From the Research
For pediatric treatment of angular cheilitis, the most effective approach is to use a combination of 1% isoconazole nitrate and 0.1% diflucortolone valerate ointment, as it 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.
Key Considerations
- Gentle cleansing of the affected corners of the mouth with warm water and mild soap, followed by thorough drying, is essential before applying any treatment.
- The use of antifungal creams such as clotrimazole 1% or nystatin cream 3-4 times daily for 7-14 days may also be effective, especially if the condition is caused by a fungal infection.
- For cases with significant inflammation, a low-potency topical steroid like hydrocortisone 1% cream can be applied sparingly twice daily for 3-5 days.
- It is crucial to encourage the child to avoid licking the corners of the mouth and maintain good oral hygiene to prevent the accumulation of saliva and bacteria.
- Applying petroleum jelly as a barrier after treatment applications can help protect the skin and promote healing.
Causes and Treatment
- Angular cheilitis in children can be caused by various factors, including saliva accumulation at mouth corners, nutritional deficiencies (particularly B vitamins, iron, or zinc), or fungal/bacterial infections 2, 3.
- Identifying the underlying etiology of the condition is critical in developing an effective treatment plan.
- If the condition does not improve within two weeks, persists, or recurs frequently, it is essential to consult a healthcare provider as it may indicate an underlying condition requiring further evaluation.
Evidence-Based Recommendations
- The most recent and highest quality study available recommends the use of 1% isoconazole nitrate and 0.1% diflucortolone valerate ointment as the most consistent treatment for angular cheilitis 1.
- Other studies have also highlighted the importance of microbial analysis and antimicrobial treatment in the management of angular cheilitis 4.