- Skin Sensitivity and Peeling Inside the Mouth
- Throat Problems
- Possible Causes
- Gum Peeling – What’s Going On?
- OTC Tooth Whiteners
- Alcohol In Oral Care Products
- Overzealous Brushing
- Give Your Gums The Attention They Deserve
- Do you have Stevens-Johnson syndrome?
- Could it be oral keratosis?
- Should you see your GP about skin peeling?
- What are peeling gums?
- Where does gum disease fit into this?
- Now what?
- Oral Leukoedema with Mucosal Desquamation Caused by Toothpaste Containing Sodium Lauryl Sulfate
- The Inside of My Mouth is Peeling. What’s Going On?
- Mouth Sores and Lip Conditions
- Signs & Symptoms
Skin Sensitivity and Peeling Inside the Mouth
Q2. I’ve heard that my old silver fillings probably contain dangerous mercury, and I should have them replaced. I don’t think insurance will pay for replacements — but I don’t want to leave poison in my mouth! Is it really dangerous to leave old fillings in place? What are the options for replacing them?
— Jill, New York
The safety of dental silver fillings (amalgams) is one of the hottest topics in dentistry today. Silver fillings are called amalgam restorations because they are an amalgamation of several metals (tin, zinc, copper, and silver) combined with elemental mercury. These metals are mixed together and then placed in the carefully prepared holes made by the dentist. Over the years, people have questioned whether the mercury portion of the fillings leaches, or comes out, and if so, whether the mercury affects their health.
It seems as if the answer is no. Recently a series of articles appeared in national publications, including the Wall Street Journal (September 12, 2006), questioning the safety and long-term efficacy of amalgams. However, an FDA advisory panel had reported on September 6 that there was no new scientific evidence to justify regulation of dental amalgams. The report was based on a review of 34 recent studies, which found “no significant new information,” though the panel did say that more research is needed.
Immediately after the FDA announcement, the American Dental Association issued a news release welcoming further study on amalgam safety, while reiterating that “the overwhelming weight of scientific evidence supports the safety and efficacy of dental amalgam” and that amalgam should remain available for dentists and patients.
I have a number of amalgams in my mouth that my dad (also a dentist) placed there 30 to 40 years ago. I personally feel they are safe and would not remove them unless I had a crack or decay around them. Amalgams are amazing restorations and are relatively low-cost, especially given the length of time that they last.
However, fillings don’t last forever; your dentist must check the integrity of them during your regular cleaning appointments. If it should come to pass that an old amalgam needs replacement because of a crack or decay, you do have options. Replacement fillings can be made of gold (one of the best materials for teeth but no longer stylish), tooth-colored bonding materials, or tooth-colored porcelain. Discuss the options with your dentist to determine which material is best suited for your mouth. People who grind their teeth may be better off with gold restorations since porcelain tends to fracture more easily. It also depends on how much tooth structure has been lost to decay and what type of bite you have.
Q3. I am 30 years old and had been seeing the same dentist my whole life, then I moved and had to find a new one. I went for my first cleaning with the new dentist and was told I had 10 cavities. I was shocked since I had just gone for a cleaning 6 months earlier and there was no problem at all. In fact I have no history of having any problems with my teeth. How do I know if I really have that bad of a problem? My teeth never even bother me.
– January, Connecticut
Dentists trained in U.S. dental schools receive very similar dental educations. There are standardized textbooks, curriculums, and local and national exams to take. These exams are written, oral, and practical. Thus, a diagnosis should be the same everywhere. However, a treatment plan or treatment options can vary. These differences can depend on the dentists’ abilities, knowledge, experience, confidence, ethics, concern and continuing education.
All dentists should agree on whether or not a cavity (a hole in the tooth) exists. But many dentists may disagree on when to treat the cavity, for there are different guidelines on this. Some dentists treat a cavity when it is only in the enamel (outer layer of tooth structure) whereas others would make note of this hole to watch and treat only if it gets deeper. Many others would wait until the cavity penetrated into the dentin (the second layer of tooth structure). This is a judgment call—there’s no right or wrong.
