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Angular cheilitis

Angular cheilitis is a common inflammatory condition that affects the corners of the mouth. It is also called angular stomatitis, cheilosis or perleche. It can come on suddenly and last a short time, or it can be an ongoing condition.

What causes angular cheilitis?

Angular cheilitis has several causes, including:

  • excessive moisture from saliva
  • a fungal, bacterial or viral infection
  • an overhanging upper lip that creates deep furrows in the corners of the mouth (marionette lines)
  • dry, chapped lips

Licking your lips a lot can make angular cheilitis worse, and certain factors can make you more likely to develop the skin condition. These include:

  • oral thrush
  • sensitive skin, especially atopic eczema
  • wearing dentures, especially if they do not fit well or you have receding gums
  • nutritional deficiencies e.g. if you have coeliac disease or low levels of iron or vitamin B2
  • certain illnesses or conditions e.g. inflammatory bowel disease or Down’s syndrome
  • retinoid medication e.g. isotretinoin for acne or acitretin for psoriasis

What are the symptoms of angular cheilitis?

Angular cheilitis usually causes skin changes at the corners of the mouth. These changes include:

  • painful cracks
  • redness
  • oozing and crusting
  • blisters
  • bleeding

In some cases, angular cheilitis may lead to an infection, such as impetigo or thrush in the skin surrounding your mouth and elsewhere.

How is angular cheilitis diagnosed?

A doctor will usually diagnose angular cheilitis based on your symptoms, medical history and an examination of your mouth. In some cases, they may also swab the corners of your mouth (and sometimes the inside of your mouth) to check for bacteria, fungi or viruses that may be causing your symptoms.

What is the treatment for cheilitis?

Angular cheilitis often needs no treatment and gets better on its own in time.

If there is an infection, it will usually be treated with an antifungal, antiseptic or antibiotic cream or ointment, depending on the type of infection.

This is typically followed by treatment with a barrier (waterproof) cream or petrolatum, which should be applied often (especially at night) to help protect the skin from moisture.

Other treatments that may be useful include:

  • steroid ointments
  • botox injections to smooth out the lines around your mouth
  • nutritional supplements - if you have low levels of specific nutrients
  • implants or injections with fillers to build up the corners of your mouth

It is common for angular cheilitis to recur.

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Dry lips

Look after your skin

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Topical corticosteroids

Stopping smoking: 10 health benefits

Date of last review: 16 June 2020

References:

Cheilitis [Internet]. Uptodate.com. 2020 [cited 3 March 2020]. Available here.

Angular cheilitis | DermNet NZ [Internet]. Dermnetnz.org. 2020 [cited 3 March 2020]. Available here.

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Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.

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