White Spots on Lips

The reasons why white spots appear on the lips range from the fairly harmless to something serious that might lead to life-threatening illness, if untreated. Let us see what some of these conditions are, and the treatment options available for them.
Given such an outlook, the appearance of white spots on lips can be particularly distressing. Whether or not you should be worried depends on the diagnosis, of course. Here are a few facts about this condition.
Fordyce's Spots
These are small, bumpy spots, frequently white but may actually manifest themselves in a range of hues, ranging in diameter from about 1 mm to 3 mm. They do not cause any discomfort or pain nor are they a form of disease. They mostly appear on the border of the lips, where the skin differs from the skin of the face. They are simply ectopic (ek-"out" and topos "place") sebaceous glands. They are not associated with hair follicles.

Causes: There are no specific causes for the occurrence of these spots and having them is not a pathological condition. In fact, they are just variations of the sebaceous glands normally found on the skin.

Treatment: Mostly, different kinds of laser treatments are used to get rid of these spots. Pulse dye lasers are usually employed.
Leucoderma (Vitiligo)
Vitiligo is a condition in which random areas, or patches, of the body are depigmented due to the inability of certain cells in the skin to synthesize the pigment, melanin. Vitiligo of the lips has the same features as that of skin on other parts of the body.

Causes: The cause of vitiligo is not known, but there are certain factors and triggers implicated in its etiology. It is suspected that it may be autoimmune in nature, and genetic factors are also involved in some, but not all cases. Skin cancer, sunburn, were found to have triggered vitiligo in some people.

Treatment: Micropigmentation can be used to inject pigment in the skin of the lips. A long-standing treatment is that of using psoralen lotion and then exposing the depigmented area to the early sunlight, the time of exposure should be reduced because the skin of the lips is sensitive. Other treatment options are topical corticosteroids, immunosuppressants and UVB-specific lotions. Another option is depigmentation of the remaining skin to make the skin tone uniform and even, but this is often the last resort, when other treatments fail to induce pigmentation in the depigmented patches.
Cold Sores
It is a viral infection, caused by the Herpes Simplex Virus (HSV). The sores, in such infections, are often blisters that itch and are also painful. The blisters are pale white in appearance and gradually disappear when the infected individual is cured. The infection is contagious and can spread by contact with the infected individual and his/her belongings.

Causes: The cause of cold sores is the Herpes Simplex Virus. It sometimes remains dormant in the body and becomes active due to some trigger in the environment. The infection is not a major one and can easily be cured with antiviral drugs.

Treatment: The treatment for cold sores includes oral medications, such as antiviral drugs for treating the infection and topical (applied externally) medications such as steroids and topical anesthetics for providing symptomatic relief.

The oral antiviral drugs used are Acyclovir, Famciclovir and Valacyclovir. The adverse effects associated with these drugs are nausea, headache and CNS effects.

For topical application, Acyclovir is available as a 5% w/w cream to be applied every four hours. Penciclovir is also available as a cream of equivalent strength. Docosanol (Abreva) is another drug used topically for cold sores.
Lip Cancer
White spots can sometimes be a sign of lip cancer and it can remain undiagnosed if the spots are mistaken for some other affliction. Biopsy of the lip tissue reveals whether the spot is neoplastic (cancerous) or not.

Causes: As in all other cancers, there may be multiple factors involved in triggering it and its progression. A positive correlation has been found between long periods of exposure to sunlight and lip cancer, but it must be emphasized that there is no single cause for it.

Treatment: Radiation, or surgery, of the tissue involved is the treatment usually adopted for early stage lip cancer.
Although white spots on the lips look obviously unappealing and every person who has them wishes to get rid of them quickly, it is worthwhile to get the cause of their appearance accurately diagnosed before proceeding, because some of the causes are innocuous, while others can develop into serious health problems. It is best to consult a physician when such spots appear, especially if they are painful and itchy.
Disclaimer: This article is for informative purposes only, and should not be used as a replacement for expert medical advice.