Erythema above the lips, making it more difficult to distinguish the vermilion border.
This left cheek incision extends from the left commissure towards the left ear and it breaches the vermilion border (click to see close-up). In order to maintain aesthetics as best possible, the first suture was placed at or near the vermilion border to ensure a contiguous line upon healing.
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 is where lipstick is sometimes applied. It represents the change in the epidermis from highly keratinized external skin to less keratinizeded internal skin. It has no sebaceous glands, sweat glands, or facial hair.[1][2]
It has a prominence on the face, creating a focus for cosmetics and is also a location for several skin diseases. Its functional properties, however, remain unknown.[3]
Structure
The lips 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.[4]
It has been described as a pale, white rolled border and also as being a red line.[1][5]
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.[6]
There are two reasons that the border appears red in some people:
The epithelium is thin and therefore the blood vessels are closer to the surface.[8]
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's spots.[2][9]
Perioral dermatitis is a rash typically around the mouth, that spares the vermilion border.[11]
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.[12]
Infections may involve the vermilion border. Cold sores are one common infection.[13]Impetigo is another.[14]
Lips that have good volume can be highlighted by defining them and injecting a dermal filler into the white vermilion border.[6]
Close attention is given when repairing any injury to the vermilion border. Even 1 mm of vermilion misalignment could be noticeable.[5]
Sunlight exposure can blur the junction between the vermilion border and the skin. Applying lip balm and sunscreen moisturizes protects it from sunlight.[15]
Vermilionectomy
Avermilionectomy (sometimes spelled vermillionectomy) is the surgical removal of the vermilion border. It is sometimes performed to treat carcinoma of the lip.[16]
