Over the counter antifungal cream for angular cheilitis

You might only experience these symptoms on one side of your mouth, or they might appear on both sides. Although these symptoms are usually only noticeable in the area around your mouth, in extreme cases they can extend all the way to your cheek.

Here’s what could be causing your angular cheilitis:

Angular cheilitis doesn’t have one specific cause, but a few things can make you more susceptible. A variety of factors can influence someone’s odds of developing angular cheilitis.

Dry mouth: People with dry mouth, aka xerostomia, have a higher likelihood of developing these mouth cracks.

Dehydration: Dehydration is one of the major causes of xerostomia. People with certain health conditions, like uncontrolled diabetes, are particularly susceptible to increased urination and dehydration and, therefore, are more likely to develop angular cheilitis.

Medications: Medications that can irritate the skin, like the acne drug isotretinoin, or treatments like chemotherapy can also cause irritation and dryness that leads to angular cheilitis.

Autoimmune conditions: Xerostomia is also a hallmark of the autoimmune condition Sjogren’s syndrome. Other autoimmune disorders, like lupus, Crohn’s disease, and ulcerative colitis, can trigger autoimmune changes that lead to a higher incidence of angular cheilitis.

Nutritional deficiencies: A lack of sufficient iron can lead to anemia, which researchers have connected with angular cheilitis. One prevalent hypothesis is that an iron deficiency can decrease a person’s immunity, though that’s not set in stone. Insufficient intake of some B vitamins and zinc have also been associated with angular cheilitis, potentially because of their roles in keeping the immune system strong.

Down syndrome: The link here could be due in part to what’s known as muscular hypotonia, or a lower than normal muscle tone. It can prompt people with Down syndrome to keep their mouths open and let their tongues protrude, irritating the corners of their mouths.

Age: Many of these risk factors translate into elderly people being most likely to develop angular cheilitis. Elderly people are more likely to experience dry mouth, for example. They also often have compromised immune systems, which makes it more difficult for them to fight off infections, says Dr. Lain. Additional risk lies in age-related changes around their mouths, says Joshua Zeichner, M.D., director of cosmetic and clinical research in dermatology at Mount Sinai Hospital. “When older individuals lose the structural support around the mouth, the corners tend to turn downward, and you develop folds in those corners, where saliva tends to pool,” Dr. Zeichner tells SELF.

Weather: I’m proof that you don’t need to fall into any of the above categories to grapple with angular cheilitis. I had my own random risk factors. For instance, my bout of the condition happened in the winter months, when skin and lips tend to get super dry, according to Dr. Lain.

Oral appliances: My symptoms also coincided with me wearing my nightly retainers again after totally ignoring them for a few years, which is a pretty common cause. “Any kind of appliance you have in your mouth—braces, retainers, or anything else that change the anatomy of your mouth—can affect what happens to your saliva while you sleep,” Dr. Lain says.

How is angular cheilitis treated?

First off, you need an accurate diagnosis. Fortunately, most dermatologists and oral medicine specialists are able to diagnose angular cheilitis right away. “The appearance is pretty characteristic,” Dr. Zeichner says.

Angular cheilitis is a common inflammatory condition that affects the corners of the mouth, known as the oral commissures. It leads to painful, cracked sores that are sometimes confused for cold sores.

Depending on what has caused the condition, angular cheilitis can last a few days or it can be a recurring condition. It is treated with skin ointments, medications, or diet changes.

This article discusses what angular cheilitis is, how it is different from cold sores, symptoms and causes of angular cheilitis, and treatment. It also explains who may be most at risk for the condition.

Also Known As

• Angular stomatitis
• Cheilosis
• Perlèche

What Is Angular Cheilitis?

Angular cheilitis causes the corners of the mouth to become inflamed. This can happen because these areas allow for the collection of saliva. The saliva will then dry out and cause the skin to crack.

Efforts to moisturize the area can sometimes cause further irritation, and extra moisture can lead to a secondary infection. Bacteria like Staphylococcus, as well as Candida yeast, can contribute to angular cheilitis. Frequently, both together can worsen angular cheilitis. Secondary infection can lead to redness, scaling, pain, and fissures.

