A Crack in the Middle of the Lip and Angular Cheilitis

Central splitting can occur with very dry or irritated lips and other forms of cheilitis. It should not automatically be treated as a mouth-corner infection, particularly if it keeps returning in the same spot or has a firm, ulcerated or blistered surface.

The term angular cheilitis specifically describes inflammation at either angle where the lips join. Saliva can collect in those folds, causing softening, redness and fissures. A split through the centre of the upper or lower lip lacks that characteristic corner pattern.

Dry weather, lip licking, biting, fragranced products, dental materials, medicines and inflammatory skin conditions can contribute to lip inflammation. Blisters, an ulcer, a persistent scab or a change extending onto nearby skin gives a clinician additional diagnostic clues.

Apply a thin coat of plain fragrance-free ointment, especially after eating or washing. Avoid licking, biting and pulling the lips apart to inspect the fissure. Pause new lip cosmetics, flavoured balms and harsh oral-care products if they coincide with the irritation.

Do not assume an antifungal or antibiotic used for angular cheilitis will treat a central crack. If the area is inflamed, a clinician can assess its exact location, surface and surrounding skin before recommending a medicated product. Photographing changes may help show whether it repeatedly opens in the same place.

Arrange an examination if the split persists, repeatedly bleeds, becomes an ulcer, forms blisters, develops a firm edge or returns despite bland barrier care. Review is also appropriate for spreading redness, discharge, worsening swelling or soreness elsewhere inside the mouth.

Seek prompt help for severe pain, fever or rapidly increasing facial swelling. Difficulty breathing or swallowing requires emergency assistance.

Ask whether the finding is dry lip inflammation, contact dermatitis, trauma or another condition rather than angular cheilitis. Discuss products touching the lips, repetitive biting, sun exposure, oral symptoms and whether testing is needed for a fissure that will not heal.