possible provoking diseases. With herpes, PCR, RIF, and ELISA are produced. In patients with lichen planus, an accumulation of immunoglobulins M is detected by direct immunofluorescence.
Visualization techniques. The presence of lichen is indicated by a yellowish-orange glow when examining smears-prints under Wood’s lamp. Patients with cancer are shown ultrasound of the lip, radiography of the lower jaw. With signs of metastasis, an extended examination is performed, including ultrasound of the OBP, chest X-rays.
Visual inspection of the lips
Visual inspection of the lips
Treatment
Conservative therapy
The list of therapeutic measures is determined taking into account the features of the pathology that causes pain in the lip:

Heilites. Exclude or minimize provoking factors (dental pathologies, meteorological effects, contact with cosmetics), treat neurotic disorders. Anti–inflammatory, antipruritic, antiallergic ointments (including hormonal ones), protective creams, immunocorrectors, antiviral agents of general action are used.
Herpes. The tendency to relapse causes the need for complex therapy aimed at restoring immunity. Antiviral drugs are used in the first 5-7 days of the disease, then immunomodulators, recombinant alpha interferons are prescribed. After 1-2 months, vaccination is recommended.
Lichen planus. Topical corticosteroids, anesthesia with local anesthetics, and medications to stimulate regeneration are indicated to eliminate inflammation and pain in ulcerative defects. For the prevention of fungal lesions in the treatment of steroids, antimycotic agents are orally prescribed. With neurotic disorders, sedative therapy is required, with an allergic predisposition – hyposensitizing, with immunodeficiency – immunomodulatory therapy.
Injuries. Patients with chronic injuries need treatment of carious teeth to eliminate the traumatic factor. In other cases, in the absence of wounds requiring surgical treatment, a gentle diet is advised, cold to reduce edema, then dry heat to accelerate resorption.
Trigeminal nerve neuralgia. Therapy is carried out using anticonvulsants, antispasmodics, antihistamines. Therapeutic blockades with glucocorticoids, physiotherapy procedures are effective: ultraphonophoresis with hydrocortisone, galvanization with novocaine.
Lip cancer.

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