Q. I have small granules on my cheeks and corner of lips with a history of smoking. Please help.

Answered by
Dr. Srinivas Saketh. G
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Apr 18, 2020

Hello doctor,

I have small spots or granules on both sides of my cheeks and on lip corners for the past eight years. I was a smoker and occasional tobacco user. I quitted this four years back. I have no pain or irritation and I am in touch with a local dentist and taking vitamin D supplements. I need an advice for further treatment.



Welcome to

The long term habit of smoking and tobacco chewing has caused this on the inside of your cheek. Good to hear that you stopped the habit. The vitamin D supplement you mentioned is also nice. But it takes time to heal. For years together, the inside of your cheek has been exposed to heat and tobacco which are responsible for such a change. It will heal, no doubt, but it takes time.

Be patient, have your dentist consultation regularly and avoid hot foods. Use a medicated mouthwash. The time taken to heal is generally more than the time taken for those spots to appear.

Thank you doctor,

I did not use tobacco regularly and even for the longterm. I thought they are Fordyce spots.



Welcome back to

If it is Fordyce spots, no treatment is necessary as it is painless and harmless. It is not cancer, nothing to worry about it. But how did you know that it was Fordyce spots? Any dentist said so?

Have regular dental appointments. Any changes, if present are to be noted and informed to the dentist. As of the clinical picture, it looks like the spots appeared due to the long term habit of smoking. (attachment removed to protect patient identity).

Thank you doctor,

I want to know whether it is very serious like speckled leukoplakia. I have quitted everything five years back. My dentist told like what you said, it will take years to heal. I would be grateful if you advise me. I am really worried and guilty and I am afraid to go for a biopsy. But my dentist said biopsy is not required. Please suggest.



Welcome back to

Good to know that you quit the habit having health concerns. I appreciate that. At the same time, do not panic. Getting panic and being anxious brings new issues.

I have seen clinically and that looks like regular smoking-induced spots. (They also appear when we suddenly put a very hot item in our mouth, but they resolve soon as the exposure duration is very short). On the other hand, smoking as you know, each cigarette has a minimum of two minutes exposure of heat to the inside of the mouth. So it has caused a considerable amount of damage.

Again, understand that still, it is totally reversible. It will heal and get back to its original condition. As of now, the condition does not look severe.

Thank you doctor,

But I have these spots on the lip corners and the upper lip.



Welcome back to

These locations are also common. So do not worry.

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