The severity of angular cheilitis is sometimes classified into subtypes:

• Minor angular cheilitis causes small flaky skin at the corners of the mouth. It might also cause tightness and slight discomfort when the mouth is opened wide.
• Mild angular cheilitis causes discomfort and tightness at the oral commissures. It may also cause flaky skin and redness, along with discomfort when the mouth is opened wide.
• Severe angular cheilitis causes pain and discomfort with talking, eating, and anything that requires you to open your mouth. You may also notice lesions at the corners of your mouth that will not heal using ointments like Neosporin or a Chapstick balm.

Chronic Angular Cheilitis

People with chronic angular cheilitis will experience severe pain, discomfort, and other symptoms. They have cyclic episodes of healing, followed by symptoms that return in response to fungal and yeast infections, drooling during sleep, allergies, and other causes.

Angular Cheilitis vs. Herpes Simplex 

Cold sores, caused by the herpes simplex virus (HSV), can cause symptoms similar to angular cheilitis. Both conditions cause the corners of the mouth to be red, raw, and inflamed. But oral herpes leads to a cold sore (a fluid-filled blister) or a cluster of blisters.

HSV typically involves the vermillion border of the upper or lower lip (not usually the corner). This is the margin of the lip between the colored area and the rest of the facial skin.

Angular cheilitis only affects the skin at the corners of the mouth, and it does not cause fluid-filled blisters to occur. Cold sores are also much more common than angular cheilitis.

Is Angular Cheilitis a STI?

No. Angular cheilitis is not contagious, nor is it transmitted by direct contact. Angular cheilitis leads to irritated skin that can be vulnerable to infection, but an STI is not the cause of the condition.

Angular Cheilitis Symptoms

The symptoms of angular cheilitis affect the oral commissures. It can be painful. Symptoms can range from mild to severe and affect one or both corners of the mouth.

The following symptoms can affect the corners of the mouth:  

• Flaky skin
• Skin tightness and discomfort
• Bleeding
• Blistering
• Fissures (cracking and splitting of the skin)
• Crusting
• Soggy, lighter-colored skin
• Redness
• Soreness
• Swelling
• Lesions or sores
• Skin pain

Some people might also experience:  

• A bad taste in the mouth
• Burning of the lips and mouth
• Dry or chapped lips
• Pain with eating

Angular Cheilitis Causes

Fungal and bacterial infections are the most common cause of angular cheilitis. Bacterial or Candida infections are common recurring causes.

Bacterial infections, including staphylococcal and beta-hemolytic streptococcal, are common causes of angular cheilitis in children.

This condition is often seen in biological males, older people, and those living with certain health conditions, including:

• Atopic dermatitis (an inflammatory skin condition)
• Conditions that cause macroglossia (a disorder in which the tongue is larger than normal), such as Down syndrome and congenital hypothyroidism
• Lupus erythematosus (an autoimmune condition causing inflammation that damages connective tissue)
• Erythema multiforme (a skin reaction triggered by an infection or certain medications)
• Crohn’s disease (an inflammatory bowel disease)
• Sarcoidosis (a systemic inflammatory disease that produces clumps of cells called granulomas)
• Diabetes (a condition in which blood sugar levels are high)
• Inflammatory bowel disease (IBD), an ongoing inflammation causes diarrhea, abdominal pain, and other symptoms
• Vitamin and mineral deficiencies

Additional causes of angular cheilitis:

• Dentures that don’t fit well
• Drooling during sleep
• Misaligned teeth or poor bite
• Wearing a face mask
• Skin allergies
• Sucking on a pacifier or thumb

If your healthcare provider can’t find the cause of your angular cheilitis, it is called idiopathic angular cheilitis.

Risk Factors

Some people have a higher risk of angular cheilitis. This includes people who:  

• Wear braces or dentures
• Have a lot of saliva
• Have crooked teeth or an unaligned bite
• Have sagging skin at the mouth or lips due to age or weight loss
• Smoke
• Suck their thumb
• Don’t get enough nutrients
• Have certain health conditions that increase the risk of the condition, including diabetes and autoimmune diseases

Risk of Angular Cheilitis in Diabetes

It is not uncommon for people with diabetes to get fungal infections that lead to angular cheilitis. For example, Candida fungi can feed off the blood sugar (glucose) the body uses for energy.

People with diabetes have too much glucose in their blood. Extra glucose can increase the risk of fungal infection. People with diabetes also have weakened immune systems, making it harder for them to fight off different types of infections that lead to angular cheilitis.  

