Vermilion border explained

Vermilion border
Latin:	pars intermedia labiorum oris

The vermilion border (sometimes spelled vermillion border), also called margin or zone, is the normally sharp demarcation between the lip and the adjacent normal skin. It represents the change in the epidermis from highly keratinized external skin to less keratinized internal skin. It has no sebaceous glands, sweat glands, or facial hair.^[1]

It has a prominence on the face, creating a focus for cosmetics (it is where lipstick is sometimes applied) and is also a location for several skin diseases. Its functional properties, however, remain unknown.^[2]

Structure

The lips are composed wholly of soft tissue. The skin of the face is thicker than the skin overlying the lips where blood vessels are closer to the surface. As a consequence, the margin of the lips shows a transition between the thicker and thinner skin, represented by the vermilion border. It therefore has the appearance of a sharp line between the coloured edge of the lip and adjoining skin.^[3]

It has been described as a pale, white rolled border and also as being a red line.^{[1] [4]}

This fine line of pale skin accentuates the colour difference between the vermilion and normal skin. Along the upper lip, two adjacent elevations of the vermilion border form the Cupid's bow.^[5]

Microanatomy

The vermilion border represents the change in the epidermis from highly keratinized external skin to less keratinized internal skin. It has no sebaceous glands, sweat glands, or facial hair.^[1]

There are two reasons that the border appears red in some people:

1. The epithelium is thin and therefore the blood vessels are closer to the surface.^[6]
2. This epithelium contains eleidin which is transparent and the blood vessels are near the surface of the papillary layer, revealing the "red blood cell" color. At the angles of the mouth, there are sebaceous glands, without hair follicles, which are called Fordyce spots.^{[7] [8]}

Clinical significance

The vermilion border is important in dentistry and oral pathology as a marker to detect disease, such as in actinic cheilitis.^[9]

Associated diseases

• Perioral dermatitis is a rash typically around the mouth, that spares the vermilion border.^[10]
• Cheilitis glandularis may present with a burning sensation over the vermilion border. This chronic progressive condition is associated with thinning of the skin of the lips and ulceration.^[11]
• Infections may involve the vermilion border. Cold sores are one common infection.^[12] Impetigo is another.^[13]
• Skin cancer can also occur at the vermilion border.
• Fetal alcohol syndrome causes facial abnormalities which include a thin vermilion border with a smooth philtrum.^[14]

Cosmetic appearance

• Sunlight exposure can blur the junction between the vermilion border and the skin. Applying lip balm and sunscreen moisturizes protects it from sunlight.^[15]

Surgery

A vermilionectomy (sometimes spelled vermillionectomy) is the surgical removal of the vermilion border. It is sometimes performed to treat carcinoma of the lip.^[16]

Close attention is given when repairing any injury to the vermilion border. Even 1 mm of vermilion misalignment could be noticeable.

See also

• List of specialized glands within the human integumentary system
• White roll

Notes and References

1. Book: https://books.google.com/books?id=iVGbPei7gZ4C&pg=PA81. Woelfel's Dental Anatomy: Its Relevance to Dentistry. Scheid. Rickne C.. Woelfel. Julian B.. 2007. Lippincott Williams & Wilkins. 9780781768603. en. 7th. 2. Oral examination: normal anatomy of the oral cavity. 81–82.
2. Kobayashi . H. Tagami . H. March 2004. Functional properties of the surface of the vermilion border of the lips are distinct from those of the facial skin.. 15030342. British Journal of Dermatology. 150. 3. 563–567. 10.1046/j.1365-2133.2003.05741.x. 42980307.
3. Web site: Anatomy of the ageing lip. ENT & Audiology News. en. 2018-02-04.
4. 2017-03-09. Complex Lip Laceration: Overview, Indications, Contraindications.
5. Luthra. Amit. 2015. Shaping Lips with Fillers. Journal of Cutaneous and Aesthetic Surgery. 8. 3. 139–142. 10.4103/0974-2077.167269. 4645142. 26644736 . free .
6. Book: Gray's Anatomy for Students E-Book. Drake. Richard. Vogl. A. Wayne. Mitchell. Adam W. M.. 2009-04-04. Elsevier Health Sciences. 978-1437720556. 1055. en.
7. Book: Chiego, Daniel J.. https://books.google.com/books?id=AM9FDwAAQBAJ&pg=PA170. Essentials of Oral Histology and Embryology: A Clinical Approach. 2018. Elsevier . 9780323569323. 14. Oral mucosa. 170. en.
8. Book: Andrews' Diseases of the Skin: Clinical Dermatology. James. William D.. Berger. Timothy. Elston. Dirk. 2015-04-12. Elsevier Health Sciences. 9780323319690. 793. en.
9. Book: Cancer Epidemiology and Prevention. Thun. Michael. Linet. Martha S.. Cerhan. James R.. Haiman. Christopher A.. Schottenfeld. David. 2017-11-07. Oxford University Press. 9780190238681. en.
10. Web site: Perioral dermatitis: It's not every rash that appears around the mouth. M.D.. Ilya Petrou. 2006-07-29. Dermatology Times. en. 2018-02-05.
11. Web site: Cheilitis Glandularis Clinical Presentation: History, Physical, Causes. emedicine.medscape.com. en. 2018-02-05.
12. Book: Kradin, Richard L.. Diagnostic Pathology of Infectious Disease E-Book. 2010-02-02. Elsevier Health Sciences. 978-1455705986. en.
13. Book: Eversole, Lewis R.. Clinical Outline of Oral Pathology: Diagnosis and Treatment. 2011. PMPH-USA. 9781607950158. en.
14. Chudley AE, Conry J, Cook JL, Loock C, Rosales T, LeBlanc N . Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis . CMAJ . 172 . 5 Suppl . S1–S21 . March 2005 . 15738468 . 557121 . 10.1503/cmaj.1040302 . dmy-all .
15. Book: The Female Body: An Owner's Manual : a Head-to-toe Guide to Good Health and Body Care-- at Any Age. registration. lip liner vermilion.. Saucer. Caroline. Torg. Elisabeth. 1996. Rodale Press. 9780875964003. en.
16. Book: Plastic Surgery E-Book: Volume 3: Craniofacial, Head and Neck Surgery and Pediatric Plastic Surgery. Rodriguez. Eduardo D.. Losee. Joseph E.. Neligan. Peter C.. 2017-08-10. Elsevier Health Sciences. 9780323356992. 309. en.