Angular Cheilitis

Angular Cheilitis: A Comprehensive Guide to Causes, Symptoms, and Treatment

Angular cheilitis, also known as perleche or angular stomatitis, is a common inflammatory condition that affects the corners of the mouth. It is characterized by redness, cracking, scaling, and sometimes painful fissures at the angles of the lips. While it may seem like a minor inconvenience, angular cheilitis can significantly impact a person’s quality of life, causing discomfort, self-consciousness, and difficulty eating or speaking.

In this comprehensive guide, we will delve into the causes, symptoms, diagnosis, and treatment options for angular cheilitis. We’ll also provide valuable tips on prevention and self-care to help you manage this condition effectively.

Understanding Angular Cheilitis

Angular cheilitis occurs when the corners of the mouth become inflamed due to a buildup of saliva. This creates a moist environment that is conducive to the growth of bacteria and fungi, leading to infection and inflammation. The condition can affect people of all ages, but it is more common in older adults and those with certain health conditions.

Causes and Risk Factors

Several factors can contribute to the development of angular cheilitis:

• Saliva accumulation: Saliva pooling at the corners of the mouth is a primary cause. This can happen due to various reasons, such as:

  • Overclosure of the mouth: People with dentures, braces, or other dental appliances may have an overclosure of the mouth, leading to saliva buildup.
  • Drooling: Excessive drooling, especially during sleep, can also contribute to the problem.
  • Lip licking: Frequent lip licking can create a moist environment at the corners of the mouth.

• Nutritional deficiencies: Deficiencies in certain vitamins and minerals, such as iron, B vitamins, and zinc, can increase the risk of angular cheilitis.

• Fungal infections: Candida albicans, a type of yeast, is a common culprit behind angular cheilitis.

• Bacterial infections: Bacteria like Staphylococcus aureus and Streptococcus species can also cause or contribute to the condition.

• Dry skin: Dry skin around the mouth can make the corners more susceptible to cracking and inflammation.

• Underlying medical conditions: Certain medical conditions, such as diabetes, autoimmune diseases, and HIV/AIDS, can weaken the immune system and increase the risk of infections, including angular cheilitis.

Symptoms of Angular Cheilitis

The symptoms of angular cheilitis can vary in severity but typically include:

• Redness: The corners of the mouth become red and inflamed.
• Cracking: The skin at the corners may crack or fissure.
• Scaling: The affected area may become dry and scaly.
• Pain or burning: Some people experience pain, burning, or a stinging sensation at the corners of the mouth.
• Crusting: Crusts may form over the cracks or fissures.
• Bleeding: In severe cases, the cracks may bleed.

Diagnosis of Angular Cheilitis

 

Diagnosing angular cheilitis usually involves a physical examination of the mouth and a review of the patient’s medical history. In some cases, the doctor may take a swab of the affected area to identify the specific bacteria or fungus causing the infection.

Treatment Options for Angular Cheilitis

The treatment for angular cheilitis depends on the underlying cause.

• Topical medications:

  • Antifungal creams or ointments: If a fungal infection is present, an antifungal medication like nystatin or clotrimazole may be prescribed.
  • Antibacterial creams or ointments: If a bacterial infection is suspected, an antibacterial cream like mupirocin may be recommended.
  • Barrier creams: Barrier creams or ointments can help protect the skin from saliva and prevent further irritation.
  • Steroid creams: In some cases, a mild steroid cream may be used to reduce inflammation.

• Oral medications:

  • Antifungal medications: If the fungal infection is severe or widespread, oral antifungal medications may be necessary.
  • Antibiotics: Oral antibiotics may be prescribed for bacterial infections.
  • Nutritional supplements: If a nutritional deficiency is contributing to the condition, supplements may be recommended.

• Other treatments:

  • Botox injections: In some cases, Botox injections may be used to reduce saliva production and prevent pooling at the corners of the mouth.
  • Fillers: Dermal fillers can be used to plump up the corners of the mouth and reduce the depth of the creases, making them less prone to saliva accumulation.

Prevention of Angular Cheilitis

Preventing angular cheilitis involves addressing the underlying causes and taking steps to keep the corners of the mouth dry. Here are some preventive measures:

• Good oral hygiene: Brush your teeth twice a day and floss daily to maintain good oral health and prevent bacterial or fungal overgrowth.
• Keep the corners of your mouth dry: Gently pat the corners of your mouth dry after eating or drinking. Avoid licking your lips.
• Use a lip balm: Apply a lip balm regularly to keep your lips moisturized and prevent cracking.
• Address underlying conditions: If you have dentures, braces, or other dental appliances, ensure they fit properly to prevent saliva buildup. If you have any underlying medical conditions, manage them effectively to reduce your risk of infections.
• Eat a balanced diet: Ensure you’re getting enough vitamins and minerals, especially iron, B vitamins, and zinc.

Self-Care Tips for Angular Cheilitis

In addition to medical treatment, several self-care measures can help manage angular cheilitis and promote healing:

• Apply a warm compress: Applying a warm compress to the affected area can help soften crusts and promote healing.
• Avoid irritants: Avoid using harsh soaps, toothpaste, or cosmetics that may irritate the corners of your mouth.
• Stay hydrated: Drink plenty of water to keep your lips and skin hydrated.
• Don’t pick or scratch: Avoid picking or scratching the affected area, as this can delay healing and increase the risk of infection.

When to See a Doctor

If you experience persistent or severe symptoms of angular cheilitis, consult your doctor or a dermatologist for evaluation and treatment. Early diagnosis and treatment can prevent complications and promote faster healing.

Angular Cheilitis in Children

 

Angular cheilitis can also affect children, often due to thumb sucking, pacifier use, or nutritional deficiencies. If your child develops angular cheilitis, consult their pediatrician for appropriate treatment.

Angular Cheilitis and COVID-19

Some studies have suggested a potential link between angular cheilitis and COVID-19. The prolonged use of face masks can create a moist environment around the mouth, increasing the risk of saliva buildup and fungal or bacterial infections. If you develop angular cheilitis while wearing a mask, consult your doctor for evaluation and treatment.

Conclusion

Angular cheilitis is a common but often bothersome condition that can affect people of all ages. By understanding its causes, symptoms, and treatment options, you can take proactive steps to manage this condition effectively and prevent its recurrence. Remember, early diagnosis and treatment are key to promoting faster healing and minimizing discomfort. If you have any concerns about angular cheilitis, don’t hesitate to consult your doctor or a dermatologist for personalized advice and treatment.

Disclaimer: This blog post is intended for informational purposes only and should not be considered a substitute for professional medical advice. Always consult your doctor for diagnosis and treatment of any medical condition.