Angular Cheilitis

What is angular cheilitis?

Angular cheilitis is a common inflammatory skin condition. It affects one or both corners of your mouth and causes irritated, cracked sores. Although painful, angular cheilitis usually isn’t serious.

Other names for angular cheilitis include angular stomatitis and perleche. Sometimes people confuse angular cheilitis with cold sores. But cold sores are a separate condition caused by a herpes virus. Cold sores are contagious; angular cheilitis is not.

Who gets angular cheilitis?

Angular cheilitis tends to be most common in the very old and very young. Elderly people may wear dentures or have sagging skin at the corners of their mouth that contributes to dry mouth corners. Pacifiers, thumb-sucking and drooling can irritate infants’ mouths.

What causes angular cheilitis?

Saliva collects at the corners of the mouth and causes dryness. Very dry skin in this area can lead to angular cheilitis. Over time, the dry skin may crack open. Sometimes bacteria or fungi get into the cracks, which can cause inflammation or an infection.

Causes of dry, cracked lip corners that can trigger angular cheilitis include:

• Atopic dermatitis or eczema.
• Dentures that don’t fit.
• Drooling during sleep.
• Fungal or yeast infections in the mouth, such as thrush.
• Misaligned teeth.
• Skin allergies.
• Sucking on a thumb or a pacifier.
• Wearing a face mask.

What are the risk factors for angular cheilitis?

People of any age, sex or ethnicity can develop angular cheilitis. Some factors that may increase your risk, include:

• Chronic health conditions, such as diabetes or inflammatory bowel disease (IBD).
• Down syndrome, which can cause dry, drooping skin on the face.
• Immune system disorders, such as HIV.
• Low levels of B vitamins, iron or protein.
• Rapid weight loss.
• Skin wrinkles due to aging.
• Smoking.
• Stress.

What are the symptoms of angular cheilitis?

Angular cheilitis can cause the following symptoms at the corners of your mouth:

• Bleeding.
• Blisters.
• Cracking.
• Crusting.
• Maceration (soggy, lighter-colored skin).
• Redness.
• Swelling.

How is angular cheilitis diagnosed?

Your primary healthcare provider or a dermatologist (provider specializing in skin conditions) can diagnose angular cheilitis. They will:

• Check your symptoms.
• Perform a physical exam.
• Review your medical history.

They may do a mouth swab to test for viruses like herpes or fungal infections. Blood tests check for illnesses or nutritional deficiencies.

Are mouth sores always the result of angular cheilitis?

Cracked lip corners aren’t always the result of angular cheilitis. There are many conditions that can cause lip or mouth sores, including:

• Actinic keratosis, or rough skin patches that can be precancerous.
• Herpes simplex virus type 1 (HSV-1), also called fever blister or cold sores.
• Leukoplakia, white patches in your mouth that can be precancerous.
• Oral cancer, which is cancer in any part of the mouth.
• Oral lichen planus, a disease of the lining of the mouth.
• Syphilis, a sexually transmitted infection (STI) that can cause red sores on the mouth or genitals.

What is the treatment for angular cheilitis?

Your treatment plan depends on the cause of the angular cheilitis. It may include:

• Antibiotics: Oral (by mouth) or topical (on the skin) antibiotics treat bacterial infections.
• Dental work: Dentures or other mouth hardware should fit correctly. Misaligned teeth or a bite may improve with braces, retainers or headgear.
• Dietary changes: Eating foods rich in protein, iron and B vitamins can clear up problems caused by a poor diet or lack of nutrients.
• Ointments or creams: Antifungal creams or topical steroids relieve swelling and pain from cracked corners of the mouth. Lip balm or petroleum jelly can keep your mouth moisturized and protected.

How can I prevent angular cheilitis?

Some causes of angular cheilitis are unavoidable. But you can reduce your risk by:

• Avoiding contact with skin allergens and irritants.
• Eating a healthy diet and drinking plenty of water.
• Keeping your lips moisturized.
• Not smoking or using tobacco products.
• Not licking your lips.
• Not using expired cosmetics.

What is the outlook for someone with angular cheilitis?

Angular cheilitis usually isn’t serious. The condition often goes away about two weeks after starting treatment. Severe angular cheilitis can result in scarring or weak, thin skin if it isn’t treated.

Angular cheilitis can come back after treatment. For some people, the condition is chronic (ongoing). They may need to manage the condition for the rest of their lives.

What can I do to make living with angular cheilitis easier?

As you treat the cause of angular cheilitis, you can reduce pain and swelling by:

• Applying ice or a cool compress to the corners of your mouth.
• Avoiding skin irritants like harsh toothpastes, mouthwashes and spicy foods.
• Staying out of the sun and extreme cold or wind.
• Using ointments or lip balm to keep the corners of your mouth moisturized.