Chronic angular cheilitis: what to know

Angular cheilitis can cause soreness, redness, scaling, splitting or crusting where the upper and lower lips meet. Saliva may collect in these folds and weaken the skin barrier, especially with lip licking, drooling, dry skin, a change in bite, or poorly fitting dentures. Once the barrier is damaged, yeast or bacteria may contribute to ongoing inflammation.

Repeated episodes do not identify a single cause by themselves. A clinician may consider contact irritation from lip or dental products, eczema, oral thrush, nutritional deficiency, diabetes, medicines that cause dry mouth, or another condition affecting healing. The pattern on examination helps guide whether testing is useful.

Keep the corners gently clean and dry, avoid licking or picking them, and apply a plain fragrance-free barrier ointment to reduce contact with saliva. Pause new lip products or strongly flavoured oral-care products if they seem to sting or coincide with the rash. Denture wearers should follow cleaning instructions and arrange a fit check if saliva pools at the mouth corners.

Treatment depends on the cause. A clinician may prescribe an antifungal or antibacterial medicine when infection is suspected. A topical corticosteroid can reduce inflammation in selected cases, but using one alone may mask or worsen an untreated infection; use it on this area only as directed. Recurrence may require addressing both the damaged barrier and the factor keeping the area moist.

Arrange an assessment if the cracks persist despite gentle barrier care, repeatedly return, affect only one side without settling, or are accompanied by mouth soreness or white patches. Seek prompt care for rapidly spreading redness, marked swelling, pus, fever, severe pain, difficulty eating or drinking, or signs of dehydration. People with diabetes, reduced immunity, or poor wound healing should seek advice early because infection may need targeted treatment.

Ask whether the appearance suggests irritation, yeast, bacteria, eczema, or a combination; whether a swab or blood test would change management; and how long to use each prescribed product. If episodes recur, discuss denture fit, dry mouth, oral symptoms, diet, medicines, and health conditions that could interfere with skin repair.