Angular cheilitis: why it happens and how to treat it

Angular cheilitis

Angular cheilitis is a common inflammatory condition of the corners of the mouth. It affects one or both corners, causing pain, redness and cracking. Angular cheilitis can appear in children and adults of all ages, and is particularly prevalent in females. The causes of the condition change depending on age, however.

Clinical forms

Children

In children, angular cheilitis is linked to atopic dermatitis on the face and lips, and has the same causes.

Adults

In adults, angular cheilitis is often linked to cosmetic routines such as the application of lipstick, lip balm or moisturizer. It is more common in women.

Elderly

In the elderly, angular cheilitis is often related to dental problems or edentulousness caused by dentures.

What are the causes of angular cheilitis?

Causes of angular cheilitis include:

• use of creams
• use of lip balm
• use of lipsticks
• use of strong toothpastes
• having a dental pathology or dentures
• sialorrhea (excessive salivation)
• excessive licking of the lips

How does angular cheilitis form?

Angular cheilitis is actually a small ulcer that is caused by the maceration of the skin, and the subsequent growth of bacteria alongside the digestive action of saliva. The ulcer is colonized with many species of bacteria and yeasts that develop due to both the presence of the lesion and the skin’s limited defenses. The ulcer is always moist, and may cause itching or discomfort when opening the mouth. This often makes the individual lick the ulcer in an attempt to relieve this pain, however, this only makes the situation worse. After some time, a small crack will form in the center of the lesion. This crack will cause pain when opening the mouth and will burn when it comes in contact with food.

Treatments to avoid

The origins of angular cheilitis are often misunderstood. Some believe it is caused by the candida yeast, likely because this yeast can sometimes be isolated in sores. While candida is definitely not the cause of angular cheilitis lesions, it can contaminate them. Once the candida has been eliminated from the ulcer, it will still not heal meaning that any treatment for angular cheilitis that contains antifungals should be avoided. Others think that bacteria is the cause of angular cheilitis, because different types of bacteria can also be isolated within the ulcers. However, these are colonizing bacteria and are not the cause of the lesions, meaning that local or systemic antibiotics will not cure cases of angular cheilitis.

DermaClub recommends…

First, any possible triggers of angular cheilitis should be removed wherever possible. Avoid getting the corners of the mouth wet when drinking (use of a straw is recommended) or when brushing the teeth, and ensure food does not come into contact with the ulcers. Avoid licking the area completely. The first step of treatment is to apply Astringent Gel to the ulcers every morning and evening. Astringent Gel reduces the microbial load and dries the lesion of the exudates that lead to excessive moisture. Apply for about one week. The second step of treatment is to apply PEG Ointment to the ulcer to heal and repair the area. The stabilization and closure of ulcers usually occurs after about ten days of using PEG Ointment.