What vitamin deficiency causes cheilitis (fissured lip)?

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From the Guidelines

Vitamin B2 (riboflavin) deficiency is the primary cause of fissured lips, a condition also known as cheilosis or angular stomatitis. This condition is characterized by oral-buccal lesions, including cheilosis, glossitis, and angular stomatitis, as noted in the espen micronutrient guideline 1. When someone lacks sufficient riboflavin, the corners of their mouth may become cracked, red, and painful. Some key points to consider in the management of riboflavin deficiency include:

  • Consuming 1.1-1.3 mg of riboflavin daily through diet or supplements, as recommended for adults
  • Good dietary sources include dairy products, eggs, lean meats, green leafy vegetables, and fortified cereals
  • For severe deficiency, a healthcare provider might recommend a higher supplemental dose of 5-10 mg daily until symptoms resolve, typically within a few weeks, as seen in a RCT where 10 mg/day of riboflavin was effective 1 Riboflavin is essential for cellular function, energy production, and maintaining the integrity of mucous membranes, including those of the lips. Without adequate riboflavin, the body cannot properly maintain these tissues, leading to inflammation and cracking. Other B vitamins, particularly B6 (pyridoxine) and B3 (niacin), may also contribute to lip health, but riboflavin deficiency is most directly associated with fissured lips, as it is frequently associated with pyridoxine, folate and niacin deficiencies with their associated symptoms 1.

From the Research

Vitamin Deficiency and Fissured Lip

  • A fissured lip is a symptom of cheilosis, which is caused by a deficiency of riboflavin (vitamin B2) 2.
  • Cheilosis is characterized by inflammation of the corners of the mouth, and it can lead to fissured lips, among other symptoms.
  • Riboflavin deficiency can also cause other symptoms such as angular stomatitis, glossitis, and seborrheic dermatitis 2, 3.
  • The deficiency of riboflavin can be due to inadequate dietary intake, impaired absorption, or increased requirement for the vitamin 4, 5.
  • Riboflavin plays a crucial role in energy metabolism, antioxidant potential, and metabolic interactions with other micronutrients, making its deficiency a significant public health concern 2, 3, 4, 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Causes and Clinical Sequelae of Riboflavin Deficiency.

Annual review of nutrition, 2023

Research

Disorders of riboflavin metabolism.

Journal of inherited metabolic disease, 2019

Research

Riboflavin (vitamin B-2) and health.

The American journal of clinical nutrition, 2003

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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