The answer to your question is to get a second opinion from a well-respected dentist in your area. Word of mouth may be a good indicator but in seeking a second opinion, make sure you analyze several factors including :
- Respect in community
- Office staff
- Office cleanliness
- Education and continuing education
- Reputation for honesty
- Level of compassion and caring
You probably have a COLD or FLU.
Drink plenty of fluids and get plenty of rest. Children should be given nonaspirin medicine for the fever. If the cold lasts longer than two to three days, see your doctor.
You may have viral GASTROENTERITIS, also called STOMACH FLU.
Drink plenty of fluids and get plenty of rest. Use an antinausea and/or antidiarrheal medicine. See your doctor if symptoms get worse, if they last longer than a week, or if you become dehydrated.
You may have STREP THROAT or MONONUCLEOSIS.
See your doctor.
These symptoms may be from BRONCHITIS, PNEUMONIA or POST-NASAL DRIP.
These illnesses need prescription treatments. See your doctor.
A dry barking cough often means CROUP or, less commonly, EPIGLOTTITIS.
Make sure the child is drinking plenty of fluids. Relieve fever and other discomfort with children’s acetaminophen. See your doctor right away if there is shortness of breath. Croup and other respiratory infections may need treatment by your doctor.
These sores are called CANKER SORES. They usually occur by themselves or with other viral illnesses.
Most of these sores will heal in 7 to 14 days. Use an anesthetic spray or an analgesic medicine. If the sores are severe, last longer than expected, or are accompanied by other symptoms, see your doctor.
This may be from TRENCH MOUTH, an infection of the gums, teeth and other tissues. A rare drug reaction, STEVENS-JOHNSON REACTION, may also cause this.
See your dentist or doctor. Poor dental hygiene may lead to this disease. Brush your teeth and floss as recommended by your dentist. Use over-the-counter pain medications to relieve discomfort.
You may have ORAL THRUSH, a yeast infection in your mouth.
This may be a simple infection, or it may come from another, more serious illness. You may be able to control the infection by eating unsweetened yogurt (with live cultures) or taking acidophilus. This may help restore normal bacteria in your body. See your doctor if it returns or doesn’t go away.
For more information, please talk to your doctor. If you think the problem is serious, call your doctor right away.
Gum Peeling – What’s Going On?
Gums are a prime indicator of your oral health. When they’re not happy, you’ll know.
They’ll bleed, for one. Sometimes though, they’ll peel. But why?
Read on to find out more about gum peeling and why you’re having this problem.
OTC Tooth Whiteners
The use of over the counter tooth whitening products has skyrocketed in recent years. But by and large, these cause oral health problems.
Your dentist is the best source of safe whitening processes because OTC products can cause extreme sensitivity in the teeth and irritation to the gums. Oh, and gum peeling, by the way.
The ingredients used may not be appropriate for some who purchase them. And your dentist can do the job in far less time.
Any whitening product – including mouthwash and toothpaste – you’re using needs to be discontinued immediately. Your peeling will subside, if this is the cause.
Alcohol In Oral Care Products
Check your mouthwash and toothpaste for alcohol. This ingredient in oral care products can cause irritation and produce dryness in the mouth.
Look not just for “alcohol” on the list of ingredients, but also “isopropyl alcohol” or “SD alcohol”. These can also cause gum peeling. If you’re not sure about a product’s efficacy or safety, consult your dentist.
If you’re brushing for too long or applying too much pressure, or even if the bristles on your brush are too hard, you can cause gums to recede.
But overzealous brushing can also cause irritation, bleeding and gum peeling. To avoid these problems, choose a brush with softer bristles and use a gentle, circular motion.
Another name for this condition is early stage gum disease. It’s a common condition, so pay attention to the response of your gums while flossing or brushing.
If you experience sores, gum peeling or irritation, you may have gingivitis, which can lead to losing teeth and other conditions.
If treated early, gingivitis is reversible, so pay attention to what’s going on in your mouth and talk to your doctor if you see any symptoms.
Give Your Gums The Attention They Deserve
Don’t take your oral health for granted. What’s going on in your mouth can have implications for your overall health.
