Angular Cheilitis
Get the right treatment for your sore lips.
Angular cheilitis is a common skin condition that causes inflammation at the corners of your mouth. Although it’s relatively easy to treat, it’s often left to worsen.
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Angular cheilitis is inflammation at the corners of the mouth where your lips meet. It can be caused by a range of things like infections, ill-fitted dentures or nutritional deficiencies. This leads to an excessive amount of saliva on the corners of your mouth, which creates an environment for bacteria and fungi to thrive in.
If you have angular cheilitis, your lips will become sore, cracked and red at the corners. They may also bleed for some people. Treatment isn’t always needed, but it can become severe if left for too long, leading to permanent scarring and discolouration. And the treatment you get typically depends on what’s causing your symptoms, so it can vary for each person.
Anyone can get angular cheilitis. But it’s more common in people who overexpose their lips to saliva, which can cause infections. So In younger children, for example, it’s commonly associated with habitual lip licking, thumb sucking, or biting the corners of the mouth. In adults, smoking and ageing can make the corners of your lips sag, which also increases saliva in the area. Similarly, 25% of people with Down syndrome have angular cheilitis, due to the protruding tongue which causes drooling. People who wear dentures are also at a high risk of getting it. This is because of the folds created by dentures which hold saliva.
In a lot of people, angular cheilitis is a symptom of another underlying condition. This can be because of an allergic reaction to certain foods and creams, or because of irritants like dental braces. There’s also a higher risk of getting it if you have an iron and vitamin B deficiency. The risk also increases for people who have HIV or a weakened immune system.
Angular cheilitis and cold sores can get confused with one another, but they’re two different lip conditions. Cold sores are typically found on one side of the lips and form painful blisters, whereas angular cheilitis is the inflammation on the corners of the mouth. Cold sores are also caused by a virus, herpes simplex, whereas angular cheilitis can be caused by fungi, bacteria or an underlying condition. It’s important to differentiate between the two as they are treated differently.
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When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
Angular cheilitis is characterised by inflammation on the corners of the mouth where your lips meet. Ill-fitted dentures, smoking and regular lip licking all lead to excessive saliva at the corners. This can cause inflammation and eczema, which allows microorganisms to colonise and infect the area.
Angular cheilitis is commonly caused by a fungal infection, Candida (a type of yeast). Although Candida is present in every healthy body, too much of it can be bad. And it’s for this reason that diabetic people are more susceptible to getting it as the yeast ‘feeds’ on the increased amount of glucose in your body. Diabetes also causes a weakened immune system, making you less able to fight off the infection.
Bacterial infections with an organism called Staphylococcus aureus are also responsible for 20% of angular cheilitis cases. Like with Candida, this bacteria is commonly found in the body, specifically the nose, but when it spreads to the lips it can cause angular cheilitis. However, in 60%-75% of cases, it’s a combination of both organisms (Candida and S. aureus).
Staging of angular cheilitis is not normally important, but it can help decide what treatment should be given. There are 4 main types:
Type 1 - A small scar or tear near the corner of your mouth. You’ll feel some tightening when you try to smile or open your mouth wide. During this, treatment is not usually needed.
Type 2 - Tears that are longer and have more depth than the ones in type 1, causing more discomfort and tightness.
Type 3 - Similar to type 2, but there are more tears which have spread from the corner of your mouth. This will be painful when you try to eat, talk or move your mouth.
Type 4 - Scars and tears with redness and inflammation on the skin above your lips. You will have sore lips which will be very sensitive. Your doctor might prescribe steroids if you have type 4..
Angular cheilitis is primarily characterised by inflammation on the corners of the mouth. However as it continues to persist, you may experience the following symptoms:
The lips and skin around the area may look red and irritated. After bleeding, you might get whiteness around the corners, dryness and flaky skin. If you have any of these symptoms, it’s best to get treatment as soon as possible, as delaying it can often make it worse.
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
The treatment for angular cheilitis will vary depending on the cause. If angular cheilitis is caused by Candida, then an antifungal medication will be prescribed. An antifungal cream like Daktarin can kill the fungi and prevent them from growing. Daktarin is especially good as it has both antibacterial and antifungal properties. Topical steroids may also be prescribed by your doctor if you have serious inflammation. This is rare though, and they’re only prescribed if necessary. Some medications are available without a prescription, but it’s important to check with your doctor before using them. With consistent use of medication, angular cheilitis can be treated within two weeks.
If the primary cause is ill-fitted dentures, you need to go to your dentist. Ill-fitted dentures can result in your mouth becoming too tightly closed. This means your jaws are close together, which creates folds at the corners of your mouth. Saliva and microorganisms collect in these folds which then cause angular cheilitis. It’s important to get your dentures fitted correctly and regularly maintain good oral hygiene. This includes rinsing and soaking your dentures every day.
Dietary changes can also resolve angular cheilitis if it's caused by a nutritional deficiency. If you have low iron, try eating more iron-rich foods such as red meats, beans and nuts. If you have a vitamin B deficiency, eat foods like broccoli, brussels sprouts and chickpeas. Taking nutritional supplements can also increase your iron and vitamin B levels.
To reduce the risk and recurrence of angular cheilitis, it's essential to adopt healthy lifestyle habits. Quitting smoking and correcting children's habits such as excessive thumb-sucking or lip-licking will help to prevent it. It’s also important to maintain good oral hygiene. Frequent brushing, and using a mouthwash containing chlorhexidine, can both help to kill bacteria and fungi.
There’s no best treatment for angular cheilitis. This is because it varies depending on your underlying cause, such as poor oral hygiene, frequent lip licking or nutritional deficiencies. This means different treatments will be better suited for different people. If you’re unsure what treatment to choose, we can help you decide. Just send a message (or a picture), to our clinicians and they’ll help you find what’s best for you.
No, if angular cheilitis isn’t severe, then treatment isn’t usually needed. But choosing to ignore it and delay treatment can lead to permanent scarring and discolouration. So it’s best to treat it as soon as possible. With correct management and medication, you can treat it within 2 weeks.
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
Have something specific you want to know? Search our info below, or ask our experts a question if you can’t find what you’re looking for.
Prevalence of Angular Cheilitis and Assessment of Factors Associated with It - A Retrospective Study. Indian Journal of Forensic Medicine & Toxicology, 14(4), pp.5947–5954.
Angular Chelitis in Complete Dentures. J. Pharm. Sci. & Res., 7(8), pp.598-599.
Face dermatitis. Dermatology for the Primary Care Provider, pp.23–55.
Angular Chelitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2023 Jan.
Angular cheilitis: A clinical and microbial study. Indian Journal of Dental Research, 28(6), p.661.
Angular Cheilitis - An Updated Overview of the Etiology, Diagnosis, and Management. International Journal of Dentistry and Oral Science, p.1600.
Review on iron and its importance for human health. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences, 19(2), pp.164–174.
B Vitamins and the Brain: Mechanisms, Dose and Efficacy—A Review. Nutrients, 8(2), p.68.
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