Overview
Angular cheilitis is a common skin condition which can cause cracked and painful sores in the corners of the mouth. People tend to confuse angular cheilitis with cold sores. Cold sores can be contagious, whereas angular cheilitis is not contagious.
Angular cheilitis can cause inflammation and painful canker sores. Perleche and angular stomatitis are the other names for angular cheilitis. Angular cheilitis can occur on one side or both sides of the mouth.
When a person gets angular cheilitis, their lips tend to become dry and cause discomfort. It can give a burning sensation and also gives you a bad taste in your mouth.
The angular cheilitis can cause major discomfort, which can lead to pain when you consume any kind of food. This can make you lose weight and cause a deficiency of nutrients.
Symptoms of Angular cheilitis
The common symptoms of angular cheilitis are listed below.
Bleeding
Angular cheilitis usually starts as dry patchy skin. When the skin becomes extremely dry and irritated, it can lead to cranky skin.
The cranky skin may progress and become swollen, which can cause sores. These sores, when further infected, can lead to bleeding.
Swollen
There are many reasons for the skin to become swollen. The saliva gets stranded in the corners of the mouth. The saliva contains an enzyme which acts on the soft skin tissues.
This enzymatic action can lead to cracked and damaged skin, which appears to be swollen.
Another reason for swollen skin is when there is continuous moisture in the corners of the lips, it can become a site for bacterial growth and infection. These bacterial infections can cause sores. Some of the common species that cause infection are Candida yeast and Staphylococcus species.
Blistered
Some people tend to drool while they sleep. This leads to saliva flowing out of the mouth unintentionally. When moisture is retained in the skin for a longer time, it can lead to infections. These infections can result in blisters.
Painful and itchy
Angular cheilitis can cause painful and itchy symptoms when an infection is caused due to bacterial species.
Lack of taste
When sores are caused near the corners of the mouth, it can lead to difficulty in consuming foods. It causes a burning sensation which can lead to loss of appetite.
Oral yeast infection
Angular cheilitis can cause yeast infection in the damaged skin. The moisture will be retained for a long time, which can lead to oral yeast infection.
Deep cracks (fissures)
Angular cheilitis can cause deeply cracked skin with permanent fissures near the corner of the mouth.
What causes Angular cheilitis?
Saliva retention is the primary cause of angular cheilitis. When the saliva gets stranded in the corners of the mouth, and when it dries, it causes the skin to crack.
When you try to lick the cracked corners of the mouth, the moisture can be a perfect place for the outcome of fungal infections, which can cause further complications.
In most cases, overexposure to moisture is the common cause of angular cheilitis. The digestive enzymes present in the saliva can damage the skin and lead to sores.
The broken skin can be invaded and colonised by the Candida albicans species. Sometimes, it can lead to superinfection of strep and staph infection which can invade the broken tissue.
These bacterial infections can slow the healing process and lead to tissue inflammation, and completely inhibits the process of wound healing.
Risk factors of Angular cheilitis
Angular cheilitis can occur to anyone who often drools in their sleep. But commonly can be seen in aged people. Their skin can become significantly loosened when they age and lose stiffness. This can increase the risk of angular cheilitis.
Poor-fitting dentures
Poor-fitting dentures can cause angular cheilitis. If the dentures are loosened or ill-fitted, it can cause an increase in the risk of angular cheilitis. The loosened dentures can rub against the corners of the mouth and lead to blisters.
Smoking
According to NCBI, smoking increases the risk of Candida species infection which leads to further complications like angular cheilitis.
Usage of retinoid products
Retinoids are compounds that are derived from vitamin A, which is used to reduce the external signs of ageing and wrinkles in the skin. Usage of such creams can increase the risk of angular cheilitis.
Weak immune system
People with weak immune systems and Diabetes are more susceptible to yeast infections. This can further develop as angular cheilitis.
Over age
Aged people are more vulnerable to these infections. They have wrinkled skin, which can cause saliva retention near the corners of the mouth. This leads to an increased risk of angular cheilitis.
Sudden weight loss
When there is sudden weight loss, the skin can lose tightness, which leads to sagging. This sagging can increase the risk of angular cheilitis.
Diagnosis of Angular cheilitis
The diagnosis of angular cheilitis will take place by physical examination. Your healthcare professional will examine your mouth sores physically and look for inflammation and cranky skin.
You will also be enquired about your existing health conditions. If there are any comorbidities, then the treatment will be decided accordingly.
How is Angular cheilitis treated?
The treatment of angular cheilitis will depend on the diagnosis. If the patient has any health condition, it will be treated with the respective medication and creams.
Topical antiseptics
The primary treatment for angular cheilitis will be a topical application of antifungal ointments that contain nystatin, clotrimazole or econazole.
Antifungal creams are used to control the infection and keep the sores from spreading. Topical creams are also recommended to control dryness and reduce inflammation.
Antibiotics
Angular cheilitis that is caused by bacteria will be treated with an antibiotic. The antibiotic can be a tablet or a topical application cream.
Some of the common antibiotics used for treatment include mupirocin and fusidic acid.
There are many over-the-counter drugs available to treat redness and inflammation of the corners of the mouth. There are many broad-spectrum antibiotics available to treat these mouth sores.
The ointment can be applied with a clean cotton swab. However, before using any ointments, it is recommended to consult your doctor. Your doctor might also prescribe some oral antibiotics to control the growth of infection caused by bacterial species.
Dietary changes
When a person has an infection, it is important to consume foods that are rich in iron and B vitamins. These nutrients help fasten the process of healing.
These mouth sores can affect a person’s appetite. The person may even tend to have bad taste. So, this can lead to nutrient deficiency. Consumption of foods that are rich in vitamins and minerals is important to cope with infection and fight against it.
Ointments/cream
Topical steroids are available to treat the mouth sores that cause discomfort. These ointments can also reduce inflammation and redness. Make sure you keep your lips moisturised with lip balms.
How to prevent Angular cheilitis?
Dry skin can lead to the breaking up of the skin. As a result, there can be bleeding. So always keep your skin moisturised.
Your saliva can also play a major role in angular cheilitis. When your lips get dry, you tend to lick it and moisturise it. This can become a breeding ground for bacterial infection and further complicate the infection. So, avoid licking your lips. Instead, use a lip balm or moisturiser.
Keep yourself away from all types of tobacco products. The usage of these products can also lead to angular cheilitis.
Make sure you are aware of the cosmetic products you are using. Do not use any expired products, as these may aggravate the condition.
When to consult a doctor?
Consult your doctor if these mouth sores become painful and cause major discomfort. If these mouth sores spread to the lips, they would require immediate medical attention.
Conclusion
Angular cheilitis is not contagious, and in most cases, it can be treated at home with an over-the-counter ointment.
Angular cheilitis can be caused due to various underlying health conditions like dry skin and nutrient deficiency.
With proper nutrition, these mouth sores can be avoided. Also, do not lick your lips often. Instead, use a moisturiser or lip balm.
