IF YOU FEEL like no amount of lip balm can alleviate your cracked lips, there may be something more behind the dryness.
Or maybe the “cold sores” on the corners of your mouth have been there forever, with no sign of healing. The truth behind your discomfort may be something you’ve never heard of.
You could have a skin condition called angular cheilitis. Commonly mistaken for cold sores or other pesky mouth infections, angular cheilitis, or AC, is often misunderstood.
“Angular cheilitis is a skin condition that causes painful inflammation in one or both corners of your mouth,” says Sonia Batra, M.D., a dermatologist and co-host of the television show The Doctors.
Batra estimates that AC affects about 0.7 percent of the population, so while it’s not super common, it’s not rare, either. While no infection surrounding the mouth is fun, the good news is AC is not super serious for most people. It often resolves without the need for medical intervention. But you get stuck with a really sticky case, the condition is curable with medication.
What causes angular cheilitis?
Most AC cases are caused by breakdown of the skin surrounding the lips from a buildup of saliva. This causes the skin to become dry and cracked, leading to nagging pain.
“When saliva breaks down and inflames skin at the corners of the mouth, the inflamed patches can become colonized by bacteria or yeast that usually reside in the mouth,” Batra says.
Inflammation and cracking from the dryness can open the door to painful sores. Burning pain can follow around the mouth, especially when opening or closing, says Batra. In the most severe cases, some have experience a bad taste in their mouths and difficulty eating. Sores can sometimes open and bleed if left untreated.
Often, people may lick their lips to try to alleviate the pain, but this actually might make it worse. “Doing so causes more saliva buildup, which creates an ideal environment for bacteria or a fungus like yeast to grow,” she says.
What does angular cheilitis look like?
Angular cheilitis typically starts with a red dry patch on the corners of the mouth. It can be on one or both sides, with a dry, scaly appearance.
Maceration of the skin is common with AC—meaning it can soften and lighten in color. If the skin gets too irritated, it can break apart and cause some bleeding. Swelling can occur as well. The skin at the corners of your mouth can break down into ulcers when left for too long— hence the confusion between AC and cold sores.
But there is a primary difference between the two, Batra says: “Visually, angular cheilitis appears in the corner of the mouth as cracked, scaly skin, while cold sores can occur anywhere around the mouth. Usually, it looks like a cluster of small blisters that become crusted over a course of days,” she says.
“In addition, cold sores have life cycles, so you will often feel a burning or itching on a certain area of the lip before a blister forms. Angular cheilitis does not have warning signs until a sore appears.”
Who’s at risk?
Well, everyone, but some people are more susceptible to angular cheilitis than others. For instance, if you have deep lines around the corners of your mouth (also known as “marionette lines“), saliva is more likely to pool in those deeper crevices, putting you more at risk of inflammation.
AC is also more common in people with recurrent oral thrush (fluffy white spots on the tongue or inner cheeks) due to an imbalance in a fungus called Candida, which can be caused by an immunodeficiency or frequent use of corticosteroids or antibiotics, says Batra.
Smokers, people with braces, and people with sensitive skin are also more vulnerable to fungal infections. It’s also especially prevalent in the elderly. People in older age brackets “often have excess saliva due to dentures, loss of teeth, and vitamin deficiencies that increase their risk,” Batra says.
Those with Down syndrome make up 25 percent of AC cases, typically because of macroglossia— an enlarged tongue that comes with the condition. This often leads to tongue protrusion and drooling.
Certain medical conditions, such as anemia, diabetes, immune disorders, and some cancers put you at risk of AC.
Is angular cheilitis contagious?
Unlike cold sores, AC is not contagious according to the Cleveland Clinic. The condition can spread to the other side of your mouth, however it is not likely to spread to other areas of your body.
How do you manage angular cheilitis symptoms?
The dry, flaky lips can get old, quick. Plus, the pain it causes is enough to annoy anyone. There’s a few things you can do to help relieve some of the symptoms associated with AC.
First, avoid skin irritants as much as possible. This can be difficult to do, but avoiding spicy foods can help, as can switching away from strong toothpastes and mouthwashes.
Reduce some swelling by holding an ice pack or other cold compress to the sides of your mouth. If you’re outside a lot, use a face mask to avoid prolonged sun exposure, extreme cold, or wind.
The best thing you can do is keep the area lubricated to prevent further drying (see below for some doctor-approved options).
How do you treat angular cheilitis?
“If you develop angular cheilitis, keep the inflamed area clean and dry to prevent the infection from worsening,” Batra says. “Your doctor may also prescribe a topical steroid cream to promote healing.” For more serious cases, your doctor may prescribe antibiotics or anti-fungal medication.
If the sore is relatively minor, you can also heal it with a few at-home hacks, including applying lip balm, petroleum jelly, or coconut oil to soothe and moisturize the irritated areas, Batra says. But be careful: if left untreated, the infection could worsen and spread to the surrounding skin or cause oral thrush.
To prevent AC from occurring, stay hydrated, keep your lips dry, apply chapstick regularly, and practice good oral hygiene, Batra says. Also, stop licking your lips.
How long does it take angular cheilitis to go away?
Angular cheilitis usually doesn’t take long to clear up, depending on your treatment path. If your doctor has prescribed a medication or topical cream, symptoms will typically clear up within 2 weeks, according to the Cleveland Clinic. Severe cases may take longer, and can cause scarring or weak skin if not treated quickly.
It is possible for AC to come back. So take care of your lips to prevent any returning cases.
Isadora Baum is a freelance writer, certified health coach, and author of 5-Minute Energy. She can’t resist a good sample, a margarita, a new HIIT class, or an easy laugh. Learn more about her on her website: isadorabaum.com.
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Melissa Matthews is the Health Writer at Men’s Health, covering the latest in food, nutrition, and health.
Cori Ritchey, NASM-CPT is an Associate Health & Fitness Editor at Men’s Health and a certified personal trainer and group fitness instructor. You can find more of her work in HealthCentral, Livestrong, Self, and others.
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