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White Spots on the Lips

White spots on the lips can be a harmless or a symptom of a harmful illness. However, the lips are some of the most important parts cosmetically and are some of the most noticeable aspects of a person.

As such, persons with white spots on the lips tend to be self-conscious and the spots could lower their self-esteem, whether the spots are harmful or not [1].

The spots differ in appearance and morphology.

The differences serve as a basis for differentiating them and diagnosing the illnesses of which they are a symptom, if any.


Some are painful and others painless.
Canker sores

Image 1: An example of a white spot (Canker sores)
Picture Source: Wikipedia

Common Locations of the White Spots

  • Areas around the lips
  • Inside the lips
  • Corners of the lips
  • Vermilion border
  • Upper lip
  • Lower lip
  • Some are not specific to the lips and may be found on other parts of the body [1]

Causes of White Spots on the Lips

Presence of White spots on lips can be due to:

  • Illnesses
  • Genetics
  • Side effects of products used
  • Low levels of personal hygiene [1]

Fordyce Spots

  • Also referred to as Fordyce granules or sebaceous prominence
  • Fordyce spots are small in size, their color ranges from white to yellowish, and are pimple-like.
  • They are commonly found on the oral mucosa and the vermilion border – The sharp demarcation between the normal body skin and the red-colored region the lips [2]. They colonize both upper and lower lips.
  • They are not specific to the lips and may be found on the inner surface of cheeks, tonsils, labia, penis, or scrotum. They appear on a sebaceous gland that lacks hair follicle [3].

Fordyce spots
Picture 2 : Fordyce spots
Image Source : fordycespotsforum.com

  • Fordyce spots are not attributed to medical condition.
  • They are painless and harmless.
  • Should not be taken as a sign of sexually transmitted infection or cancer
  • Affect both genders
  • Tend to be larger with age

Treatment of Fordyce spots

  • Electro desiccation
  • Micro-punch technique
  • Pulsed dye lasers
  • Anti-sebum creams or ointments
  • Chemical peels
  • However, doctors discourage treating Fordyce spots

White spots due to Human Papilloma virus infection – HPV

  • White spots on the lips could also be caused by HPV infection.
  • Some of the strains of HPV are associated with various types of cancer e.g. vaginal, cervical, anal, mouth and oropharyngeal cancers.
  • HPV can be transmitted via intimate skin-to-skin contact such as: anal, vaginal, or oral sex with an infected person [1].

 

Lip warts caused by HPV

Photo 3 : Lip warts caused by HPV
Image Source : www.clinicaladvisor.com

  • Warts due to oral HPV occur on the lips or anywhere inside the oral cavity.
  • The spots are white in color, dome or flat –shaped and may appear as small, spiked projections.
  • Painless unless irritated

Treatment of Oral HPV

  • There is no cure for HPV but sometimes it disappears spontaneously [4].
  • HPV vaccines reduce the risk of getting genital and cervical cancers.
  • The vaccines, however, have not been proved to work against oral cancer caused by oral HPV infections [1].

Milia

  • These are tiny, hard, white bumps that keep disappearing and recurring [5]
  • Mainly occur on the face
  • Caused by trapped skin cells that were meant to be shed off [5]
  • Common among babies because their oil gland is still developing [6]
  • However, it may occur in teens and adults as well.
  • Milia have also been attributed to sun damage, lip care products, and reaction to toothpaste.

Infant with Milia
Image 4 : Infant with milia
Picture Source : skinsight.com

Treatment of milia

  • Exfoliation
  • Retinol creams [5]
  • Do not remove them forcefully since it may cause scarring [6]

Oral thrush

  • Caused by fungal infection caused by Candida albicans [1]
  • The spots are creamy and may appear on lips, oral cavity, tonsils or the gum
  • May be patchy

White patchy lips
Picture 5 : Oral candidiasis – White patchy lips
Photo Source : Wikipedia.com

  • People using corticosteroids, antibiotics or birth control pills are more vulnerable
  • Illnesses such as cancer, diabetes, HIV and anemia compromise immunity and also predispose the patient to the infections [7]
  • Pregnancy and organ transplants are also risk factors
    Treatment
  • Antifungal medications [7]
  • Can be controlled by managing illnesses such as diabetes properly.