Because we’re talking about gum peeling, it’s important to understand that peeling gums can be an indicator of practices you should be reforming to promote better oral health.
Your mouth is a kind of barometer of the body. Give your gums the attention they deserve because they might be telling you something you need to know.
Be sure to consult with your dentist at any sign of change in the health of your gums, including irritation, bleeding and gum peeling.
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If the skin peeling is widespread – you must seek treatment for this from your doctor or dentist.
Do you have Stevens-Johnson syndrome?
Stevens-Johnson syndrome is a rare, serious disorder of your skin and mucous membranes. It’s usually a reaction to a medication or an infection.
Often, it begins with flu-like symptoms, followed by a painful red or purplish rash that usually affects the mouth and lips but can be more widespread. This then spreads and blisters. Then the top layer of the affected skin dies, sheds and finally heals.
Stevens-Johnson syndrome is a medical emergency that usually requires hospitalisation so you would definitely know something was seriously wrong if you had it.
Could it be oral keratosis?
Oral keratosis is a thickening of the keratin layer of the oral mucosa. Because the oral mucosa is always wet, this results in a slightly raised white patch.
The most common site that this is seen is in the palate of smokers where the hot irritant smoke causes the skin covering the palate to lay down a thicker layer of keratin in an attempt to protect itself.
Should you see your GP about skin peeling?
Localised burns are easy for a patient to diagnose themselves and resolve fully after only a week or so. More widespread peeling of the mouth must be checked out by a dentist or a medical doctor.
If any patient has an ulcer in their mouth that takes longer than two weeks to fully resolve, then they should see their dentist to get it checked out as soon as possible.
You should visit a doctor if you are worried about any symptoms in your mouth that have not resolved after two weeks, though it may well be that your dentist will be more familiar than your doctor with conditions that can affect the mouth.
Last updated: 08-10-19
Dr Bill Schaeffer – BDS MBBS FDS RCS (Eng) MRCS (Eng) Implant Surgeon and Specialist Oral Surgeon Dr Bill Schaeffer is both a dentist and a medical doctor.
Are you experiencing peeling gums? This may be a symptom of a larger health issue. Even before we learn how to hold a toothbrush on our own, we begin to understand the importance of keeping our teeth cavity-free. Not to say that’s always enough motivation to want to brush our teeth as often and for as long as we should or to avoid the things that can increase our risk of getting cavities. It just means that we get that our teeth are important to our oral health.
The trouble is, most of us never come to appreciate the tissue surrounding our teeth in the same way. But in many ways, the gums are just as valuable of an indicator of our oral health as the teeth. And not just our oral health; our overall health, too.
Studies are beginning to confirm what periodontists have suspected for a while now: , including heart disease and diabetes. People with gum disease, which includes half of American adults, are also at greater risk of developing certain types of cancer and Alzheimer’s disease.
Still, too many of us are willing to shrug it off when we notice our gums are bleeding or peeling a little after brushing. As long as I don’t have any cavities, I’m good, we think. But they can be early warning signs of a potentially serious problem. And the longer we go on ignoring them, hoping they’ll disappear on their own, the bigger the threat becomes to our overall health.
What are peeling gums?
Peeling gums is a pretty accurate name for what’s going on. You’ll notice small bits of loose dead tissue sloughing off your gums and the inside of your cheeks. It’s not enough to gag you. In fact, you’re likely to chew on them or simply swallow them without giving much thought to what it is.
Peeling gums may also be accompanied by:
- Bleeding gums
- Discoloration on your gums and the inside of your cheeks
- Changes in the texture of your gums
- Sores or blisters on your gums
Gum disease is a common cause of peeling gums. (More on that in a moment.) But there are also a number of oral hygiene products that can have the same effect, including over-the-counter whitening products. Aside from failing to do what they’re supposed to and eating away at your teeth, home whitening kits can also trigger a slew of issues with your gums, like peeling.
If you’ve noticed any peeling or another adverse effect, such as increased gum or teeth sensitivity, after using a whitening kit, toothpaste, or mouthwash, stop using the product and schedule an appointment with your dentist, just to be on the safe side.
