What is a lip ulcer or ulceration? Can cancer cause it? Find out more about the causes, types and some home remedies for mild cases. You will also get an insight into what they look like with the aid of images and pictures we selected from patients at random.
Meaning
Ulcers are painful sores that usually appear inside the mouth mucosa but can also appear on other susceptible body parts covered with skin. Lip ulcers commonly appear on the inner of the lip surface or in the mouth.
An ulcer on the lip or inside the mouth can be painful or not painful, i.e., an ulcer in the mouth or on inner lips can cause pain, irritation, tingling sensation and other symptoms that may vary according to the type or kind you have.
However, they are different from lip herpes or cold sores until ulceration occurs. For instance, cold sores usually appear on the outer lip surface area including the skin around lips.
Pictures and types
These tips or basic questioning can guide one to understanding what type or kind of ulceration you are more likely experiencing.
- Does it appear in singles, in multiples or in a cluster?
- Are they inside the lips, cheeks or gums occur or appear again after the initial episodes?
- How long do the ulcers last before they clear or heal?
- What factors or sort of things are likely to trigger?
- Do you have a systemic illness or infection?
- Have you had a change in terms of your dental health or problem?
Location, size, and shape of ulceration in the mouth can also help identify the specific types or forms. Take a closer look at the picture samples.
1. Traumatic
According to Medscape, traumatic injuries due to mechanical, electrical or chemical aspects involving the oral cavity may typically lead to the formation of surface ulcerations. Such traumatic injuries may encompass several things as highlighted below.
- Bruxism or teeth grinding and self-mutation bites
- Chemical burns caused by acidic (hyaluronic acid) or basic substances
- Presence of cracked, fractured, malformed teeth
- Ill-fitting dentures
- Premature teeth eruptions
- Injuries involving electric at places of works
- Burn injury from heat sources as opposed to chemical or mechanical ones
How do I know if I have a traumatic ulcer?
2. Aphthous ulcers or aphthous stomatitis (canker sores)
These occur on mucosa and with a tendency to recur (in a week’s time, moth or possibly year). Their common locations include inside lips, cheeks and under tongue.
How do I know that I have an aphthous ulcer in my mouth? Before they form in mouth some people have aired out a burning sensation. They are usually presented as small, round or oval shaped. They appear pale yellow with a reddish swelling (red halo) around each.
In many cases, the one inside lips heal on their own and rarely leaves a mark behind. The healing duration is about 1 week. Individuals may feel pain but not as much as the pain due to traumatic one.
You can have a single ulcer or multiple rounds or oval areas of ulceration which can form at the same time.
What causes aphthous stomatitis?
The causes of aphthous ulcer are not clearly identified. However, dentists and dermatologists link their occurrence in the mouth to the following factors.
- Emotional stress, depression, etc.
- Lack of sleep
- Viral infections
- Menstrual cycle/hormonal shifts
- Certain foods (e.g. chocolate)
- Certain chemicals in kinds of toothpaste
- Nutritional deficiencies in vitamin B, folic and iron
- Certain medications such as Nicorandil and anti-inflammatory medicines
- Oral nicotine as a replacement therapy and cocaine
Sometimes lip trauma, drug eruption, and herpes simplex virus are thought to be causative factors.
Who can get aphthous stomatitis?
Anyone can get an aphthous ulcer. However, occurrence in women in periods tends to be above the rest of the age groups.
NOTE: There is no treatment that will prevent aphthous stomatitis from recurring.
3. Eosinophilic ulcer on lips
Moving on, another kind of oral ulceration is eosinophilic. According to the DermNet New Zealand, this is another one with a distinct appearance and characteristic inflammatory cell studied under a microscope. The occurrence of this kind is uncommon but middle to grown-ups are affected at one point in their lifetime.
Dermatologists do not understand yet why or causes it. However, from the clinical feature, study and presentations, trauma due to teeth or poorly fitting dentures can possibly result to formation of these ulcers.
Areas affected include inside cheeks, mouth floor, lower lip (most cases) and the gums including those behind molar tooth.
In terms of symptoms, eosinophilic is almost always a culprit for painful eating.
It may heal on its own, but (depending on typical symptoms after a proper diagnosis) optional treatments may comprise the following.
Pain relief for mouth sore
- Surgical excision
- Simple curettage and diathermy
- Topical corticosteroid – mild mouthwash, creams, intra-lesion injection, etc.
