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Laser Treatment for Sun Damaged Lips

Lasers are the best treatment for moderately to severely sun-damaged lips. They enable accurate destruction of the abnormal surface layers of the lip. Other less effective treatments for sun damage include creams (Efudix and Aldara) and photodynamic therapy (PDT).
Correction of these precancerous changes in the surface layers of the lip may prevent the development of a lip cancer at a later stage. Treatment also helps to reduce problems such as peeling, cracking, lip discomfort and uneven lip colour. Before the laser treatment, a biopsy of the lip may be necessary to confirm the diagnosis and that there is no cancer present.

THE PROCEDURE:

Your lip will be photographed before and after treatment. Local anaesthetic is injected into the gums and lip to completely numb the lower lip. It is important for the eyes to be protected from the laser beam and they will be covered prior to starting treatment. The treatment itself takes only a few minutes. The laser makes a “popping” noise. During the treatment a smoke evacuator is used to remove fumes – this makes a noise rather like a vacuum cleaner.

POSTOPERATIVE COURSE:

The treated area of your lip will look red and will ooze small amounts of blood immediately postoperatively. A thin layer of Bactroban antibiotic ointment is applied. After the anaesthetic wears off (about 1 to 2 hours) your lip will feel swollen and painful. You are likely to need some pain-killers for the first day and night (e.g. Panadol, Panamax, Panadeine Forte).

The treated area on the lip will develop a crust which is initially bloody then slightly yellowish. Crusts should be gently removed with saline and alternating Vaseline and Bactroban ointment should be applied every 2 hours during the first 3-5 days. You may find it helpful to gently splash the lip with warm water or run it under the shower to soften the crusting before cleaning in the morning.

An appointment will be made for review in the first few days. After this, Vaseline (petroleum jelly) should continue to be applied 5-6 times daily. If the lip dries out, more frequent application of the ointment may be used. It is usually most difficult to keep the lip clean during the first week, thereafter it becomes much easier.

The lip heals at the corners of the mouth by the end of the second week while the centre heals last. It will usually take one month for your lip to heal.
It is normal for your lip to feel a bit sensitive for a few months afterwards.

After the lip has healed it is very important that you should regularly apply a lip sunscreen (e.g. Hamilton’s, Q-V or zinc) at least 2 to 3 times a day all year round. This should help prevent any recurrence of your problems.

COMPLICATIONS:

The most common problem is the return of your sun-damaged changes. This happens early on in about 5% and at a later stage in about 5-10%.
An uncommon complication is the development of scarring, either within the red portion of the lips or along the junction with the surrounding skin. This can be helped with the early injection of cortisone preparations. Scarring is most likely at the site of a biopsy or any previous treatment.
Infection is an uncommon problem. If you have had lip cold sores, please let me know before the laser surgery and I will arrange for you to take anti-viral medication starting on the morning of the procedure.

If you have any questions or problems during the course of your treatment please call:
Adelaide Skin & Eye Centre 8211 0000 (Monday to Friday 9am to 5pm)

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