Angular cheilitis is a common inflammatory skin condition affecting the corners of the mouth. It is often confused with a cold sore; however, angular cheilitis is not contagious. This inflammatory condition appears for a variety of reasons and often in conjunction with underlying medical problems. Read on to learn how to diagnose, treat, and prevent it.
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Angular cheilitis is an inflammatory skin condition that appears at the corners of the mouth.
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People with angular cheilitis may complain of itching or soreness at the corners of the mouth and present with redness, fissures, crusting, or bleeding in those areas.
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Angular cheilitis is mostly commonly caused by a candidal infection, but other causes include aging, trauma, nutritional deficiencies, medications, and certain systemic diseases.
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In most cases, angular cheilitis is diagnosed on physical exam; however, some may require swab cultures, labs, or skin biopsies.
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Treatment of angular cheilitis depends on the underlying cause.
What is angular cheilitis?
Angular cheilitis, also known as angular stomatitis, cracked lip corners, or perleche, is a common inflammatory skin condition at the corners of the mouth. Most cases involve both corners of the mouth. It affects mostly older adults and young children. Angular cheilitis is not contagious and can appear as a result of many underlying issues.
Causes of angular cheilitis
People suffer from cracked lip corners due to various causes. However, it stems from skin inflammation at the corners of the mouth. This inflammation may be due to saliva collecting there and causing tissue maceration and subsequent infection, irritation, or dryness.
The causes of angular cheilitis include:
- Aging. As skin ages, it begins to sag at the corners of the mouth. This sagging creates crevices where saliva can collect, leading to irritation and macerated skin.
- Dental issues. Certain dental issues cause trauma and injury to the corners of the mouth, such as poor-fitting dentures or tooth decay.
- Contact dermatitis or eczema. Certain oral hygiene products or skin products cause irritation or allergic reactions at the corners of the mouth.
- Infection. Inflammation at the corners of the mouth can breed infection with bacteria such as Staphylococcus aureus or yeast like Candida albicans.
- Nutritional deficiencies. Angular cheilitis can occur as a result of several nutritional deficiencies, such as zinc and protein.
- Systemic disease. It often appears in conjunction with certain medical conditions, like Sjogren's disease and diabetes. Sjogren's disease causes dry mouth, which leads to inflammation at the corners of the mouth. Additionally, people with diabetes are at increased risk of infections, especially from Candida, due to immunosuppression.
- Medications. Some medications can cause dry mouth, making people susceptible to inflammation at the corners of the mouth. These medications include antihistamines and isotretinoin.
- Radiation. Radiation causes skin inflammation and breakdown, which can occur at the corners of the mouth.
- Dry climate. When the climate is dry, skin gets inflamed and cracks, especially at the corners of the mouth.
- Trauma. Trauma to the corners of the mouth leads to inflammation, such as thumb sucking, lip licking, and smoking.
- Immunosuppression. When the immune system is suppressed due to certain medical conditions, like HIV, or medications, like steroids, it makes people prone to infection, which can occur at the corners of the mouth.
Signs and symptoms of angular cheilitis
While angular cheilitis is a common skin problem, it is not life-threatening. People usually complain of symptoms like soreness, itching, or pain at the corners of the mouth. This is accompanied by skin findings at the corners of the mouth, such as redness, cracking, scaling, bleeding, crusting, swelling, and fissures.
Diagnosing angular cheilitis
Most cases of angular cheilitis are diagnosed by physical exam by a doctor. A doctor will also take an extensive history to determine the underlying cause. Sometimes, labwork is also necessary. It is also common for your doctor to perform a swab to send for bacterial and fungal cultures to discover if there's an infection and which organism is causing it. Rare cases may require a skin biopsy.
Treatment of angular cheilitis
Treatment of cracked lip corners varies based on the underlying cause of the skin inflammation. Correct diagnosis of the underlying cause will lead to effective treatment. There is no magic angular cheilitis cream or angular cheilitis overnight cure. Those people who develop cracked lip corners should see a dermatologist immediately for prompt diagnosis.
| Causes of angular cheilitis | Treatments of angular cheilitis |
| Aging | Because the skin sags as we age, many doctors use dermal fillers to plump the skin, removing the crevices where saliva can collect. Zinc oxide barrier creams are a great angular cheilitis over-the-counter treatment to protect the skin. |
| Dental issues | Regular dental visits keep teeth healthy and prevent tooth decay. If dentures don't fit properly, see a dentist immediately to prevent issues. |
| Contact dermatitis or eczema | The use of topical steroids or steroid-sparing agents (Protopic and Elidel) can soothe inflammation at the corners of the mouth. |
| Infection | Bacterial infections can be treated with topical or oral antibiotics, while yeast infections resolve with topical or oral antifungal medications. |
| Nutritional deficiencies | A healthy diet can treat and prevent cracked lip corners. For people with a nutritional deficiency, their doctor may recommend vitamin supplements and a diet plan. |
| Systemic disease | Treatment of the underlying condition may prevent cracked lip corners from occurring and even speed up its resolution. |
| Medications | If a certain medication is causing angular cheilitis, a doctor can change it. |
| Radiation | If radiation caused cracked lip corners, there are different products that protect the skin, such as petrolatum or zinc oxide. |
| Dry climate | Keeping the skin well moisturized is key to preventing dryness and skin breakdown. A great angular cheilitis at-home treatment is petroleum jelly to moisturize the skin. Using a humidifier at home can also help keep skin from drying out. |
| Trauma | If trauma, like thumb sucking, smoking, or lip licking, caused this problem, avoiding these habits should help. |
| Immunosuppression | For people who are immunosuppressed, their doctor can prescribe topical or oral medications to help prevent cracked lip corners. |
Tips to help prevent angular cheilitis
Certain lifestyle choices may help prevent angular cheilitis, especially for people at risk of developing it due to an underlying medical condition. For people who have underlying medical problems that put them at risk for developing cracked lip corners, they should try to prevent it. These tips may not prevent all cases of cracked lip corners, but they may help.
Here are some angular cheilitis self-care prevention tips:
- Avoid allergens and irritants found in skin and oral products.
- Maintain a good healthy diet.
- Avoid smoking, thumb sucking, or lick the lips.
- Maintain proper dental hygiene.
- Keep skin well moisturized and protected with petroleum jelly.
- Avoid the sun, which can burn, damage, and dry out the skin.
Angular cheilitis is a skin condition affecting the corners of the mouth due to various underlying causes and preferentially affects the elderly and young children. The good news is that it is usually easily treated and is not contagious. People developing cracked lip corners should see a dermatologist immediately. Prompt and correct treatment is key to the quick resolution of this condition.
FAQ
What is the difference between angular cheilitis and cold sores?
While angular cheilitis and cold sores may look similar, they are different. Cold sores are caused by the herpes virus and are contagious. Angular cheilitis is not caused by a virus and is not contagious.
What foods should I avoid if I have angular cheilitis?
If you have cracked lip corners, you should avoid eating or drinking citrus because it can irritate the skin. Furthermore, spicy food can worsen angular cheilitis. It's best to stick to mild foods and beverages.
What can happen if angular cheilitis is not treated?
If angular cheilitis is not treated, the open sores will get larger and more painful. It can also lead to scarring and make it hard to open your mouth. If it is due to an infection, like Candida, it can spread to the skin on your face or your mouth.
- Acta Clinica Croatica. Differential Diagnosis of Cheilitis - How to Classify Cheilitis?
- StatPearls. Angular Chelitis.
- American Family Physician. Common Oral Conditions in Older Persons.
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