Chronic Angular Cheilitis: Causes, Symptoms, and Treatment Options

Angular cheilitis issues?

Hello, I am currently 17 years old and have been experiencing angular cheilitis since I was about 2 or 3 years old.
I have visited a dermatologist at a clinic, and the doctor told my parents that it would improve as I grew older.
However, it has been over a decade, and the condition continues to recur without disappearing, varying only in severity.
I also experience dry lips and often have a lot of dead skin on my lips, and sometimes I deal with cracking issues.
I used to apply Vaseline for a while, but using too little was ineffective, and using too much caused redness and swelling.
I do not have a habit of licking my lips, I do not eat spicy food, and no one else in my family has similar issues.
I would like to ask for some advice from a physician.
Thank you!

Nìmíng, 10~19 year old female. Ask Date: 2023/08/09

Dr. Wu Yuxin reply Dermatology

Is the frequency of applying Vaseline sufficient? It is recommended to apply it at least every 2 hours.
The detailed reason will still need to be confirmed by examining the skin lesions.

Reply Date: 2023/08/09

More Info

Chronic angular cheilitis, also known as angular stomatitis, is a condition characterized by inflammation and cracking at the corners of the mouth. It can be a frustrating and persistent issue, especially when it has been ongoing for many years, as in your case. Understanding the causes, symptoms, and treatment options is crucial for managing this condition effectively.

Causes
Angular cheilitis can arise from a variety of factors, often involving a combination of causes:
1. Nutritional Deficiencies: Deficiencies in vitamins, particularly B vitamins (such as riboflavin, niacin, and B12) and iron, can contribute to the development of angular cheilitis. These nutrients are essential for maintaining healthy skin and mucous membranes.

2. Fungal or Bacterial Infections: The corners of the mouth can become a breeding ground for yeast (Candida) or bacteria (such as Staphylococcus aureus), especially in individuals with a compromised immune system or those who wear dentures.

3. Irritation and Trauma: Repeated licking of the lips, excessive moisture, or irritation from dental appliances can lead to inflammation. Additionally, habits such as biting the lips or corners of the mouth can exacerbate the condition.

4. Skin Conditions: Conditions like eczema or psoriasis can also manifest at the corners of the mouth, leading to similar symptoms.

5. Underlying Health Issues: Chronic conditions such as diabetes or immune disorders can predispose individuals to angular cheilitis due to altered skin integrity or immune response.

Symptoms
The primary symptoms of chronic angular cheilitis include:
- Redness and inflammation at the corners of the mouth
- Cracking or fissuring, which can be painful
- Dryness and peeling of the lips
- Discomfort or pain when opening the mouth or eating
In your case, the presence of dry lips and dead skin could indicate that the condition is exacerbated by environmental factors or underlying skin issues.

Treatment Options
1. Topical Treatments:
- Antifungal Creams: If a fungal infection is suspected, antifungal creams such as clotrimazole or miconazole can be effective.

- Antibiotic Ointments: For bacterial infections, topical antibiotics like mupirocin may be prescribed.

- Hydration: Applying emollients like petroleum jelly or lanolin can help keep the area moisturized. However, it's essential to find a balance, as too much can lead to irritation.

2. Addressing Nutritional Deficiencies:
- A healthcare provider may recommend dietary changes or supplements to address any vitamin or mineral deficiencies. Foods rich in B vitamins and iron should be included in your diet.

3. Avoiding Irritants:
- Identifying and avoiding potential irritants, such as certain lip products or foods that may cause reactions, is crucial.
4. Maintaining Oral Hygiene:
- Good oral hygiene practices can help prevent infections. Regularly brushing your teeth and maintaining clean lips can reduce the risk of irritation.

5. Consultation with Specialists:
- If the condition persists despite treatment, it may be beneficial to consult with a dermatologist or an allergist. They can provide further evaluation and may conduct tests to rule out underlying conditions or allergies.

6. Lifestyle Modifications:
- Staying hydrated and avoiding habits that may irritate the area, such as licking your lips or using harsh soaps, can also help manage symptoms.

Conclusion
Chronic angular cheilitis can be a challenging condition, especially when it persists over many years. It is essential to take a comprehensive approach to treatment, addressing potential underlying causes and symptoms. If you haven't already, consider revisiting a healthcare provider for a thorough evaluation and tailored treatment plan. With the right approach, you can find relief from this condition and improve your quality of life.

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