Angular cheilitis, also called angular stomatitis or perlèche cheilosis, produces inflamed lesions and painful cracks that appear at the corners of the mouth that may bleed. The condition is caused by deficiencies in nutrition and has also been linked with bulimia nervosa and anorexia nervosa. It can also occur as part of a complex of symptoms associated with Plummer-Vinson syndrome. Cold weather, certain drugs that dry the skin, and excessive vitamin A are other causes of angular cheilitis. Treatment of the condition is based on its cause.
While the cause of angular cheilitis is often fungal, bacterial infections also occur. In addition, once the cracks in the mouth become severe, more fungus and bacteria may grow, further intensifying the effects. For example, thrush, or Candida albicans, may begin to grow in the cracks causing a multi-layered problem. For sufferers of angular cheilitis, licking the lips will only make the situation worse.
In older people, the condition can be triggered by the loss of teeth or poorly-fitting dentures, causing excessive pursing of the mouth. If dentures are not fitted properly, saliva can to pool in the corners of the mouth creating an environment perfect for the growth of angular cheilitis. Excessive biting in an effort to make the dentures fit may also cause increased amounts of saliva.
Angular cheilitis can also signal that the patient suffers from bulimia nervosa or anorexia nervosa. Frequent vomiting will cause stomach acid to pass by the corners of the mouth and may inflame the area. Malnutrition is especially a cause for concern if the lesions are paired with either of these disorders.
Vitamin B2 deficiency and iron deficiency anemia have also been associated with angular cheilitis. The presence of the disease can also signal that the patient is unable to absorb certain food nutrients. The patient may also be suffering from another issue of which malnutrition is a symptom, including celiac disease.
After determining the underlying cause of angular cheilitis by consulting with a doctor or dentist, the patient should first address any nutritional deficiencies by making dietary changes and possibly supplementing his or her diet with vitamins and minerals. The doctor may also prescribe an antibiotic or anti-fungal medication depending on the cause. Mild cases can usually be treated with over-the-counter medications and minor symptoms can be alleviated with lip balm. Because the bacteria or fungus causing the condition thrive in a damp environment, it is best to avoid lotions and creams that add substantial moisture.
Regardless of the medicines and other steps taken to treat the symptoms of angular cheilitis, it is important to recognize that prevention is critical. Topical treatments, fungicides, and antibiotics will only temporarily alleviate symptoms. Unless the underlying nutritional causes of angular cheilitis are addressed, the symptoms will in all likelihood recur.