Several situations can provide the appearance of angular cheilitis, the most common are the use of dental appliances or dentures. If the causes are not attacked, the injury may persist, they become chronic.
In this article we will address the following points about angular cheilitis:
- What is angular cheilitis
- Symptoms of angular cheilitis
- Treatment of angular cheilitis
What is Angular Cheilitis?
Angular cheilitis is a wound that occurs due to an inflammatory process at the angle of the mouth. Injuries can be unilateral or bilateral. The elderly are the most affected, but angular cheilitis can also occur in children and young people.
The accumulation of saliva at the commissure of the mouth appears to be the main triggering factor, to facilitate maceration of the skin, formation of cracks and injury of bacterial or fungal contamination.
Situations that promote the accumulation of saliva in the angle of the mouth, trauma or infection of the skin around the mouth are the main risk factors for angular cheilitis. We can cite some risk situations:
- Natural process of aging, which causes the fall of the skin at the corners of the mouth, favoring the accumulation of saliva in this region.
- The absence of teeth, which changes the angle of the mouth, causing effects similar to aging.
- Use of maladaptive prostheses.
- Use of dental appliances.
- Oral candidiasis.
- Poor oral hygiene.
- Allergic to toothpaste and other dental products.
- Problems that cause lesions around the mouth, such as atopic dermatitis, psoriasis or seborrheic dermatitis of the skin.
- Dry lips, favoring the appearance of angular wounds.
- Use of drugs that dry mouth, such as isotretinoin.
- Compulsive licking lips, keeping them always moist and exposed to germs in the mouth.
- Excessive consumption of foods high in sugar, which promotes the growth of Candida fungus.
- Use of inhaled steroids, which favors the growth of germs in the oral cavity.
- Patients with immunodeficiency, whether due to illness or immunosuppressive drug use, are also at increased risk of developing angular cheilitis. These cases include patients with HIV, cancer, neutropenia, diabetes mellitus, anorexia or transplanted organs.
Less frequently, the angular cheilitis can be caused by nutritional deficiencies, such as lack of vitamin B, folic acid or iron.
Symptoms of Angular Cheilitis
Angular cheilitis may present as a fissure, crevice, ulceration, redness or crusting in the corner of the mouth. The lesions do not enter the mouth by joining the skin with the mucous membrane of the lips. As the skin of the lip angle is injured, the simple action of opening the mouth can cause intense pain and burning. The lesions of angular cheilitis, usually do not bleed, but can become infected, inflamed and gets with a pus scab.
Angular cheilitis can develop into a chronic and persistent lesion or present alternating with periods of improvement and worsening of the lesions.
Treatment of Angular Cheilitis
The first part of the treatment to cure the angular cheilitis is trying to eliminate or correct the problems that their appearance offers. In many cases the simple elimination of risk factors is enough to cure perleche. In the elderly, the use of a suitable dental prosthesis may be the only action needed.
In many cases, however, we can only cure the angular cheilitis with medicines. The use of ointments may solve the problem, but you should first investigate the presence of bacteria or fungi in the lesions, because it changes the composition of ointments like that germ if you want to treat.
If there is no bacterial or fungal infection, moisturizing and anti-inflammatory ointments such as zinc oxide (present in Hypoglossus) or Omcilon Orabase are useful. Vaseline-based creams or ointments are also an option.
If there is a fungal infection, ointments may be used with cotrimazole, nystatin, or miconazole. In some cases, the physician may indicate the use of fluconazole tablets to aid in the elimination of fungal lesions. If there is bacterial infection, ointments such as mupirocin are indicated. Usually the treatment of angular cheilitis with ointment of 1 to 3 weeks takes place.
There is also a guide called Angular Cheilitis Free Forever PDF created by Jason White which has given good results to its users. Its an all natural and holistic treatment, which is very much suggested to do first before taking meds.
You may also be interested in: Cheilitis Pharmacological Treatment.