Actinic cheilitis. A treatment review

Actinic cheilitis is a common premalignant condition, significant for symptoms and potential development into invasive squamous cell carcinoma. Multiple methods of treatment have been reported for this entity.

The purpose of this article is to review and compare the accepted treatment modalities reported for actinic cheilitis.

The English language literature was reviewed for treatment options, efficacy and adverse effects.

Cryosurgery, electrocautery, 5-fluorouracil, carbon dioxide laser, and scalpel vermilionectomy were all clinically effective. All therapies, with the exception of chemical peeling, appear to have a low clinical failure rate. Histological clearance of disease was demonstrated in carbon dioxide laser-treated patients. 5-Fluorouracil failed to achieve complete removal of histologic dysplasia. The carbon dioxide laser may be associated with less scarring and an improved cosmetic outcome in comparison with the scalpel vermilionectomy.

Focal actinic cheilitis is easily treated with cryosurgery or electrosurgery. Extensive actinic cheilitis requires 5-fluorouracil, carbon dioxide laser, or scalpel vermilionectomy for adequate treatment. The carbon dioxide laser offers some advantages over scalpel vermilionectomy.