Angular cheilitis is a condition in which one or both corners of the mouth are inflamed and sore. It is also known as cheilosis, angular stomatitis or perlèche, and is characterized by inflammation of the skin or mouth lining at the mouth corners in the presence of moisture.
It is often associated with the presence of a yeast-type fungus such as Candida or localised bacterial infection.
The very first sign of angular cheilitis is often a slight tightness in one or both corners of the mouth and some discomfort when opening wide.
There then follows redness and soreness and the temptation is to lick the corners of the mouth with the tongue but, unfortunately this only makes matters worse.
The condition can gradually get better by itself, but often tends to get worse if not treated and can make eating and talking quite difficult. There is also the embarrassment of presenting an unattractive face to the world with painful cracks at the corners of the mouth, sometimes with bleeding. It may occasionally spread to adjacent skin areas but is generally confined to the corners of the mouth where the warm moist conditions suit it best.
Angular cheilitis is due to a combination of factors which tend to favour the establishment of a surface infection by bacteria or yeasts such as Candida which are usually present in saliva.
Dribbling from the corners of the mouth is one factor seen mainly in young children and also in the elderly, where the facial height has reduced causing deep wrinkles in the corners of the mouth. This is especially apparent in those without their own teeth or with old or poor fitting dentures.
Deep furrows at the mouth corners from years of smoking can predispose to angular cheilitis, and so can poor general health and/or nutrition.
The following conditions can all tend to make a person more susceptible to the problem;
- celiac disease,
- mineral or vitamin deficiency,
- ulcerative colitis,
- Crohn’s disease,
- HIV/Aids and
- use of corticosteroids or antibiotics.
Some medications for acne or psoriasis can predispose a person, and even pregnancy can be enough to trigger an attack of angular cheilitis – possibly due to the body being subjected to extra stress.
In fact, any illness, localised mouth trauma, or weakening of the immune system can seemingly be enough for bacteria or fungus in the mouth region to suddenly multiply and cause localised soreness.
Treatment and Prevention
Often people mistake angular cheilitis for chapped lips or cold sores and treat the condition inappropriately. It may respond to application of lip balm or Vaseline which prevents moisture contact, but if it doesn’t seem to improve after a few days it is best to try an anti-fungal cream, gel, topical anti-bacterial cream, or medication which your doctor or dentist can advise you about.
Since the mouth has a good blood supply the condition tends to cure fairly quickly in most people, especially if helped by using a suitable anti-fungal agent as a gel or cream.
In the absence of proper angular cheilitis treatment, however, it can recur and even keep coming and going for months.
Some health experts may advocate nutritional supplements such as vitamins and minerals as an extra remedy. These may also help one’s general health, especially during the winter months, and especially if you’re not eating a healthy, varied diet.
To avoid susceptibility to this disease it is best to get adequate sleep, a good diet, and avoid getting chapped lips or licking the lips when out and about in cold weather.
If the problem is persistent and there are deep wrinkles or fissures at the angles of the mouth (in a middle-age or older person) it may be worth considering some dermal filler treatment, to prevent the likelihood of angular cheilitis recurring.
Angular cheilitis is not serious but can be miserable and embarrassing to endure. If you spot the signs early enough, however, suitable treatment will quickly clear the condition up.