It’s not just whitening mouthwashes or toothpaste, either. Most mouthwashes contain some type of alcohol, which can dry out the mouth and irritate the gums. Similarly, a 2016 study found that low-pH toothpastes were likely to cause peeling gums, among other symptoms.
You don’t need to start experiencing symptoms to change your mouthwash or toothpaste. Look for a mouthwash that says “alcohol-free,” or something to that effect, on the label. Toothpastes are a little trickier because there are so many varieties. Look for one that’s marketed as “sensitive,” or try a brand made with natural ingredients, like Tom’s of Maine.
Where does gum disease fit into this?
You could be brushing with a Tom’s toothpaste and swishing with an alcohol-free mouthwash and still be experiencing peeling. In that scenario, you may have gingivitis, the earliest form of gum disease, without realizing it.
Gingivitis can cause the gums to become red, swollen, and bleed easily. It can slip under the radar because there’s usually little, if any, discomfort. And it can develop for a number of reasons unrelated to our brushing-and-flossing regimens, including: smoking, stress, hormonal fluctuations, the use of certain medications, certain systematic diseases, aging, and a genetic predisposition. Though, the most common cause is inconsistent brushing and flossing and not keeping up with twice-a-year dental checkups.
The good news: Gingivitis is reversible as long as it’s treated early. If, however, it’s left unchecked, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque will irritate the gums and stimulate a chronic inflammatory response in which the body basically turns on itself, and the gums and bone that support the teeth gradually breakdown.
For what sounds like a very dramatic process, the symptoms can be pretty mild. In other words, one day you’re shrugging off peeling gums. The next, you’re staring into the mirror at deep pockets that have formed around your teeth. This much more serious form of gum disease, which is known as periodontitis, as you may already have realized, is a lot more difficult (and costly) to remedy.
If you’re reading this to be extra cautious, keep doing what you’re doing: brushing and flossing twice a day and seeing your dentist every six months. If, however, you’ve noticed some occasional peeling, don’t ignore it. You may barely notice it, and it may not be painful, but it’s most likely a sign that something’s not right in your mouth.
In such a case, it’s always better to be safe than sorry. See your dentist or schedule an appointment with me. Either way, we’ll determine the source of your peeling and then tailor a treatment plan that will have you smiling again in no time.
Oral Leukoedema with Mucosal Desquamation Caused by Toothpaste Containing Sodium Lauryl Sulfate
To the Editor:
A 34-year-old woman presented for evaluation of dry mouth and painless peeling of the oral mucosa of 2 months’ duration. She denied any other skin eruptions, dry eyes, vulvar or vaginal pain, or recent hair loss. A recent antinuclear antibodies test was negative. The patient’s medical history was otherwise unremarkable and her current medications included multivitamins only.
Oral examination revealed peeling gray-white tissue on the buccal mucosa and mouth floor (Figure 1). After the tissue was manually removed with a tongue blade, the mucosal base was normal in color and texture. The patient denied bruxism, biting of the mucosa or other oral trauma, or use of tobacco or nonsteroidal anti-inflammatory drugs.
Figure 1. Oral examination revealed peeling gray-white tissue on the buccal mucosa and mouth floor.
Biopsies from the buccal mucosa were performed to rule out erosive lichen planus and autoimmune blistering disorders. Microscopy revealed parakeratosis and intracellular edema of the mucosa. An intraepithelial cleft at the parakeratotic surface also was present (Figure 2). Minimal inflammation was noted. Fungal staining and direct immunofluorescence were negative.
Figure 2. Intraepithelial linear cleft in the parakeratotic surface with intracellular edema present in the upper one-third to one-half of the stratum spinosum (H&E, original magnification ×20).
