Swollen Lips Symptom Evaluation

What are Swollen Lips?

Swollen lip is a condition where one or both the lips enlarge in size. Swollen lips can happen due to injury, infection, allergies, sunburn, vitamin deficiencies and certain systemic conditions.

Common associated Symptoms with Swollen Lips:

• Painful lips
• Difficulty eating /talking /opening the mouth
• Chapped lips
• Blisters on the lips
• Fever
• Headache
• Cold sores
• Cracks on the lips

Swelling of the lips can be of upper or lower lips or of both the lips. It may be also one of the symptoms of a more generalized disease. Some of the conditions that present with swollen lips are:

Allergies - Lip swelling can happen as a result of allergy to certain foods, climatic changes, pollen, animal dander or any cosmetic product used on lips. It can present with swelling of lips, hives, difficulty in breathing or swallowing and itching of eyes. Testing for allergy helps identify the cause. Avoiding the cause can prevent the reaction. In case of an acute attack, antihistamines or steroids may be required.

Angioedema - Angioedema is a condition that presents with swelling under the skin often over the lips and eyes. It may also involve other body regions like hand, legs and genitalia. Swelling can be itchy and painful. Difficulty breathing and abdominal pain are also common with this condition. It is caused due to allergy to various substances like:

• Foods - peanuts, cheese, Shell-fish, prawns, nuts, berries
• Pollen
• Insect bites
• Drugs like ACE inhibitors, NSAID's, sulfa, penicillin and other antibiotics

Hereditary angioedema is also a possibility, though it is rare

Immediate medical attention is warranted as it can become life threatening. Treatment with corticosteroids along with epinephrine shots may be required.

Infections (e.g. Cold sore caused by Herpes simplex) - Swelling of lips can be caused by bacteria or viruses or fungi. Herpes simplex virus infection causes cold sores on the lips. Dry lips with cracks on the lips can facilitate the entry of germs and spread the infection. Lip infections usually present with swelling, redness of lips, pain with cracks and bleeding. Treatment varies depending on the cause.

Chapped lips - It is a condition causing dry lips due to weather conditions or lack of self care for lips. It presents with cracked lips, swelling, dryness, sores, bleeding and flaking. Causes of chapped lips include:

• Certain medications like lithium, vitamin A and chemotherapy drugs
• Frequent sun exposure in summer and lack of humidity in winter
• Frequent licking of lips which results in lack of moisture

Nutritional deficiencies - Certain vitamins and minerals are necessary for lip health. These include B complex vitamins (B2, 3, 6), and vitamin A. One of the minerals necessary for lip care is zinc. Deficiency in this mineral causes dry, swollen, cracked lips and tongue. Foods rich in these vitamins and minerals should be included in the diet to avoid lip problems.

Trauma & Injuries - Trauma to the lips due to an injury such as fall or due to assault or due to taking in hot liquids or food is not uncommon and can cause swelling and mild pain. Usually this can be managed with cold packs. However, if this leads to bleeding, severe swelling, pain and sometimes mild fever, then further evaluation is required to check for infection or severe injury. Cosmetic procedures like lip enhancement surgeries can also result in lip swelling.

Chelitis - Chelitis is severe dryness of lips with cracks in the corners of the mouth as well as on the lips. It is often seen in a condition called Crohn's disease and sometimes after dental procedures. It presents with lumpy lips, plaques or ulcers on the lips which are red in color.

Lip cancer - A localized swelling may appear on the lip, which may spread to the surrounding parts and ulcerate. A biopsy may be needed to confirm the diagnosis.

Conditions that cause generalized swelling of the body - Conditions that cause generalized fluid accumulation and swelling in the body may also result in swelling of the lips. These conditions include kidney failure, liver failure or heart failure.

Melkersson-Rosenthal Syndrome (MRS) - This is a rare syndrome where the patient has the triad of facial paralysis, chronic edema of the lip, and a fissured tongue.

References:

1. Angioedema - (http://www.nhs.uk/conditions/Angioedema/Pages/Introduction.aspx)
2. Cheilitis granulomatosa - (http://www.ncbi.nlm.nih.gov/pubmed/22031641)

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