Abstract
Background: Actinic cheilitis, herpes labialis and lip cancer are relatively common conditions presenting on the lips associated with exposure to periods of sun exposure and thereby ultraviolet radiation. Objective: This systematic review aimed to determine the efficacy of the application of sunscreen-containing lip-protecting agents (LPA) in the prevention of actinic cheilitis (AC), recurrent herpes labialis (RHL) and lip cancer (LC). Methods: This review was conducted in accordance with the PRISMA guidelines and registered with the PROSPERO database. A literature search was conducted using SCOPUS, Google Scholar, Medline (Ovid), Pubmed, CINAHL, Cochrane Library databases and manual search using search terms actinic cheilitis (AC), recurrent herpes labialis (RHL) and lip cancer (LC) along with lip protecting agents and their variations as keywords. A total of 1,567 papers were yielded. Of them, nine studies were eligible for qualitative data synthesis. Results: Nine articles (3 AC, 5 RHL, 1 LC) were deemed eligible and thus selected for qualitative synthesis. Three studies on AC identified approximately 21.7% lower prevalence of lesions when some form of lip protection was used. Eighty percent of studies on RHL identified that the application of LPA is effective in preventing RHL. Subjects who applied LPA more than once daily only had half the risk of having LC compared to those who applied once daily. Conclusion: This review of randomised controlled trials (RCTs) and observational studies supports the use of LPA as an effective method in preventing lip-associated lesions. Further, RCTs and observational studies should aim at determining a definitive LPA application regime and optimal SPF strength to prevent lip-associated lesions. This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO): Registration Number - CRD42020177484. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020177484
Highlights
This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO): Registration Number CRD42020177484. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020177484
This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO): https://www.crd.york.ac.uk/prospero/display_record.php?ID=C
The inclusion criteria were human studies published in English language, full-text availability, peer-reviewed, randomised controlled trials, observational studies, and focusing on the prevention of lip-associated lesions through the use of an lip-protecting agents (LPA)
Summary
Ultraviolet Radiation (UVR) is found in abundance in the environment, contributing to a spectrum of skin lesions including inflammatory lesions, degenerative aging and skin. The lips are frequently neglected when it comes to sun protection [1]. Actinic Cheilitis (AC) is a potentially malignant oral disorder that frequently affects the vermillion border of the lower lip, with a global prevalence of 0.45% to 2.4% [5]. A variety of premalignant lesions are found in patients exposed to UVR, including AC. Other factors linked to the malignant transformation of AC include tobacco smoking and genetic predisposition [8 - 10]. Herpes labialis and lip cancer are relatively common conditions presenting on the lips associated with exposure to periods of sun exposure and thereby ultraviolet radiation
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