Rash in Corner of Mouth: Angular Cheilitis and its Treatment

Rash in Corner of mouth can be bothersome for most individuals. This painful condition called as angular cheilitis. Although not serious issue, this can cause difficulties in day to day activities like eating or talking. Good news is that it is highly preventable. Unlike chapped lips, which generally occurs due to lack of moisture, angular cheilitis is cause by excess moisture in the corner of the mouth or infection.

What is Angular Cheilitis?

Angular cheilitis is also called as angular stomatitis. Angular cheilitis is an inflammatory condition that causes red, swollen, scales, crusting and fissuring in the corner of the mouth. This may affect one corner of the mouth or both.  It is usually confined to the corners and does not spread. Depending on the underlying cause it can go quickly or persist for long.

What causes Angular Cheilitis?

Because it is a multi-factorial disease, so the cause of Angular cheilitis varies from individual to individual. It can be due to infection or other non-infectious cause like repetitive licking or irritation, nutritional  vitamin  deficiency or other skin causes.

Common causes of angular cheilitis are:

• Irritant contact dermatitis due to repetitive licking or contact with saliva.
• Dry chapped lips
• Yeast or fungal infection in the corner of the mouth
• Viral infections like herpes (cold sores).

Who are at risk of angular cheilitis?

Children and adults with poor health condition or weak immunity are mostly affected. Because, licking of the lips can further worsen the disease, it must a avoided. Risk factors include:

• Infants and old age
• Individuals with wrinkling or increased folding of skin at the corners of the mouth
• People with diabetes, coeliac disease or inflammatory bowel disease like Crohn disease and uncreative colitis.
• Long term antibiotics or corticosteroids use
• Atopic skin sensitive to toothpaste, makeup, and other food
• Poor fitting dentures
• Poor nutrition, vitamin deficiency like riboflavin or iron deficiency.
• People with Down syndrome
• People on Oral retinoid medication like isotretinoin or acitretin.
• Chronic Smokers

Sign and Symptoms of Angular Cheilitis

Common signs and symptoms of Angular cheilitis include:

• Swollen, thickened and red rash in the corner of the mouth.
• Dry, scaly, crusted and fissured lesion at the angle of the mouth.
• Burning, pain and soreness in the area affected.
• Irritation and itching at the corner of the mouth

Symptoms may be either in one side of the mouth or both. It is usually confined to the corners only and does not spread. But in rare cases it can spread to adjacent area due to bacteria (impetigo) or fungus ( candidiais) infection.

Treatment of Angular Cheilitis

Most of the healthy individuals need no treatment, it resolves by itself. When not improved following treatment can be initiated depending on the specific cause:

1. Individual with uncontrolled diabetes need diet and lifestyle changes and anti-diabetes medications.
2. People with poor nutrition and vitamins deficiency need vitamin supplements.
3. If it is due to yeast or fungus oral or topical antifungal medications is used.
4. When there is a bacterial infection oral or topical antibiotic is given.
5. Topical steroids cream used for short period help heal the lesion quick
6. Use thick moisturizer, vaseline or lip balm frequently.
7. Individuals with wrinkling or increased folding of skin at the corners of the mouth can benefit from Botox or Filler injection.