Keeping your blood sugar managed is the best way to prevent bacterial and fungal infections that lead to angular cheilitis. Make sure you are eating well, exercising, not smoking, and taking diabetes medicines correctly.

When to See a Healthcare Provider

It is possible to treat angular cheilitis at home using home remedies like petroleum jelly. However, if symptoms persist or worsen, you should consult a healthcare provider . You should also see your healthcare provider if you have any of the conditions that increase your risk of angular cheilitis, including autoimmune diseases and diabetes.  

To find out whether you have angular cheilitis, your healthcare provider will examine your mouth for cracks, blisters, and swelling. They will also ask you about any underlying conditions you have or habits that might affect your lips and the corners of your mouth.

There are other conditions, like herpes labialis (lip cold sores) and erosive lichen planus (an immune-mediated itchy skin rash), that can cause symptoms similar to angular cheilitis.

The best way to determine the exact condition causing the symptoms is by swabbing the nose and mouth and sending the samples to a lab to test for different kinds of fungus and bacteria.

Angular Cheilitis Treatment

Angular cheilitis is a highly treatable condition. But treatment often depends on the underlying cause and whether an infection is present.  

Fungal Infections 

When angular cheilitis is caused by a fungal infection, it is treated with antifungal creams. Antifungals are considered the first-line treatment for angular cheilitis. Antifungal treatment can clear the infection and keep affected skin areas free from future infections.  

Some of the most common antifungal creams used to treat angular cheilitis are:

• Mycostatin (nystatin)
• Lotrimin (clotrimazole)
• Lotrimin AF (minonazole)
• Extina (ketoconazole) 

Bacterial Infections  

Angular cheilitis caused by a bacterial infection is usually treated with antibiotics—either oral (by mouth) or topical (on the skin). Common angular cheilitis medications that are antibiotics include Bactroban (mupirocin) and Fucidin (fusidic acid).

Other Angular Cheilitis Causes 

Some researchers believe that angular cheilitis is caused by vitamin and mineral deficiencies, including iron, folate, and B vitamins. For example, studies suggest a link between the nutrient absorption problems encountered by people living with IBD and their risk of angular cheilitis.

It is possible that improving these deficiencies can improve symptoms. These deficiencies can be corrected with vitamin and mineral supplements and a balanced diet.  

Keeping skin areas affected by angular cheilitis clean and dry is also important. Do not allow saliva to sit at the corners of the mouth. Lip balms and petroleum jelly can also help to manage cracking, crusting, and swollen skin.  

If ill-fitting dentures or dental problems cause angular cheilitis, refitting dentures or treating dental troubles can help resolve symptoms and prevent recurrences.

Some healthcare providers recommend injectable collagen fillers if droopy lips are to blame for angular cheilitis. Droopy lips can cause the corners of the mouth to turn outward, which makes it easier for saliva to accumulate.

Summary  

Angular cheilitis is an inflammatory skin condition that affects the corners of the mouth, leading to painful, cracked skin. It is sometimes confused with cold sores, but unlike cold sores, angular cheilitis isn’t contagious. Angular cheilitis is usually treatable with antifungal creams, antibiotics, and diet changes.

A Word From Verywell

The outlook for most people with angular cheilitis is usually good. The condition typically goes away within a week or two of starting treatment. But people with chronic angular cheilitis need to manage and treat the condition for the rest of their lives, so be sure to seek out an accurate diagnosis.

Frequently Asked Questions

• How fast does angular cheilitis heal?

  Depending on what has caused angular cheilitis and how the condition is treated, it could take up to two weeks for your skin to heal and for symptoms to dissipate.
  

• Can you get prescription-grade lip balm for angular cheilitis?

  Your healthcare provider can prescribe a prescription-strength lip balm if needed. However, many over-the-counter medicated lip balms can be just as helpful.

• Does angular cheilitis come back?

  Angular cheilitis can return, especially if you do not finish treatment or if the underlying cause isn’t addressed. Severe angular cheilitis can lead to recurrent episodes and will need to be managed for life.
  

What is the best over

What is the fastest way to cure angular cheilitis?

Can I use hydrocortisone cream for angular cheilitis?

Does Lotrimin work for angular cheilitis?