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Lip or Mouth Ulcer Types, Causes, Pictures, Remedies and Preventive Tips

What is a lip ulcer or ulceration? Can cancer cause mouth ulcer? An ulcer on the lip or inside mouth can be painful. Find out more on the causes, types and some home remedies for mild ulceration. You will also get an insight into what a mouth ulcer looks like with the aid of images and pictures we selected from patients at random.

What is a lip ulcer?

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 mouth.

An ulcer in mouth or on inner lips can cause pain, irritation, tingling sensation and other symptoms that may vary according to type or kind of the resulting ulceration. 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.

Mouth or lip ulcer pictures and types

Lip ulcer types
Lip ulcer types

These tips or basic questioning can guide one to understanding what type or kind of ulceration you are more likely experiencing.

  • Does ulceration appear in singles, in multiples or in a cluster?
  • Do the ulcers 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 the lip ulcers?
  • 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 mouth can also help identify the specific types or forms. Take a closer look at the picture samples.

1.      Traumatic lip ulcer

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)

Aphthous lip mucosa ulceration
Aphthous lip mucosa ulceration

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.

Multiple ulcers
Multiple ulcers

In many cases, aphthous ulcers 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 lip ulcers.

You can have a single ulcer or multiple round 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 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 toothpastes
  • 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 ulcer. According to the DermNet New Zealand, this is another lip ulcer with distinct appearance and characteristic inflammatory cell studied under a microscope. The occurrence of this kind of lip ulcer is uncommon but middle to grown-ups are affected at one point in their lifetime.

Dermatologists do not understand yet why or causes of eosinophilic ulcer. 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 lip ulcer 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
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 of lip ulcer 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 mouth ulcers
  • Blood disorders especially if mouth ulcers occasionally form on lip mucosa
  • Mouth ulcers can be caused by anemia
  • Mouth or lip ulcerations 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 lip ulcer or canker sores

A canker sore on inner lower lip
A canker sore on inner lower lip

These mouth ulcers have no known cure hence, relying on general measures is 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 anaesthetics 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, these presentation is not a threat in terms of being infectious. Therefore, if you have aphthous stomatitis, you cannot spread to healthy individuals.

Are mouth ulcers signs 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. These ulcers occur on lips, gums, palate, beneath tongue and the symptoms usually last longer that what a mild lip ulcer should take to heal.

Therefore, cancer of the mouth can cause mouth ulcers. 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 lip ulcers, some cases that involve recurring ulcerations should be reported to a dentist for proper examination. These are some of the symptoms that you should take note of.

  • If the lip ulcer lasts for more than 3 weeks
  • You are unwell
  • The ulcers keep coming back

Lip or mouth ulcer 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 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 mouth ulcer?

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 to lip ulcer or 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 mouth ulcers.

  • Do not give hydrogen peroxide to children or toddlers
  • If the mouth ulcers 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
Our Sources and Citations
  1. DermNet New Zealand. Mouth ulcers. http://www.dermnetnz.org/topics/mouth-ulcers/. Accessed online on 12 April 2017.
  2. Mouth Ulcers: https://patient.info/health/mouth-ulcers-leaflet
  3. Traumatic Ulcers: http://emedicine.medscape.com/article/1079501-overview#a4
  4. How to Remove a Mouth Ulcer: http://www.wikihow.com/Remove-a-Mouth-Ulcer

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