Angular cheilitis, or cracked lip corners, is a common, painful inflammatory condition affecting the oral commissures where the upper and lower lips meet. It appears as red, swollen patches that often crack, sometimes leading to bleeding or crusting. Prompt treatment is important because the compromised skin barrier is susceptible to secondary infection. This article provides steps for immediate relief and long-term prevention.
Immediate Steps for Relief and Healing
The first step in managing a cracked lip corner is to create an environment conducive to healing by controlling moisture and protecting the delicate skin. Although the area may feel dry, the condition is often worsened by saliva, so keeping the corner of the mouth dry is necessary. Use a gentle, non-irritating cleanser to keep the area clean, then immediately and gently pat it completely dry.
A barrier ointment, such as plain petroleum jelly or a thick lip balm, should be applied frequently throughout the day. This protective layer seals the wound, preventing the constant cycle of moisture and evaporation that hinders healing. When applying any product, use a clean cotton swab or a freshly washed finger and dab the product onto the area rather than rubbing it in, which can further irritate the fissure.
If the condition does not quickly improve with barrier protection alone, over-the-counter treatments may be necessary, as a fungal or bacterial infection is a frequent complication. Many cases involve an overgrowth of Candida yeast, which is often treated with topical antifungal creams containing ingredients like clotrimazole or miconazole. These products are available at pharmacies and should be applied directly to the affected area for up to two weeks.
For significant redness and swelling, a small amount of over-the-counter hydrocortisone 1% ointment can be applied to reduce inflammation. Topical steroids should not be used long-term and are often combined with an antifungal to address the likely infectious component. If the crack appears to have a yellowish crust, suggesting a bacterial infection, a topical antibiotic ointment may also be recommended.
Common Causes and Contributing Factors
Angular cheilitis is typically a multifactorial condition, arising from a combination of mechanical, infectious, and systemic issues. The most common trigger is the accumulation of saliva at the corners of the mouth, which leads to maceration—the softening and breakdown of the skin. Once the skin is compromised, the warm, moist environment becomes an ideal breeding ground for microorganisms.
Infections are a frequent complication, with the yeast Candida albicans being the most common culprit, often alongside bacteria like Staphylococcus aureus. Saliva may pool due to anatomical factors, such as deep folds at the mouth corners, or mechanical factors, including ill-fitting dentures or orthodontic devices. The constant presence of moisture allows these pathogens to colonize the area, driving the inflammatory cycle.
Systemic factors can also increase susceptibility to developing cracked lip corners. Deficiencies in certain micronutrients, particularly iron, zinc, and B vitamins like riboflavin (B2) and B12, are known contributors. Chronic health conditions such as diabetes or a weakened immune system can predispose a person to fungal overgrowth, making the skin more vulnerable to cracking and delayed healing.
Preventing Future Occurrences
Long-term prevention focuses on modifying habits and addressing underlying systemic or mechanical issues that contribute to moisture accumulation and skin compromise. A primary goal is to break the habit of frequently licking the lips or the corners of the mouth, as this cycle of wetting and drying is irritating to the skin. Using an unflavored, unscented barrier ointment at night serves as a protective measure and a reminder to avoid lip-licking during sleep.
Maintaining excellent oral hygiene is important, especially for individuals who wear dentures, as these appliances can serve as reservoirs for Candida. Dentures should be thoroughly cleaned and soaked overnight, potentially in a diluted solution, to reduce the microbial load. Addressing mechanical issues, such as getting ill-fitting dentures adjusted or seeing a dentist about a misaligned bite, can reduce the depth of the folds where saliva collects.
A diet rich in essential micronutrients is helpful for reducing recurrence, especially if a nutritional deficiency was a contributing factor. Ensuring adequate intake of B vitamins and iron supports overall skin health and immune function. If the condition persists despite two weeks of diligent home treatment with barrier ointments and over-the-counter creams, seeking professional medical advice is warranted to rule out an underlying systemic issue or to obtain a prescription-strength antifungal or antibiotic.