Angular Cheilitis: Causes, Symptoms, and Treatment Options

Angular cheilitis?

Hello, I would like to ask about an issue with my lips.
It started with severe peeling of my lower lip, accompanied by a prickling and burning sensation.
After the skin peeled off, I noticed red spots.
Soon after, my upper lip also began to peel and develop red spots, and both the inner sides of my lips were covered with a white film.
This lasted for about a week, after which small blisters appeared at the edges of both lips, causing some itching.
During this time, I consulted three dermatologists, who said it did not resemble simple herpes or a candidiasis infection.
They prescribed anti-inflammatory medication and an oral ointment, but there was no improvement.
The condition has persisted for half a month now; the blisters have stopped forming, but the peeling has not improved, and both my upper and lower lips continue to peel repeatedly.
There are also slight pinpoint areas of bleeding on the inner sides of my lips.
Later, I visited a dentist, who found no issues with my teeth but was also unsure of the cause, merely speculating it could be angular cheilitis.
Although I was given an oral ointment to apply, there has been no noticeable effect.
I have never experienced this condition before, and I still do not know what disease this is.
The medications I have applied do not seem to work.
What should I do?

Xiao Mian Xian, 20~29 year old female. Ask Date: 2006/05/10

Dr. Zeng Guanghui reply Dentistry

Ulcerative lesions in the oral mucosa may be caused by recurrent aphthous ulcers (commonly known as canker sores), viral infections (such as herpetic stomatitis), or long-term irritation from physical factors (such as sharp edges of teeth or ill-fitting dentures), or malocclusion.
Recurrent aphthous ulcers may be triggered by autoimmune disturbances or excessive psychological stress, while viral infections are often accompanied by vesicular symptoms.
Physical factors may present with recurrent trauma to the oral mucosa.
It is recommended to consult an oral medicine specialist for further diagnosis and treatment.

Reply Date: 2006/05/10

More Info

Angular cheilitis, also known as angular stomatitis or perleche, is a condition characterized by inflammation and cracking at the corners of the mouth. It can be quite uncomfortable and may lead to further complications if not addressed properly. Understanding the causes, symptoms, and treatment options for angular cheilitis is crucial for effective management.

Causes
Angular cheilitis can arise from various factors, including:
1. Fungal Infections: Candida species are often implicated, especially in individuals with compromised immune systems or those who wear dentures.

2. Bacterial Infections: Staphylococcus aureus can also be a contributing factor.

3. Nutritional Deficiencies: Deficiencies in vitamins, particularly B vitamins (like riboflavin, niacin, and B12) and iron, can lead to angular cheilitis.

4. Irritation: Excessive saliva accumulation, often due to habits like lip licking or drooling, can irritate the corners of the mouth.

5. Underlying Health Conditions: Conditions such as diabetes, inflammatory bowel disease, or autoimmune disorders can predispose individuals to angular cheilitis.

6. Allergic Reactions: Allergies to certain dental products or lip balms can also trigger symptoms.

Symptoms
The symptoms of angular cheilitis typically include:
- Cracking and redness at the corners of the mouth
- Pain or discomfort, especially when opening the mouth
- Dryness and peeling of the lips
- Formation of blisters or sores
- Possible bleeding from the affected areas
In your case, the progression from severe peeling and burning sensations to the development of blisters and slight bleeding suggests a persistent inflammatory process, which may not solely be angular cheilitis but could involve other dermatological conditions or infections.

Treatment Options
The treatment for angular cheilitis focuses on addressing the underlying causes and alleviating symptoms:
1. Topical Treatments: Antifungal creams (like clotrimazole or miconazole) or antibacterial ointments (like mupirocin) may be prescribed if a fungal or bacterial infection is suspected.

2. Hydration and Moisturization: Keeping the lips moisturized with emollients can help prevent further cracking and irritation.

3. Nutritional Support: If nutritional deficiencies are identified, dietary adjustments or supplements may be necessary.

4. Avoiding Irritants: Identifying and avoiding potential irritants, such as certain dental products or allergens, can help reduce symptoms.

5. Oral Hygiene: Maintaining good oral hygiene and regular dental check-ups can prevent secondary infections.

Next Steps
Given that your symptoms have persisted for over a month and have not responded to initial treatments, it may be beneficial to seek a second opinion from a dermatologist who specializes in oral conditions. They may consider performing a biopsy or other diagnostic tests to rule out conditions such as:
- Lichen Planus: An inflammatory condition that can affect the oral mucosa.

- Contact Dermatitis: An allergic reaction that could be contributing to your symptoms.

- Herpes Simplex Virus: Although initially ruled out, a more thorough evaluation may be warranted.

In the meantime, continue using any prescribed topical treatments and maintain good lip care. If you experience worsening symptoms or new developments, do not hesitate to seek immediate medical attention.
In summary, while angular cheilitis is a common condition, your case may involve additional complexities that require a comprehensive evaluation and tailored treatment plan.

Similar Q&A

Effective Treatments for Angular Cheilitis: Relief and Remedies

Hello Doctor, it seems that I have developed angular cheilitis recently. There is a sore at the corner of my mouth, and around the sore and on my lips, there are red, itchy bumps. The sore hurts when I open my mouth, and it feels dry and sticks together when my mouth is closed, c...

Dr. Wu Yuxin reply Dermatology
If there is no infection, it is recommended to apply petroleum jelly every 2 hours. The lesions that are becoming increasingly numerous and itchy are concerning, and without seeing the lesions, it is difficult to determine the exact issue. If this is very bothersome, please seek ...

Understanding Angular Cheilitis: Symptoms, Treatment, and Contagion Risks

Hello, Doctor! Could you please explain what angular cheilitis is? I have abnormal skin around the corners of my mouth, and after researching online, it might be angular cheilitis or perioral dermatitis. How can I differentiate between the two? If it is angular cheilitis, how sho...

Dr. Wu Yuxin reply Dermatology
Your question is unclear. Would you like to seek a consultation to clarify your condition?

Can You Use Oral Ointment for Angular Cheilitis?

Cracking at the corners of the mouth seems to be angular cheilitis. Can I use [Shu Kou Yan] oral ointment? Is the yellowish fluid resembling tissue fluid a sign of infection?

Dr. Wu Yuxin reply Dermatology
Without seeing the lesion, I cannot recommend medication. I suggest you consult a nearby dermatologist for evaluation and treatment.

Unexplained Swelling and Redness at the Corners of the Mouth

My mother is about 53 years old, and for the past few months, the corners of her mouth have been red and swollen. It doesn't itch. She has been drinking fresh juice, which sometimes helps, but other times the condition continues to reappear. I would like to know what might b...

Dr. Cai Jueren reply Family Medicine
Angular cheilitis, referred to as "stomatitis" in Taiwanese, is characterized by redness, swelling, or ulceration at the corners of the mouth, and may sometimes lead to skin fissures. This condition is often accompanied by pain or a burning sensation, prompting patients...