Angular cheilitis, also known as angular stomatitis and perlèche, causes swollen, red patches in the corners on the outside of your lips.
Angular cheilitis can occur on one or both sides of your mouth. It’s an inflammatory condition that can either last a few days or be a chronic problem. It can affect people of all ages, including infants.
Symptoms of angular cheilitis
Symptoms of angular cheilitis will almost exclusively appear at the corners of the mouth. The symptoms can be painful. These can vary from mild redness to open, bleeding blisters.
If you’re experiencing angular cheilitis, the corners of your mouth may be:
Other symptoms include:
bad taste in your mouth
burning feeling on your lips or mouth
lips feeling dry or chapped
difficulty eating as a result of the irritation
What causes angular cheilitis?
There are several different causes of angular cheilitis. The most common is yeast infection as a result of saliva.
Saliva can build up and get trapped in the corners of the lips, which causes lips to crack. A person may lick their lips more in an attempt to soothe the pain or dryness of their lips.
This excess saliva will sit in the corners, which is the perfect warm environment for fungus like yeast to grow.
Viruses and bacteria can also cause it to develop.
Certain people are more at risk for developing angular cheilitis, including those who:
have an overhang of the upper lip, creating deeper angles at the corners of the lips
have regular oral thrush
frequently use corticosteroids or antibiotics
have sensitive skin
have other inflammatory illnesses, such as Crohn’s disease
use oral retinoid medication
have anemia, diabetes, or cancer
have deficiencies of vitamins B-9, B-6, B-2, or B-3, or the mineral zinc
have Sjögren’s syndrome
How is angular cheilitis diagnosed?
Because angular cheilitis can be the sign of a fungal or bacterial infection, you should consult your doctor to determine how to treat it. Your primary care doctor can diagnose angular cheilitis, but dermatologists may be able to provide the best treatment.
Your doctor will examine your skin, and ask about any other skin irritations elsewhere on your body.
They’ll likely ask you about your personal and family history of oral thrush and yeast infections. They’ll also ask what other conditions you have and what medications you’re taking.
Your doctor will likely take culture swabs from the corners of your mouth to send to a lab to test. This will help them diagnose a cause.
Can angular cheilitis cause complications? While many cases of angular cheilitis are relatively easy to treat, once your doctor identifies an underlying cause, you’ll want to treat it. If it’s the result of a bacterial or fungal infection — which most are — the infection could spread to adjacent skin. It could also lead to oral thrush.
How is angular cheilitis treated? The underlying cause of angular cheilitis will determine treatment. If your doctor suspects a nutritional deficiency, they’ll likely make dietary or supplement recommendations. If yeast is present, your doctor will likely prescribe a topical antifungal. “Topical” means you apply the medication to your skin. You’ll need to use topical antibiotics if a bacterial infection is responsible for your condition. Other treatment options include:
topical antiseptics to keep open wounds clean
topical steroid ointment
filler injections to reduce the creases at the corners of your mouth
sipping water or sucking on a hard candy for dry mouth
You can also use home treatments to treat your angular cheilitis, including:
using lip balm regularly to prevent chapped lips
applying petroleum jelly or coconut oil to the corners of your mouth, which can form a barrier from saliva
What is the outlook for angular cheilitis?
Once your doctor is able to determine the underlying cause of angular cheilitis, it typically responds well to treatment. Many cases won’t even require extra care outside of home treatments on a more regular basis.
If you’ve tried home treatment and your symptoms haven’t resolved after 2 weeks, make an appointment to see your doctor.