The gray-white clinical appearance of the oral mucosa resembled leukoedema, but the peeling phenomenon was uncharacteristic. Histologically, leukoedema typically has a parakeratotic and acanthotic epithelium with marked intracellular edema of the spinous layer.1,2 Our patient demonstrated intracellular edema with the additional finding of a superficial intraepithelial cleft. These features were consistent with the observed mucosal sloughing and normal tissue base and led to our diagnosis of leukoedema with mucosal desquamation. This clinical and histologic picture was previously described in another report, but a causative agent could not be identified.2
Because leukoedema can be secondary to chemical or mechanical trauma,3 we hypothesized that the patient’s toothpaste may be the causative agent. After discontinuing use of her regular toothpaste and keeping the rest of her oral hygiene routine unchanged, the patient’s condition resolved within 2 days. The patient could not identify how long she had been using the toothpaste before symptoms began.
Our case as well as a report in the literature suggest that leukoedema with mucosal desquamation may be the result of contact mucositis to dental hygiene products.3 Reports in the dental literature suggest that a possible cause for oral mucosal desquamation is sensitivity to sodium lauryl sulfate (SLS),1,4 an ingredient used in some toothpastes, including the one used by our patient. The patient has since switched to a non–SLS-containing toothpaste and has remained asymptomatic. She was unwilling to reintroduce an SLS-containing product for further evaluation.
Sodium lauryl sulfate is a strong anionic detergent that is commonly used as a foaming agent in dentifrices.4 In products with higher concentrations of SLS, the incidence of oral epithelial desquamation increases. Triclosan has been shown to protect against this irritant phenomenon.5 Interestingly, the SLS-containing toothpaste used by our patient did not contain triclosan.
Although leukoedema and mucosal desquamation induced by oral care products are well-described in the dental literature, it is important for dermatologists to be aware of this phenomenon, as the differential diagnosis includes autoimmune blistering disorders and erosive lichen planus, for which dermatology referral may be requested. Further studies of SLS and other toothpaste ingredients are needed to establish if sloughing of the oral mucosa is primarily caused by SLS or another ingredient.
Quite a common symptom of many conditions, peeling in the mouth can be a painful and inconvenient experience. Peeling inside of the mouth, on the roof and back of the throat, as well as the skin in the inner lips can be indicative of an auto-immune condition, a nutrient deficiency, bad eating habits and even an allergic reaction.
Others have experienced peeling of the skin inside the mouth after taking certain oral medications.
Which auto-immune diseases can cause this?
The phrase ‘auto-immune’ describes the condition where the body’s immune system attacks its own host, i.e. your own body. It can mistake part of your body, like your joints or skin, as foreign. It releases proteins called autoantibodies that attack healthy cells, explains Health Line.
Auto-immune diseases that can cause peeling skin inside of the mouth are Discoid Lupus Erythematosus (also referred to as DLE, Rheumatic Skin Disease, and Oral Lichen Planus. All these diseases are known to cause oral lesions.
Malnutrition happens when humans do not consume enough healthy, nutrient dense food. We all have a daily recommended allowance for the vitamins, minerals and calories we take. If we consistently fall short of these needed nutrients, we run the risk of becoming malnourished, which can be devastating to one’s health.
According to the Journal of Clinical and Diagnostic Research: “Malnutrition may alter the homeostasis, which can lead to disease progression of the oral cavity, reduce the resistance to the microbial biofilm and reduce the capacity of tissue healing. It may even affect the development of the oral cavity.”
Mouth sores and oral skin peeling can also be a result of poor dental hygiene. The mouth is wet and warm enough to be the perfect breeding ground for germs. Make a habit of brushing, flossing and rinsing your mouth with warm salt water three or four times a day, preferably a few minutes after meals.
A 12-year-old girl was on her fourth day of fever, conjunctivitis and rash with red marks behind her ears when she showed up in the Hopkins Children’s ED. Then over the next few days following admission, pediatric resident Tamar Rubinstein noted at a recent case conference, the rash rapidly progressed to her hands and feet in the form of lesions and papules coalescing into plaques. Worse, she had lip and mouth sores so painful she couldn’t eat. What could be causing these symptoms?
