From the Guidelines
To manage angular cheilitis, apply an over-the-counter antifungal cream like clotrimazole 1% or miconazole 2% to the affected corners of the mouth 2-3 times daily for 1-2 weeks, as this approach is supported by the most recent and highest quality evidence available 1. The management of angular cheilitis involves a combination of topical treatments and preventive measures.
- Apply an antifungal cream to the affected area to target the fungal component of the condition.
- Use a moisturizing lip balm regularly to prevent dryness and irritation.
- For faster relief, consider combining the antifungal cream with a low-potency topical steroid like hydrocortisone 1% cream, applied sparingly twice daily for up to 7 days, as suggested by expert opinion 1. If symptoms persist or worsen after 2 weeks, it is essential to consult a healthcare provider, who may prescribe stronger antifungal medications or antibiotics if a bacterial infection is suspected. To prevent recurrence:
- Maintain good oral hygiene
- Stay hydrated
- Avoid licking your lips
- Use a humidifier in dry environments
- Address any nutritional deficiencies, particularly B vitamins and iron Angular cheilitis is often caused by a combination of moisture, irritation, and overgrowth of fungi or bacteria in the corners of the mouth.
- The antifungal cream targets the fungal component,
- while moisturizers and steroids address the irritation and inflammation.
- Addressing underlying factors like nutrition and hydration helps prevent future episodes, as emphasized in the management of oral and gastrointestinal mucosal injury 1.
From the Research
Management of Angular Cheilitis
The management of angular cheilitis involves various treatment options, including:
- Topical treatments, such as antifungals, with limited scientific evidence to support their reliability 2
- Alternative treatments, including 1% isoconazole nitrate (ISN) and 0.1% diflucortolone valerate (DFV) ointment, which has been found to be a consistent treatment for angular cheilitis due to its broad spectrum of activity against dermatophytes and bacteria, and its anti-inflammatory properties 2
- Occlusal vertical dimension restoration, B-vitamin supplementation, anti-drooling prosthetic device, and photodynamic therapy, which have been experimented and proposed, mostly in the form of case reports or case series on a small number of individuals 2
- Identifying and addressing underlying etiologies, such as nutritional, systemic, and drug-related factors, which is required to appropriately focus treatment efforts 3
- Local etiologies, such as irritant, allergic, and infectious causes, which need to be identified and addressed in developing an effective treatment plan for angular cheilitis 4
Treatment Approaches
Different treatment approaches have been reported, including:
- The use of hyaluronic acid dermal fillers, which has been shown to be effective in achieving complete remission of recurrent angular cheilitis in a case report 5
- Conservative treatment approaches, which can be effective in managing angular cheilitis, especially in elderly patients 5
- The importance of establishing the underlying etiology of angular cheilitis to develop an effective treatment plan, as emphasized in various studies2, 3, 4