What is the treatment for dry, chapped skin along one edge of the mouth?

Treatment for Dry, Chapped Skin Along One Edge of the Mouth

Apply white soft paraffin ointment (such as petroleum jelly) to the affected area every 2 hours until symptoms resolve, avoiding petroleum-based products for chronic use beyond initial healing. 1

Initial Management Approach

The dry, chapped skin along one edge of the mouth most likely represents angular cheilitis or simple chapping, which requires immediate barrier protection and moisture restoration.

First-Line Treatment

Immediate barrier protection:

• Apply white soft paraffin ointment every 2 hours during the acute phase to protect and moisturize the affected area 1, 2
• This provides immediate relief and prevents further moisture loss 1
• Continue frequent application until the skin barrier is restored 1

Important caveat: While white soft paraffin (petroleum jelly) is recommended for acute management, do not use petroleum-based products chronically as they promote mucosal dehydration and increase secondary infection risk 3. Transition to animal or plant-based oils (beeswax, cocoa butter, lanolin) for ongoing maintenance 1

If No Improvement After 48-72 Hours

If simple emollient therapy fails, consider angular cheilitis with infectious component:

Combination therapy approach:

• Apply topical antifungal-corticosteroid combination to address both Candida infection and inflammation 3
• Alternative: Nystatin oral suspension (100,000 units four times daily for 1 week) or miconazole oral gel (5-10 mL held in mouth after food four times daily for 1 week) 1, 3
• For bacterial component: Use antiseptic oral rinse containing 0.2% chlorhexidine twice daily 1, 3

Supportive measures:

• Clean the area daily with warm saline mouthwashes 1, 2
• Apply benzydamine hydrochloride rinse or spray every 3 hours if painful, particularly before eating 1, 2

Treatment Duration and Monitoring

Reassessment timeline:

• If no improvement after 2 weeks of appropriate treatment, reevaluate the diagnosis 2, 3
• Consider underlying causes: ill-fitting dentures, diabetes, immunosuppression, or lip-licking habits 3
• More resistant cases may require fluconazole 100 mg/day for 7-14 days 3

Critical Pitfalls to Avoid

Do not use:

• Alcohol-containing mouthwashes, which cause additional pain and irritation 1, 2
• Glycerin or lemon-glycerin swabs, which dry the mouth rather than moisturize 1
• Petroleum-based products chronically beyond initial healing phase 1, 3

When to escalate care:

• If blistering develops, consider autoimmune blistering diseases requiring dermatology referral 2
• Immunocompromised patients may require more aggressive and prolonged therapy 3
• Persistent cases unresponsive to standard treatment warrant specialist evaluation 2, 3

Maintenance After Healing

Once the acute phase resolves, transition to:

• Animal or plant-based lip moisturizers (beeswax, cocoa butter, lanolin) for daily maintenance 1
• Address any mechanical factors like ill-fitting dentures or loss of vertical dimension 3
• Maintain good oral hygiene with gentle brushing and bland rinses 1