Angular cheilitis

Definition

What is angular cheilitis?

Angular cheilitis (also known as angular stomatitis and perleche) is a condition that causes red, swollen patches in the corners of your mouth where your lips meet and make an angle.

Angular cheilitis can occur on one or both sides of the mouth. It’s an inflammatory condition and can last a few days or be a chronic problem.

How common is angular cheilitis?

Angular cheilitis can affect people of all ages, including infants. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of angular cheilitis?

The main things you’ll notice are irritation and soreness in the corner(s) of your mouth. One or both corners may be:

• Bleeding
• Blistered
• Cracked
• Crusty
• Itchy
• Painful
• Red
• Scaly
• Swollen

Your lips can feel dry and uncomfortable. Sometimes your lips and mouth can feel like they’re burning. You also might have a bad taste in your mouth.

If the irritation is strong, it can make it hard for you to eat. You may not get enough nutrients or you may lose weight.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes angular cheilitis?

There are several different causes of angular cheilitis. The most common is yeast infection as a result of saliva.

Saliva gets trapped and builds up in the corners of your mouth. When it dries, the skin in the area can crack. You may lick your lips often to soothe your cracked skin. The warmth and moisture in the corners of your mouth create the perfect conditions for fungus to grow and multiply-and cause infection.

Fungal infection is the most common cause of angular cheilitis. It’s usually caused by a type of yeast called Candida– the same fungus that causes diaper rash in babies. Certain bacteria strains also can cause it.

If your doctor can’t find the cause, it’s called idiopathic angular cheilitis.

Risk factors

What increases my risk for angular cheilitis?

You’re more likely to get angular cheilitis if the corners of your mouth are moist a lot of the time. This might happen for many reasons, such as:

• You have braces.
• You wear dentures that don’t fit well.
• You lick your lips a lot.
• You have a lot of saliva.
• Your teeth are crooked, or your bite isn’t lined up correctly.
• You have sagging skin around your mouth from weight loss or age.
• You suck your thumb.
• You smoke.
• You don’t get enough nutrients, like vitamin B or iron.

Certain medical conditions can put you at a higher risk, such as:

• Anemia
• Cancers of the blood
• Diabetes
• Down syndrome
• Immune disorders, like HIV
• Kidney, liver, lung, or pancreatic cancer

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is angular cheilitis diagnosed?

To find out if you have angular cheilitis, your doctor will examine your mouth closely to look at any cracks, redness, swelling, or blisters. He’ll also ask you about habits you might have that could affect your lips.

Other conditions (such as herpes labialis and erosive lichen planus) can cause symptoms similar to angular cheilitis. To be sure of the cause, your doctor might swab the corners of your mouth and your nose and send it to a lab to see what kinds of bacteria or fungi might be there.

How is angular cheilitis treated?

The goal is to clear out the infection and keep the area dry so your skin isn’t infected again. Your doctor will recommend an antifungal cream to treat fungal infections. Some are:

• Nystatin (mycostatin)
• Ketoconazole (extina)
• Clotrimazole (lotrimin)
• Miconazole (lotrimin af, micatin, monistat derm)

If your infection is bacterial, your doctor will prescribe an antibacterial medication, such as:

• Mupirocin (bactroban)
• Fusidic acid (fucidin, fucithalmic)

If your angular cheilitis isn’t caused by a fungal or bacterial infection, your doctor may suggest you put petroleum jelly on the inflamed areas. This protects your mouth from moisture so the sores can heal.

Other treatment options include:

• Topical antiseptics to keep open wounds clean
• Topical steroid ointment
• Filler injections to reduce the creases at the corners of the mouth

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage angular cheilitis?

The following lifestyles and home remedies might help you cope with angular cheilitis:

• Using lip balm regularly to prevent chapped lips
• Applying petroleum jelly to the corners of the mouth
• Applying coconut oil to the corners of the mouth, which can help dry skin

If you have any questions, please consult with your doctor to better understand the best solution for you.