From the Guidelines
The primary treatment approach for pediatric angular cheilitis should focus on maintaining good oral hygiene, applying topical treatments, and addressing any underlying conditions that may be contributing to the development of the condition. When considering the treatment of pediatric angular cheilitis, it's essential to prioritize strategies that promote healing, reduce discomfort, and prevent infection.
- Key considerations include:
- Gentle cleansing of the affected area with warm saline mouthwashes or an oral sponge, as suggested in the guidelines for managing Stevens-Johnson syndrome/toxic epidermal necrolysis in children and young people 1.
- Application of white soft paraffin ointment to the lips every 2 hours during the acute phase to help protect the skin and promote a moist environment conducive to healing 1.
- Use of an anti-inflammatory oral rinse or spray containing benzydamine hydrochloride every 2-4 hours, particularly before eating, to reduce pain and inflammation 1.
- Consideration of a potent topical corticosteroid mouthwash, such as betamethasone sodium phosphate, four times a day, or in infants, clobetasol propionate 0.05% cream or ointment applied topically to affected areas, including lips, during the acute phase 1. Given the potential for fungal or bacterial infections to complicate angular cheilitis, antifungal or antibacterial treatments may also be necessary, although the provided evidence does not directly address these aspects.
- It is crucial to:
- Monitor the child's condition closely and adjust the treatment plan as needed based on the clinical response.
- Educate the child and their caregivers on the importance of good oral hygiene practices and how to apply topical treatments correctly.
- Consider underlying conditions that may be contributing to the development of angular cheilitis, such as nutritional deficiencies or ill-fitting dental appliances, and address these as part of the comprehensive treatment plan.
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 guideline for pediatric angular Cheilitis is to ask a doctor for children under 2 years of age. For children 2 years of age and older, the guideline is to:
- Clean the affected area
- Apply a small amount of the product (equal to the surface area of the tip of a finger)
- Apply 1 to 3 times daily
- May be covered with a sterile bandage 2
From the Research
Treatment Guideline for Pediatric Angular Cheilitis
There are no specific studies provided that focus on pediatric angular cheilitis. However, based on the available evidence for angular cheilitis in general, the following treatment options can be considered:
- Antifungal treatments, such as nystatin, have been shown to be effective in treating angular cheilitis, especially when the infection is caused by Candida albicans 3.
- Topical treatments, including 1% isoconazole nitrate and 0.1% diflucortolone valerate ointment, have been found to be effective in treating angular cheilitis due to their broad spectrum of activity against dermatophytes and bacteria, as well as their anti-inflammatory properties 4.
- Identifying and addressing underlying nutritional, systemic, and drug-related factors that may be contributing to the development of angular cheilitis is also important for effective treatment 5.
- Other treatment options, such as occlusal vertical dimension restoration, B-vitamin supplementation, anti-drooling prosthetic devices, and photodynamic therapy, have been proposed, but more research is needed to fully evaluate their effectiveness 4.
Factors Affecting Treatment
Several factors can affect the treatment of angular cheilitis, including:
- Age: Increasing age has been found to be closely related to the length of the healing process 3.
- Dry skin and extended skinfolds at the corner of the mouth can also impact the healing process 3.
- Microbial analysis and antimicrobial treatment can be important in treating angular cheilitis, especially when the infection is caused by Candida albicans and/or Staphylococcus aureus 3.