When we think of sun protection, we often focus on our face, arms, and legs — but one of the most vulnerable areas to UV damage is right under your nose: the lips. In Western Australia’s harsh climate, the bottom lip in particular is a common site for squamous cell carcinoma (SCC), a type of non-melanoma skin cancer that can be both aggressive and damaging if left untreated.
As a Dermal Clinician and Skin Cancer Screening Practitioner, I also frequently detect actinic cheilitis — a precancerous condition of the lips — during skin checks. Left unchecked, this can progress to SCC.
Why the Bottom Lip Is at High Risk
The lips are made of delicate skin with minimal natural protection. Unlike other parts of the body, they contain very little melanin, the pigment that helps defend against UV radiation.
The bottom lip is more exposed to direct sunlight than the top lip because of its angle towards the sun, particularly when we’re outdoors fishing, gardening, working, or driving.
In my experience, SCCs on the lips tend to develop more frequently in men, often because they are less likely to use SPF lip balm consistently and may have spent decades working outdoors without lip protection.
Actinic Cheilitis: The Warning Sign
Actinic cheilitis is caused by chronic sun exposure and appears as:
- Persistent dryness or cracking of the lips.
- Scaly or rough patches.
- A pale, blotchy, or mottled appearance.
While some people dismiss it as “chapped lips,” this condition is actually pre-cancerous and can develop into SCC if ignored.
Squamous Cell Carcinoma (SCC) of the Lip
SCC of the lip may appear as:
- A sore or ulcer that doesn’t heal.
- A thickened or crusty patch.
- A firm lump.
SCC on the lips can be more aggressive than on other parts of the body. The rich blood supply in the lip area means there’s a higher risk of the cancer spreading if not detected and treated early.
Why Outdoor Workers Are at Greater Risk
Outdoor workers often spend years exposed to intense sunlight, and many I see in my clinic have not been in the habit of reapplying sunscreen to their lips.
Add to this the fact that cigarette smoking introduces additional carcinogens directly to the lip tissue, and you have a double impact:
- UV damage from the sun.
- Chemical damage from smoking.
This combination significantly increases the risk of SCC forming in the lower lip.
Women and the Upper Lip Risk
Interestingly, I often detect SCC in women just above the upper lip. This may be because the upper lip area protrudes slightly and catches the sun, but there’s another factor:
- Many women apply sunscreen in the morning under makeup but don’t reapply during the day.
- Heat and perspiration can cause sunscreen to wear off quickly around the mouth area.
This means the skin above the lip is left exposed to high UV levels, making it a common site for sun damage and SCC.
Protecting Your Lips from Sun Damage
Prevention is straightforward, but it requires daily commitment:
- Use an SPF lip balm (SPF 30 or higher) and reapply regularly, especially after eating, drinking, or swimming.
- Choose a broad-spectrum sunscreen and remember to apply it to the skin above your lips.
- Avoid smoking — this eliminates a major carcinogen and improves your overall lip health.
- Wear a broad-brimmed hat to shade the lower face and lips when outdoors.
The Role of Regular Screening
A professional skin check is the most reliable way to catch changes in the lips early. I routinely examine the lips, the skin above and around them, and the surrounding facial areas during my screenings.
Many of my clients are surprised to learn they have early signs of sun damage on their lips — damage that they hadn’t noticed themselves. By detecting these changes early, we can act before SCC develops or progresses.
What to Expect in a Lip Examination
During your skin check, I will:
- Carefully inspect the lips and surrounding skin.
- Use a dermatoscope to identify subtle changes that may not be visible otherwise.
- Provide tailored prevention advice, including lip care routines and sun protection strategies.
When to Book a Skin Check
If you have any persistent dryness, scaling, or sores on your lips that haven’t healed after a couple of weeks, it’s time for a professional examination. The same applies if you notice changes to the skin above your lip.
In Western Australia’s climate, lip protection is just as important as sunscreen for the rest of your body. Early detection of actinic cheilitis or SCC can prevent significant tissue damage and improve outcomes.
Christine Comans
Dermal Clinician & Skin Cancer Screening Practitioner
Based in Subiaco, WA | Servicing metropolitan and regional areas
www.skinchx.com.au.