Summary about Disease
Cheilosis, also known as angular cheilitis or perleche, is an inflammatory condition affecting the corners of the mouth. It manifests as cracks, fissures, scaling, and sometimes crusting at the angles of the lips. It can be uncomfortable, painful, and cosmetically bothersome. While often a nuisance, it can sometimes indicate an underlying nutritional deficiency or infection.
Symptoms
Cracking and fissuring at the corners of the mouth
Redness and inflammation
Scaling and crusting
Pain or burning sensation
Itching
Bleeding when the mouth is opened wide
Dryness around the lips
Blisters (in some cases, especially if infection is involved)
Causes
Infections: Bacterial (Staphylococcus aureus) or fungal (Candida albicans) infections are common culprits.
Nutritional Deficiencies: Deficiencies in iron, riboflavin (vitamin B2), folate (vitamin B9), or vitamin B12 can contribute.
Irritation: Excessive lip licking, drooling (especially during sleep), poorly fitting dentures, or allergies to lip products.
Dry Mouth: Conditions causing dry mouth (xerostomia) can increase the risk.
Immunocompromised States: Individuals with weakened immune systems are more susceptible.
Structural Issues: Deep skin folds at the corners of the mouth, often associated with aging or weight loss.
Certain Medications: Some medications can cause dry mouth or suppress the immune system.
Underlying Medical Conditions: Conditions like diabetes or inflammatory bowel disease can increase the risk.
Medicine Used
Treatment depends on the underlying cause:
Antifungal Creams: Nystatin, clotrimazole, or miconazole are used for fungal infections.
Antibacterial Ointments: Mupirocin or bacitracin are used for bacterial infections.
Topical Corticosteroids: Mild corticosteroids can reduce inflammation (use with caution and under medical supervision).
Barrier Creams/Ointments: Petroleum jelly, zinc oxide, or lanolin can protect the area and promote healing.
Nutritional Supplements: Iron, riboflavin, folate, or vitamin B12 supplements may be prescribed if deficiencies are identified.
Prescription Medications: In severe cases or if the condition is linked to an underlying medical problem, a doctor may prescribe stronger medications.
Is Communicable
Cheilosis itself is not directly communicable. However, if it's caused by a bacterial or fungal infection, the infection can potentially be spread through direct contact (e.g., kissing, sharing utensils), although this is not highly contagious.
Precautions
Maintain Good Oral Hygiene: Brush your teeth regularly and use mouthwash.
Avoid Lip Licking: Resist the urge to lick your lips, as this can worsen dryness and irritation.
Use Lip Balm: Apply a moisturizing lip balm throughout the day, especially in dry or cold weather.
Address Underlying Medical Conditions: Manage any underlying conditions, such as diabetes, that may contribute to cheilosis.
Avoid Irritants: Identify and avoid potential irritants, such as certain lip products or foods.
Proper Denture Care: If you wear dentures, ensure they fit properly and are cleaned regularly.
Humidify Your Environment: Use a humidifier to increase moisture in the air, especially during dry seasons.
Balanced Diet: Eat a balanced diet rich in vitamins and minerals.
How long does an outbreak last?
The duration of cheilosis can vary depending on the cause and treatment:
Mild Cases (due to irritation): May resolve within a few days to a week with proper care and avoidance of irritants.
Infectious Cases (bacterial or fungal): Usually clear up within 1-2 weeks with appropriate antifungal or antibacterial treatment.
Nutritional Deficiency-Related Cases: Improvement is seen over several weeks to months as nutritional deficiencies are addressed.
Chronic Cases: If linked to underlying medical conditions or structural issues, cheilosis may be a recurring or chronic problem requiring ongoing management.
How is it diagnosed?
Visual Examination: A doctor or dentist can usually diagnose cheilosis based on a visual examination of the affected area.
Medical History: The doctor will ask about your medical history, medications, and any potential risk factors.
Swab or Culture: If an infection is suspected, a swab or culture may be taken to identify the specific bacteria or fungus.
Blood Tests: Blood tests may be ordered to check for nutritional deficiencies or underlying medical conditions.
Timeline of Symptoms
The onset and progression of symptoms can vary:
Initial Stage: Mild redness and dryness at the corners of the mouth.
Progression: Cracks and fissures develop, often accompanied by pain or burning.
Advanced Stage: Scaling, crusting, and bleeding may occur. If infection is present, blisters or pus-filled sores may develop.
Chronic Cases: Symptoms may persist for weeks or months, with periods of improvement and worsening.
Important Considerations
Rule out underlying conditions: Persistent or recurrent cheilosis warrants investigation for potential underlying nutritional deficiencies or medical problems.
Avoid self-treating with strong medications: Use of inappropriate topical corticosteroids or antibiotics can worsen the condition.
See a doctor or dentist: If symptoms are severe, persistent, or accompanied by other symptoms (e.g., fever, swollen lymph nodes), seek professional medical advice.
Prevention is key: Implementing preventative measures, such as maintaining good oral hygiene and using lip balm, can help reduce the risk of recurrence.
Proper diagnosis for effective treatment: Correctly identifying the cause (infection, deficiency, irritation) is critical to selecting the right treatment approach.