Because the girl appeared to meet some of the criteria for Kawasaki’s disease – fever for 5 or more days, swelling in her hands and feet, and strawberry tongue and cracked lips – the autoimmune disorder was placed on the differential list. But she was 12, well beyond the age – 5 and under – in which 95 percent of Kawasaki cases occur. Nor was her conjunctivitis, fever curve or rash consistent with Kawasaki’s. Unlike the rash associated with Kawasaki’s disease, which is red with some purple spots, this rash was a blistering, full-thickness injury to the epidermis.
“On her third day in the hospital her rash had become more bullous on her hands and feet,” said Rubinstein. “By day eight there was large peeling on her palms.”
“When we saw this necrosis in the skin, Kawasaki’s disease was no longer in her differential,” said pediatric dermatologist Bernard Cohen.
So what was it? There appeared to be no clues in her family history of colon cancer, diabetes and hypertension. But, interestingly, the child had been treated with antibiotics for a urinary tract infection diagnosed by her pediatrician three weeks later. Were her skin and oral mucosa symptoms drug-related? That, along with sloughing and peeling of skin on the child’s hands, got Rubinstein and the team to consider Stevens Johnson Syndrome, or SJS, a rare skin condition that can be caused by an allergic reaction to drugs.
SJS typically begins with flu-like symptoms, followed by a painful red or purplish rash that spreads and blisters, leading to the top layer of skin to die and shed. Though SJS can be caused by an infection like Herpes or hepatitis, most often medications like antibiotics and anti-inflammatories are to blame. When pediatricians see peeling skin and other symptoms associated with SJS, noted Cohen, they should immediately cease administration of the medication.
“If it’s a dangerous skin eruption and you can identify the source or the drug, you want to stop it,” Cohen said. “If it’s a drug the patient has to be on for whatever reason, and it’s a skin rash not associated with systemic findings, you might be able to keep the patient on that drug.”
So what can be done to treat the skin condition? While there may be a tendency to treat such full-thickness wounds as burn injuries, Cohen warns against it, stressing that peeling skin is healing skin.
“I know surgeons are aching to come in and debride such wounds, but when you have a necrosis of the epidermis that’s intact at the edges, that intact skin is the best possible wound care dressing you can ever have. It keeps it moist, protects it from infection, and allows the underlying skin to re-epithelialize.”
Pediatricians, Cohen added, need to be wary of a more serious related condition called toxic epidermal necrolysis, or TEN, which results in blistering and peeling of the skin in sheets, leaving large raw areas of open flesh. The difference between SJS and TEN, he explained, is the extent of skin involvement: “You have the same symptoms, but when more than 30 percent of the skin is affected, we call it TEN.”
Nonetheless, Cohen said pediatricians should not get hung up on dermatologic terms but care for the child clinically, treat the dehydration and poor food input often resulting from the mouth and throat pain, and do a skin biopsy to distinguish from other blistering skin conditions. He encourages a wait and watch approach and recommends against using systemic steroids.
“The first thing we’ll ask is whether the mucus membranes are involved and if so how many. Also, is this kid compromised in any way medically?” Cohen said. “These are the things you’ll factor in how you manage the child.”
The Inside of My Mouth is Peeling. What’s Going On?
June 23, 2015
If you notice that the inside of your cheeks appear to “peel” from time to time, it could be because you’re having a mild allergic reaction to your toothpaste.
But it also could mean something more serious:, gingivitis/periodontitis, canker sores or the more serious mouth ulcers, or even Stevens-Johnson Syndrome.
- First, the toothpaste reaction: some people have a mild allergic reaction to whitening toothpastes. If you suspect this to be the cause of the peeling, simply stop using the toothpaste.
- Gums peeling is a sign of a more serious condition: you could have a very bad case of gingivitis or even periodontal disease. If you notice that your gums are peeling away from your teeth, you probably have one of these conditions. Both gingivitis and periodontal disease make your gum tissues become inflamed. If left untreated, your gum could start to recede from your teeth and some of your gum tissue may even peel away. If your gum is both receding and peeling away at the same time, get to your dentist ASAP!
- You may have canker sores or mouth ulcers. These tend to look like small white pumps on your gums, As the sores/ulcers heal, some of the gum tissue around them may peel. It’s very important that you see a dentist regularly so that he can check for these sores, as mouth ulcers could be an indication of oral/mouth cancer!
