From the Guidelines
The most effective treatment for angular cheilitis involves applying an antifungal agent, such as nystatin oral suspension 100,000 units four times daily for 1 week, or miconazole oral gel 5–10 mL held in the mouth after food four times daily for 1 week, as Candidal infection is a common cause 1. When treating angular cheilitis, it's essential to address both the underlying causes and symptoms.
- Apply an antifungal agent to the affected areas, as fungal infection is a common cause.
- Use an antiseptic oral rinse, such as 1.5% hydrogen peroxide mouthwash or 0.2% chlorhexidine digluconate mouthwash, twice daily to reduce bacterial colonization of the mucosa 1.
- Consider using a topical corticosteroid, such as betamethasone sodium phosphate 0.5 mg in 10 mL water as a 3-min rinse-and-spit preparation, four times daily to reduce inflammation 1.
- Keep the affected areas clean and dry, and avoid licking the corners of the mouth as saliva can worsen the condition.
- Applying a barrier, such as petroleum jelly, can protect the area while healing.
- Address contributing factors, such as ill-fitting dentures, vitamin deficiencies, or skin conditions. It's crucial to note that if the condition persists beyond 2-3 weeks despite treatment, or if it's severe or recurrent, consulting a healthcare provider is necessary as this may indicate an underlying medical condition requiring different management. In cases where bacterial or candidal secondary infection is suspected, oral and lip swabs should be taken regularly, and treatment should be adjusted accordingly 1.
From the FDA Drug Label
Directions adults and children 2 years of age and older: clean the affected area apply a small amount of this product (an amount equal to the surface area of the tip of a finger) on the area 1 to 3 times daily may be covered with a sterile bandage children under 2 years of age: ask a doctor The treatment for angular cheilitis is not explicitly mentioned in the provided drug label. However, based on the given information for the treatment of skin infections using bacitracin (TOP), the following general treatment approach can be considered:
- Clean the affected area
- Apply a small amount of bacitracin (TOP) on the area 1 to 3 times daily
- The affected area may be covered with a sterile bandage For children under 2 years of age, it is recommended to ask a doctor 2
From the Research
Treatment Options for Angular Cheilitis
- Antifungals are often considered the first-line treatment for angular cheilitis, although there is limited scientific evidence to support their reliability 3
- A combination of 1% isoconazole nitrate and 0.1% diflucortolone valerate ointment has been found to 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 3
- Other treatment options that have been proposed include topical treatments, occlusal vertical dimension restoration, B-vitamin supplementation, anti-drooling prosthetic devices, and photodynamic therapy 3
- Treatment of angular cheilitis should be considered in a longer perspective due to the high incidence of recurrence, with 80% of patients experiencing recurrence on one or more occasions during a 5-year observation period 4
Underlying Causes and Treatment
- Iron deficiency should be considered as a potential predisposing factor in angular cheilitis, particularly in women of child-bearing age 5
- Angular cheilitis may be associated with a variety of nutritional, systemic, and drug-related factors, and establishing the underlying etiology is necessary to focus treatment efforts effectively 6
- The disease has a mixed etiology, with bacterial and fungal components, and may be a clinical sign of an underlying disease 7