From the Guidelines
Oral steroids should not be used for treating cracked lips and angular cheilitis due to their potential for significant systemic side effects and the availability of more targeted and effective treatments. These conditions are usually better managed with topical treatments that directly address the underlying causes, such as fungal or bacterial infections for angular cheilitis, or dryness and irritation for cracked lips. For angular cheilitis, antifungal creams like clotrimazole 1% or ketoconazole 2% applied 2-3 times daily for 1-2 weeks are more appropriate, as they directly target the fungal infection without the systemic risks associated with oral steroids 1. If bacterial infection is suspected, topical antibiotics like mupirocin may be prescribed. For simple cracked lips, regular application of petroleum jelly or lip balms containing beeswax, shea butter, or lanolin is recommended, as these provide moisturizing and protective benefits without the risks of oral steroid use. Some key considerations in managing these conditions include:
- Identifying and treating any underlying infections or conditions that may be contributing to the symptoms
- Using targeted topical treatments that are effective for the specific condition
- Avoiding the use of oral steroids due to their potential for significant side effects, including immune suppression, mood changes, and metabolic disturbances, as noted in guidelines for managing urticaria, which also emphasize the restricted use of oral corticosteroids to severe acute cases or specific conditions like delayed pressure urticaria or urticarial vasculitis 1. It's also important to consult a healthcare provider if symptoms persist despite appropriate topical treatments, to identify any underlying causes such as nutritional deficiencies (like B vitamins, iron, or zinc), allergic reactions, or systemic conditions that might require different management approaches.
From the Research
Treatment Options for Cracked Lips and Angular Cheilitis
- The use of oral steroids for cracked lips and angular cheilitis is not explicitly mentioned in the provided studies 2, 3.
- However, the study by 2 suggests that a combination of 1% isoconazole nitrate and 0.1% diflucortolone valerate ointment can be an effective treatment for angular cheilitis due to its broad spectrum of activity against dermatophytes and bacteria, as well as its anti-inflammatory properties.
- The same study highlights the need for further research to assess the consistency of different treatments for angular cheilitis, including the potential use of oral steroids 2.
- Another study 3 emphasizes the importance of identifying the underlying causes of angular cheilitis, including nutritional, systemic, and drug-related factors, in order to develop an effective treatment plan.
- There is no direct evidence in the provided studies to support the use of oral steroids for cracked lips and angular cheilitis, and more research is needed to explore this potential treatment option 2, 3.