Angular cheilitis, commonly known as a cracked lip corner, is a painful inflammatory condition affecting the commissures, or angles, of the mouth. This issue manifests as redness, swelling, and sometimes deep cracks or fissures at one or both corners of the lips. The condition, often called perleche or angular stomatitis, can make speaking, eating, and even smiling uncomfortable. Understanding the cause is the first step toward effective treatment and prevention.
Identifying the Root Causes
Cracked lip corners are not caused by simple dryness but stem from a combination of moisture accumulation and opportunistic infection. The initial trigger is often mechanical irritation, where saliva pools in the folds at the mouth corners, leading to chronic moisture. As saliva evaporates, it leaves the skin dry and prone to cracking, often encouraging lip licking to soothe the area.
The warm, moist environment created by saliva pooling provides an ideal breeding ground for microbes. Fungal overgrowth, particularly from Candida albicans yeast, is the most common infectious agent involved in angular cheilitis. While less frequent, bacterial strains like Staphylococcus aureus or certain Streptococcus species can also colonize the cracked skin.
Systemic factors, such as nutritional deficiencies, compromise the skin’s integrity and increase susceptibility. Deficiencies in B vitamins (riboflavin and cobalamin) and iron are frequently linked to angular cheilitis. Since these nutrients support skin health and immune function, a lack of them hinders the body’s ability to repair the damaged area.
Immediate Healing Strategies
The primary goal for immediate healing is to keep the affected area protected and dry while combating microbial growth. After gently cleansing the corners of the mouth, applying a thick occlusive barrier is essential to shield the crack from saliva and external irritants. Petroleum jelly or a zinc oxide paste work well by sealing in moisture from the skin while repelling external wetness.
If the cracks appear red, inflamed, or have a whitish film, a fungal or bacterial infection may be present. Over-the-counter combination creams containing a mild antifungal (like clotrimazole) and a low-dose topical steroid (such as 1% hydrocortisone) can address both yeast and inflammation. Apply these products according to package directions, typically after cleaning and before applying a barrier.
Careful moisture management is necessary during the healing phase. Pat the area completely dry after eating, drinking, or oral hygiene before reapplying the protective barrier. The repeated application of the occlusive ointment, especially at night, prevents saliva from collecting and macerating the skin while you sleep.
Preventing Recurrence
Once inflammation subsides, habit modification is necessary to prevent recurrence. Stopping the habit of lip licking or picking at the corners is necessary, as this mechanical irritation often initiates the moisture-trap environment. Addressing habitual mouth breathing, particularly during sleep, also reduces the amount of saliva that pools and evaporates around the lips.
Ill-fitting dental appliances, such as dentures or retainers, can contribute to recurrence by creating folds that trap moisture and reduce the vertical dimension of the mouth. Consulting a dentist to ensure proper fit is a necessary step, as this can eliminate a physical pocket where microbes thrive. Good oral hygiene is also a preventative measure to reduce the microbial load in the mouth.
If a nutritional cause was suspected, increasing the dietary intake of iron and B vitamins can support skin and immune health. Foods rich in B vitamins include whole grains, meat, and eggs, while iron can be found in red meat, beans, and dark leafy greens. Continuing a protective routine, like applying a simple barrier ointment nightly, even after the cracks have healed, provides a layer of defense against minor irritation.
When Professional Help is Necessary
Most mild cases of angular cheilitis improve within 7 to 10 days with consistent home care and barrier protection. However, if the cracked corners persist beyond two weeks despite diligent treatment, professional medical intervention is required. A doctor or dermatologist should examine the area to rule out other conditions that may resemble angular cheilitis, such as cold sores or eczema.
Medical consultation is warranted if the area becomes painful, starts to bleed, or the redness spreads beyond the corner of the mouth. Frequent recurrence suggests an underlying issue that needs investigation, such as anemia, diabetes, or systemic immune compromise.
A healthcare provider can perform a swab culture to identify the fungal or bacterial strain responsible for the infection. Based on the diagnosis, they can prescribe stronger topical medications, such as prescription-strength antifungals or antibiotics, which are more potent than over-the-counter options. Blood tests may also be ordered to check for nutritional deficiencies requiring specific supplementation.