Herpes simplex virus (HSV)

  • The spots are painful, white, itchy, and bumpy
  • Appear as blisters on the lips
  • HSV is contagious and is transmitted through skin contact [1]

Herpes blister on the lower lip
Figure 6: Herpes blister on the lower lip
Picture Source: wikipedia

Treatment

  • Oral and antiviral medication

White spots caused by oral cancer

  • Initially, they appear as white, flat spots on the lip that begin to ulcerate in latter stages.
  • The spots then grow, harden and don’t heal

Lower lip cancerous white bump
Picture 7 : Lower lip cancerous white bump
Image Source: healcure.org

  • Genetics, excessive drinking, smoking, and HPV infections are risk factors [8]

Treatment

  • Surgical removal of the tumor, chemotherapy and/or radiation therapy

Canker sores

  • These are painful, burning ulcerative patches that are round in shape [9].
  • Color ranges from white to gray to pale yellow with red edges

 Canker sores inside lower lip
Photo 7 : Canker sores inside lower lip
Picture Source: healcure.org

Causes of Canker sores

  • Allergic reactions to elements in food
  • Suppressed immune system
  • Tissue trauma
  • Nutritional deficiencies
  • Cohn’s and celiac diseases have also been associated with canker sores [1]

Treatment

  • Usually heal with no medication [9].
  • In chronic cases a doctor could prescribe antimicrobial mouth rinse, corticosteroid ointment, or OTC [1]

Vitiligo

  • Vitiligo is a medical condition in which the melanocytes fail to produce melanin leading to white patches on the skin [10]
  • Cause unknown but researchers have linked it with an autoimmune disease, heredity and cancer [1, 9]
  • They are more of white patches rather than white spots

Vitiligo patches on lips
Image 8 : Vitiligo patches on lips
Photo Source: md-health.com

Treatment

  • Steroid therapy
  • Tattooing
  • Skin grafting
  • Skin graft
  • Melanocyte transplant
  • Psoralen photohemotherapy
  • Depigmentation

White raised spot due to lip pimple

  • A pimple on the lips can cause a white dot on the lip.

White spot on lip due to pimple

Picture 9 : White spot on lip due to pimple
Image Source: pimplestap.com

Treatment

  • Varies depending on the cause of the acne

Fibroma

  • These are malignant tumors of the connective tissue
  • They form from lumps within the mouth
  • Attributed to trauma from lip biting and teeth grinding
  • Can be pink, or whitish in color

Fibroma white raised spot on inner lip
Image 10 : Fibroma white raised spot on inner lip
Photo Source: healcure.com

Treatment

  • Surgical removal

Management of White Spots on lips

  • Do not scratch the spots on the lips. It could cause an infection [5].
  • Rinse the lip with warm and salty water. Swish it then spit
  • See a doctor if the spots on the lips bleed, lead to swelling of the neck and jaw, make the tongue numb, or make swallowing difficulty [1, 9].

References :

  1. Heal Cure. White Spots on Lips Pictures, Small, on Lower, Upper, Inside, Lip Corner Causes Cancer, HPV & Cure [Internet]. 2015 [cited 18 January 2016]. Available from: http://www.healcure.org/lip/lip-bumps-spots/white-spots-on-lips-causes-pictures-small-on-lower-upper-inside-lip/
  2. Lee J, Lee J, Kwon N, Yu D, Kim G, Park C et al. Clinicopathologic Manifestations of Patients with Fordyce’s Spots. Annals of Dermatology [Internet]. 2012 [cited 18 January 2016];24(1):103. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3283840/
  3. 14. RA M. [Fordyce’s spots: disease, heterotopia or adenoma? Histological and ultrastructural study]. – PubMed – NCBI [Internet]. Ncbi.nlm.nih.gov. 2016 [cited 18 January 2016]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/6943138
  4. 15. Weiss A, Dym H. Oral lesions caused by human papillomavirus [Internet]. Clinical Advisor. 2011 [cited 18 January 2016]. Available from: http://www.clinicaladvisor.com/cmece-features/oral-lesions-caused-by-human-papillomavirus/article/193918/
  5. Kunin A. Milia [Internet]. DERMAdoctor Blog. 2012 [cited 18 January 2016]. Available from: http://www.dermadoctor.com/blog/milia/
  6. Skinsight.com. Milia in an Infant or Baby: Condition, Treatment and Pictures – Overview | skinsight [Internet]. 2016 [cited 18 January 2016]. Available from: http://www.skinsight.com/infant/milia.htm
  7. Nhs.uk. Oral thrush in adults – NHS Choices [Internet]. 2016 [cited 18 January 2016]. Available from: http://www.nhs.uk/Conditions/Oral-thrush—adults/Pages/Introduction.aspx
  8. Oralcancer.org. The Oral Cancer Foundation [Internet]. 2016 [cited 18 January 2016]. Available from: http://www.oralcancer.org/
  9. Md-health.com. White Spots on Lips | MD-Health.com [Internet]. 2016 [cited 18 January 2016]. Available from: http://www.md-health.com/White-Spots-On-Lips.html
  10. Mayoclinic.org. Vitiligo Causes – Mayo Clinic [Internet]. 2016 [cited 18 January 2016]. Available from: http://www.mayoclinic.org/diseases-conditions/vitiligo/basics/causes/con-20032007

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