Lip injuries range from minor scrapes to significant cuts. Understanding when a lip injury requires professional medical attention is important for proper healing. While small cuts may heal on their own, certain characteristics indicate the need for stitches.
Key Indicators for Stitches
A lip injury often requires stitches if the wound is deep, extending through the full thickness of the lip or exposing underlying fat or muscle tissue. Wounds longer than approximately one-quarter inch (about 1 centimeter) often need suturing to promote healing and reduce scarring. Gaping, where wound edges do not come together easily, is another sign.
Cuts involving the vermilion border—the distinct red line where the lip meets the surrounding skin—typically need precise stitching, as even a one-millimeter misalignment can result in a noticeable cosmetic difference. Persistent bleeding that does not stop after 10 to 15 minutes of direct pressure also indicates a need for medical evaluation. Additionally, seek medical attention if foreign objects are embedded, the injury was caused by a dirty object, or if lip function (like speaking or eating) is affected.
Immediate Actions After a Lip Injury
After a lip injury, control bleeding by applying direct, firm pressure to the wound with a clean cloth or sterile gauze for at least 10 to 15 minutes. If the cloth becomes soaked, place a new one on top without removing the original.
Once bleeding slows, gently clean the wound with mild soap and cool water to remove dirt. Avoid scrubbing or using harsh antiseptics like hydrogen peroxide or alcohol, as these impede healing. For cuts inside the mouth, rinse with cool water or a warm saltwater solution.
Apply a cold compress or ice pack wrapped in a cloth to reduce swelling and discomfort for 10 to 20 minutes at a time. Avoid disrupting the wound, such as picking at it or excessive manipulation.
Medical Evaluation and Stitching
A healthcare professional will assess the wound’s depth, extent, and whether underlying structures like nerves or muscles are affected. They may also inquire about the injury’s cause and tetanus vaccination status.
Before stitching, the wound area will be numbed with a local anesthetic, often via a nerve block to minimize lip tissue distortion. The wound is then cleaned and debrided, removing damaged or contaminated tissue. This step is essential for preventing infection and promoting healing.
For deep or “through-and-through” lacerations, multiple layers of stitches are used. Absorbable sutures, which dissolve over time, may be used for deeper layers or inside the mouth. For external skin and the vermilion border, non-absorbable sutures (often 6-0 nylon) are preferred for precision and better cosmetic outcomes, though these require removal. A tetanus shot may be administered if immunization is not current, and antibiotics might be prescribed for contaminated wounds or those extending into the oral mucosa.
Post-Stitch Healing and Care
After stitches are in place, proper wound care is essential for effective healing and to minimize scarring. Keep the sutured area clean, following your healthcare provider’s instructions, which may include applying prescribed antibiotic ointments. Avoid touching or picking at the wound and any scabs, as this disrupts healing and increases infection risk.
Dietary adjustments are often recommended; consume soft foods that require minimal chewing to reduce strain on the healing lip. Avoid hot, spicy, or acidic foods and beverages that could irritate the wound. Pain can be managed with over-the-counter pain relievers like acetaminophen or ibuprofen, as advised.
Watch for signs of infection, including increased redness, swelling, warmth, pus, or fever, and seek medical attention if these symptoms develop. Non-absorbable stitches on the external lip are typically removed within 5 to 7 days to prevent “track marks” and reduce scarring, while dissolvable stitches break down naturally. Protect the healing lip from sun exposure with sunscreen, and gentle massage of the scar, once fully healed, can help improve its appearance over several months.