Angular cheilitis is a common condition caused by an inflammatory process that affects the corners of the mouth (oral commissures). Other names for it are angular stomatitis and cheilosis.
The following factors usually underlie angular cheilitis:
-Dribbling of saliva, usually during sleep if you are unable to breathe through your nose. This results in eczema-like changes, a form of contact irritant dermatitis.
-Dry chapped lips.
-Growth of bacteria (impetigo), yeasts (thrush) or virus (cold sores).
Predisposing factors to angular cheilitis include:
Oral thrush: in your case, if you are on steroids (oral or injectable) or taking a prolonged antibiotic course, these may result in harmful bacterial overgrowth (antibiotics) or fungal proliferation (steroids)
-Poor nutrition: iron deficiency and riboflavin (vitamin B2) deficiency
-Systemic illness, particularly inflammatory bowel disease or diabetes
-Sensitive skin, especially atopic dermatitis
-Oral retinoid medication.
It is made worse by repeatedly licking the lips.
Culture of swabs taken from the corners of the mouth are required to rule out the presence of an infection and may reveal:
Candida albicans (fungus)
Staphylococcus aureus (bacteria)
Herpes simplex (the virus that causes the cold sores).
If a nutritional deficiency is suspected, then blood tests should be done to rule out iron deficiency or riboflavin deficiency.
In general, no treatment is needed and angular cheilitis resolves by itself. But if it persists, and depending on the specific cause, the following treatments may be useful:
Lip balm or thick emollient ointment, applied frequently
Topical antiseptics
Topical or oral antistaphylococcal antibiotic
Topical antifungal cream
Oral antifungal medication
Topical steroid ointment
Nutritional supplements
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Annual Checkup
It is recommended that all individuals see a Family Doctor for a full medical examination annually. Adults should get their blood pressure checked (US Preventive Task Force), a flu vaccine (CDC) and more each year.
The American Dental Association recommends dental cleanings for adults at least twice annually. Some stains can only be removed by a professional cleaning.
It’s recommended by the American Academy of Ophthalmology that every adult between the ages of 18 and 80 does an eye examination at least once every two years.
It's recommended by the American Cancer Association that every adult between the age of 20 and 80 does an annual skin screening by a licensed dermatologist.
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