From the Research
The most effective treatment for angular cheilitis involves addressing the underlying cause, with a combination cream containing 1% isoconazole nitrate and 0.1% diflucortolone valerate ointment being the most consistent treatment, as it has a broad spectrum of activity against dermatophytes and bacteria, and anti-inflammatory properties, as shown in the study by 1. The diagnosis of angular cheilitis, also known as cheilosis or perleche, typically involves a clinical examination to identify the underlying cause, which may include fungal infection, bacterial infection, nutritional deficiencies, or excessive moisture. Some key points to consider in the diagnosis and treatment of angular cheilitis include:
- The condition can be caused by various factors, including fungal and bacterial infections, nutritional deficiencies, and excessive moisture, as noted in the study by 2.
- Treatment should be tailored to the underlying cause, with antifungal creams, such as clotrimazole 1% or miconazole 2%, being effective for fungal infections, and mupirocin 2% ointment being effective for bacterial infections, as discussed in the example answer.
- Nutritional deficiencies, particularly of B vitamins, iron, or zinc, should be corrected through supplements if identified, as mentioned in the study by 3.
- To prevent recurrence, it is essential to maintain good oral hygiene, avoid licking the corners of the mouth, apply petroleum jelly as a barrier, and stay hydrated, as noted in the example answer.
- The condition develops because the corners of the mouth create a perfect environment for microorganisms to thrive, especially when saliva accumulates and maceration occurs, breaking down the skin barrier and allowing infection to develop, as discussed in the study by 4. Some other treatment options that have been reported to be effective in specific cases of cheilitis include:
- Topical tacrolimus 0.03% ointment, which has been used to treat atopic cheilitis, as shown in the study by 4.
- Topical 0.03% tacrolimus ointment, which has been used to treat plasma cell cheilitis, as reported in the study by 5. However, the most recent and highest quality study, 1, recommends the use of a combination cream containing 1% isoconazole nitrate and 0.1% diflucortolone valerate ointment as the most consistent treatment for angular cheilitis.