Healthy Corners of the Mouth – Angular Cheilitis

Angular cheilitis is a skin infection or inflammation found at the corners of the lips or around the lips.  It is due to fungus (candida) or bacteria (Staphylococcus) that are able to thrive because of excessive moisture at the corners of the mouth or a microbial imbalance.  Other risk factors include diabetes, people undergoing head and neck radiation treatment, and the immunocompromised. People suffering from angular cheilitis may also have problems with deficiencies in iron, B12, and folate, as well as drooping of the corners of the mouth that promote a moist environment in facial wrinkles.  This drooping of the mouth may be due to tooth loss, which allows the cheeks to sink in; poor fitting dentures that don’t create a “full” facial form; and perhaps even the aging process in combination with deficiencies mentioned earlier. How do you know if you suffer from angular cheilitis?  It is found at the corners of the mouth.  It presents as a red, rash-like spot with tenderness, cracking of the skin and corners of the mouth, and sometimes ulceration. Angular cheilitis photos.  Notice the redness at the corners of the Mouth.

Prevention

Dentures may act as a reservoir of Candida (fungus) and bacteria.  Try soaking dentures overnight in a solution made up of 10 parts water and one part household bleach.  If you have a partial denture with a metal base, the bleach often discolors the metal.  Instead of bleach try using chorhexidine mouthrinse. If the cause is due to poor fitting dentures then you may be able to have a dentist make a new denture.  One preventive/treatment method for wrinkles can be prosthetic lip fillers (called dermal fillers) that plastic surgeons can place.  By filling the lip it often stretches wrinkles and eliminates a reservoir for moisture.

Treatment

Treatment of angular cheilitis usually involves topical antifungals such as nystatin, clotrimazole, or econazole.  Combinations of topical antifungal and topical steroid can also be prescribed, such as Mycostatin and triamcinolone or iodoquinol and hydrocortisone.  In cases where topical ointments are not sufficient, oral antifungals may be used. If you or someone you know suffers from these sores at the corners of the lip, call us or your dentist to schedule a consultation appointment.