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What to Know About Pale Lips

Medically Reviewed by Dan Brennan, MD on May 05, 2021

The color of your lips may tell you more about your health than you realize. Your lips can change color for a variety of reasons.

Lips and Their Function

Your lips play an important role in facial expression, eating and drinking, speech, sensation, and intimacy. 

Your lips are involved in creating many sounds when you talk. Babies rely on their lips to create a suction during breastfeeding. They are key to expressing emotions such as smiling and frowning. Your lips are also an erogenous zone that can be stimulated during kissing.

Structure of Lips

The red part of your lips is known as the vermilion. The vermillion border is the margin of paler skin that separates your vermilion from the surrounding skin on your face.

Most of the skin on your face has 16 cellular layers. But your lips only have three to five. The skin on your lips lacks the skin cells called melanocytes that produce pigment. That’s why the blood vessels in your lip appear more prominently.

The vermilion of your lips can range in color from reddish-pink to brown.

Causes of Pale Lips

There are several different possible causes for your pale lips.

Anemia‌

Pale lips are one of the common signs of anemia. This is a condition where your body doesn’t have enough red blood cells. It may be caused by the following:

  • Your body doesn’t make enough red blood cells.
  • Your body destroys red blood cells. 
  • Blood loss, such as heavy menstrual bleeding

Anemia can also be caused by a variety of diseases that affect blood cell production. This includes inflammatory diseases like cancer and HIV.

The signs and symptoms of anemia can vary. Some people with anemia may not have any symptoms. Anemia symptoms can include:

There are many types of anemia. Here are a few of the most common ones.

Iron deficiency anemia. This means that your body doesn’t have enough iron. You may feel very fatigued and short of breath if you have iron deficiency anemia. Pale skin is also another symptom.

Vitamin B12 deficiency . Your pale lips may be a sign that you lack vitamin B12. Your body needs vitamin B12 to produce red blood cells. Like most vitamins, B12 can’t be made by your body. You have to get it from food or supplements. Anemia can result when you do not get enough.

Vitiligo

This is a condition that causes patches of your skin to lose color and turn milky-white. Skin cells called melanocytes make the pigment in your skin called melanin. These melanocytes can be destroyed if you have vitiligo. Its exact cause hasn’t been determined but researchers say vitiligo may be an autoimmune disorder.

You can get vitiligo on your lower lip. It starts as a small dot that spreads to become a streak along your vermilion border.

Actinic Cheilitis

This is a condition also known as sailor’s lip that’s caused by long-term exposure to sunlight. This usually affects your lower lip. It tends to be more exposed to the sun. 

Among the symptoms of actinic cheilitis are spots on your lip that look slightly white or milky. When the spots are more advanced, they may be thickened or scaly. They might also develop ulcers. You may also lose the vermilion border of your lips. 

If not treated, actinic cheilitis can lead to squamous cell carcinoma. This is a type of skin cancer. You can reduce your risk of actinic cheilitis by:

  • Wearing wide-brimmed hats
  • Using sunscreen
  • Using lip balm containing SPF or zinc
  • Getting your skin checked regularly

Lip Cancer 

Cancer of the lip is quite common in the US. It can be mistaken for a cold sore or lesion. White patches on the lip are one of the symptoms of lip cancer. Other symptoms include: 

  • Lumps, blisters, or sores on your lips that won’t go away
  • Bleeding or pain on your lip
  • Swelling of your jaw

Oral Thrush

White patches inside your mouth, on your tongue, and lips could be due to oral thrush.

Candida is a type of fungus that lives on your skin and inside your body. But sometimes it can spread and cause infections such as oral thrush. This condition tends to affect babies, especially those under 1 month old, and people with weakened immune systems. It’s uncommon in healthy adults.

Some of the other symptoms of oral thrush include:

  • Redness or soreness of your mouth
  • Losing taste
  • Pain when you’re swallowing
  • A cotton-like feeling in your mouth
  • Redness and cracking at the corners of your mouth.

Low Blood Sugar

Hypoglycemia or low blood sugar usually occurs in people with diabetes. It’s caused by too much insulin in your body. Insulin is a hormone made in your pancreas that lets your body use glucose for energy. Pale skin is one of the symptoms of low blood sugar.

Some other symptoms of hypoglycemia are: 

  • Dizziness or lightheadedness
  • Nausea
  • Weakness
  • Faster heart rate
  • Sweating and chills
  • Trembling or shaking
  • Irritability or nervousness
  • Restless sleep
  • Hunger

When to See Your Doctor

Some of the possible causes of pale lips can lead to serious health conditions. You should see your doctor if your lips start to become pale or they develop new lesions. 

WebMD Medical Reference

Sources

SOURCES: 

American Family Physician: “Recognition and Treatment of Actinic Cheilitis.”

American Journal of Medical Genetics: “Elements of morphology: Standard terminology for the lips, mouth, and oral region.”

CDC: “Candida infections of the mouth, throat, and esophagus.”

Cleveland Clinic: “Hypoglycemia (Low Blood Sugar).”

Harvard Health Publishing: “Vitamin B12 deficiency can be sneaky, harmful.”

Journal of Cutaneous and Aesthetic Surgery: “Micropigmentation in Vitiligo of Lateral Lower Lip."

Journal of Oral Medicine and Oral Surgery: “Labial vitiligo associated with a factice disorder: a case report.”

MAYO CLINIC: “Anemia,” “Iron deficiency anemia.”

Nursing Times: “Update on oral candidosis.”

StatPearls: “Actinic Cheilitis,” “Anatomy, Head and Neck, Lips.”

UC Irvine Department of Head & Neck Surgery: “LIP CANCER.”

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