From the Research
Angular cheilitis should be treated with a combination of 1% isoconazole nitrate and 0.1% diflucortolone valerate ointment, as this combination has been found to be the most consistent treatment due to its broad spectrum of activity against dermatophytes and bacteria, and its anti-inflammatory properties 1.
Treatment Approach
When managing angular cheilitis, it's crucial to address both the symptoms and the underlying causes. The condition is characterized by erythema, rhagades, ulcerations, and crusting of one or both lip commissures and perilabial skin, leading to unpleasant and painful discomfort.
- Apply the recommended ointment to the affected areas 2-3 times daily for 7-14 days.
- Keep the area clean and dry to prevent moisture accumulation, which can exacerbate the condition.
- Apply petroleum jelly as a barrier to prevent further irritation.
Underlying Causes
Addressing the underlying causes of angular cheilitis is essential for effective treatment. These causes can include:
- Nutritional deficiencies, particularly B vitamins, iron, and zinc 2.
- Moisture trapping in skin folds.
- Immune system issues.
- Poor denture fit, if applicable.
- Excessive licking of the lips.
Importance of Multi-Faceted Approach
A multi-faceted treatment approach is most effective for angular cheilitis, as the condition often results from a combination of factors. By addressing both the symptoms and the underlying causes, most cases can resolve within 1-2 weeks with proper treatment. It's also important to note that while antifungals are commonly used as a first-line treatment, the scientific evidence supporting their reliability is limited, with only two RCTs published between the 1970s and 1980s 1, 3.