- Stevens-Johnson Syndrome is a very serious condition. Peeling inside your mouth is a symptom that occurs long after other symptoms have presented themselves. The condition usually is a reaction to an infection or a medication. The syndrome usually starts with flu-like symptoms (high fever, aches and pains) and then is followed by a purple or red rash that blisters and spreads along your skin and the mucous membranes of your mouth (and even your genitals, nose, and eyes). The top layer of the affected areas of your skin can die and shed (hence, the peeling). Recovery can take months. If, in addition to flu-like symptoms, you experience any of the symptoms mentioned above, you need to see a doctor as soon as possible. The good news about Stevens-Johnson Syndrome? It’s rare!
If you’re at all concerned about the inside of your cheeks peeling, gums peeling from your teeth or any other symptoms appearing in your mouth, contact Plano dentist Dr. Darren Dickson.
Image courtesy of patrisyu/FreeDigitalPhotos.net
Mouth Sores and Lip Conditions
Sores on the lips and mouth are common and can be harmless or serious health problems. One must be sure to have a persistent mouth sore examined and diagnosed by an expert, because cancer of the lips with a basal cell or squamous cell carcinoma is common, particularly in older patients. Basal and squamous cell cancers can be symptomless, or can bleed and be sore. Patients who have sun-damaged lips, known as actinic cheilitis, are at higher risk for skin cancer of the lips. Dark brown or black single flat spots are usually benign oral melanotic macules, but as with any dark skin lesion, one needs to make sure that the lesion is not a melanoma.
Common benign lesions on the outside of the lips include rashes due to allergic contact dermatitis, chapped lips, warts, Fordyce spots, herpes simplex, and milia. Sometimes people become sensitive to allergens touching the lips such as lanolin in lip balm or ChapStick®; even eating mangoes can cause the lips and skin around the lips to break out in a rash. Fordyce spots are a term for normal oil glands (sebaceous glands) of the lips; sometimes people notice them for the first time and mistakenly think the spots represent a skin disease. Milia are very common little white cysts that can occur on the border of the lips or anywhere on the face. Cold sores, or herpes simplex, are also called “fever blisters.” People frequently experience tingling or itch before the small blisters of a cold sore come out. Herpes is a recurring viral infection.
Inside the mouth, persistent white lesions can be concerning. Oral lichen planus is a benign condition of the inside cheeks, lips, or tongue. This diagnosis should be made by a professional, because white lesions inside the mouth can also be squamous cell carcinoma. A common cause of white lesions in the mouth is oral candidiasis, which is a yeast infection. Candidiasis is more common in people who recently took antibiotics, in diabetics, and in immunocompromised patients.
Signs & Symptoms
It can take between 10 days and 3 months for the first signs of syphilis to appear. Some men or women infected with syphilis don’t show any signs or symptoms.
If left untreated, a syphilis infection will happen in 3 stages.
Stage 1: Primary
The first sign is a painless sore (chancre) on the penis, anus, labia, vagina, cervix, throat or lips. This is an easy sign to miss, as chancres usually heal and disappear in 1-5 weeks. Swollen glands are another first sign of infection.
Stage 2: Secondary
In this stage, skin lesions or a rash appear all over the body, including the palms of the hands and the soles of the feet. These lesions might also appear in the mouth and the genital area. This rash is easy to confuse with other skin conditions.
A person in the secondary stage of syphilis might also experience:
- swollen glands
- a sore throat
- patchy hair loss
While these symptoms will subside even without treatment, the infection will remain in the blood, organs, and other tissue. With no treatment, the rash may recur over the next 1-2 years. This is a very contagious time.
Stage 3: Latent Stage
If left untreated the bacteria spreads to all parts of the body. Since there are no outward signs of the disease in this stage, a blood test is the only way to know if syphilis is still present.
Between 3-30 years after the primary infection, the bacteria will seriously damage various body organs such as the heart, large blood vessels, bones, joints or central nervous system.