- *Oral antibiotics
- *Radiotherapy
Other causes lip or mouth ulcer
Mouth ulcer can also be due to:
- Systemic infections such as viral infections – Epstein-Barr virus, oral or genital herpes simplex virus HSV-1 and HSV-2, varicella-zoster virus
- Though less common, certain viral and bacterial infections may cause them
- Blood disorders especially if they occasionally form on lip mucosa
- They can be caused by anemia
- They can be a sign of an underlying disease
- Inherited conditions such as Epidermolysis bullosa
- Inflammatory gastrointestinal diseases or conditions including Crohn’s disease, Coeliac disease Gardner syndrome and ulcerative colitis
- Autoimmune disease/conditions. For instance Behçet’s disease, Systemic lupus erythematosus (SLE) or Granulomatosis with polyangiitis (Wegener’s granulomatosis)
- Kawasaki
- Skin conditions – lichen planus, dermatitis herpetiformis, erythema multiforme, etc.
How to manage aphthous or canker sores
These ulcers have no known cure hence, relying on general measures is a good way to go.
- Reduce stress
- Individuals with occasional recurring episodes can use pastes that form a barrier over the ulcer as a protective layer against irritants
- Local anesthetics Benzocaine or Lignocaine (lidocaine) to reduce pain
- Medicated toothpaste without Sodium Laureth Sulfate
- Medical procedures such as cauterization can also be of help
- Limited or controlled use of antibacterial mouthwashes to keep bad bacteria at bay
- Keep off any trigger be it food or medicines. Patients must do so when they have adequately consulted a medic
- Dietary supplements of vitamins or minerals. Again, this should be a clinic approach
Even though, aphthous stomatitis is a recurrent problem, this presentation is not a threat in terms of being infectious. Therefore, if you have aphthous stomatitis, you cannot spread to healthy individuals.
Are they a sign of oral cancer?
Can lip or oral cancer cause oral ulceration? Painless lip ulceration in flat cells on lip, formation of bumps in mouth that won’t heal and persistent symptoms may be primary signs of a potentially dangerous oral condition.
Now, according to the Oral Health Foundation, cancer of the mouth can first appear as a mouth ulcer. They occur on lips, gums, palate, beneath the tongue and the symptoms usually last longer than what a mild lip ulcer should take to heal.
Therefore, cancer of the mouth can cause sores on your mouth. In many cases cancer of the mouth is usually linked to heavy smoking and drinking and HPV on the lips. These three appear to be the greater oral cancer risks. However, age, gender may be other factors that add up on the list of the risks.
Again, if you have a single ulcer anywhere in your mouth that lasts longer than three weeks, please see a dentist.
Symptoms to look out for
While healing naturally is the general belief or truth about these ulcers, some cases that involve recurring cases should be reported to a dentist for a proper examination. These are some of the symptoms that you should take note of.
- If they last for more than 3 weeks
- You are unwell
- They keep coming back
Remedies
Discomfort from painful ulcer? Here is what can you can do to make you feel better.
Use a saline or salty water solution
Dissolve about 5 pinches of salt in a glass of water. Swish a few rounds in mouth and spit. Do it a few more times and may repeat at some other time of day. Don’t use cold water on open ulcer
Ice chips to numb lips
These remedies will help you remove pain on sores by its numbing effect. If the sores have raptured, avoid ice chips or flakes with pointed or sharp edges.
OTC medicines
If the ulcers result from infection you would want to go for pain relievers from over the counter or ask your health physician to prescribe medication in case the pain is too much.
Keep off the pain causing things
Avoid consumption of hot and spicy foods especially if you have multiple ulceration inside mouth – lip, or on the tongue.
Take care when cleaning
If your mouth sores or ulcer are right along the gums or nearby the teeth, be gentle while brushing. Use a soft bristle toothbrush, but be GENTLE always to stop irritating your inner lips.
(A discussion with more details on medication products like gels or creams for mouth sores will be dealt with on a separate post.)
Can you prevent them
Prevention is almost impossible but practical in terms of reducing the mouth ulcer risks. These involve the simple procedures and routines recommended by dentists.
- Try to always keep your mouth as clean and healthy and at required standards whether you have other oral problems that make cleaning excusable
- Use of high-quality toothbrushes could greatly minimize chances of harming your oral mucosa
- Dealing with deficiencies such as vitamins A, C, and E
- Regularly going for checkup or visiting your dentist
Consider safety tips and precautions
Since anyone is liable for these sores, it is important to take precautions and stay safe by action to avert any mishaps. For example, below are helpful self-care tips for recurring cases.
- Do not give hydrogen peroxide to children or toddlers
- If they persist or won’t heal after 3 weeks
- If you cannot get over pain always seek medical advice
- Avoid sharing personal items such as towels and medicines if you have been diagnosed of HSV – type 1 or 2
- Limit your sexual behavior like oral sex especially if you have more than one sexual partners
