From the Guidelines
Treatment for angular cheilitis should focus on addressing the underlying causes and symptoms, with a priority on keeping the affected area clean and dry, and applying antifungal or antibacterial creams as necessary. The provided guidelines for actinic keratosis 1 do not directly address angular cheilitis, as it is explicitly excluded from these guidelines. However, based on general medical knowledge, treatment typically involves applying an antifungal cream like clotrimazole 1% or miconazole 2% three to four times daily for 7-14 days, as fungal infections are common culprits. Some key considerations for treatment include:
- Applying a thin layer of petroleum jelly to protect the corners of the mouth while healing
- Using a low-potency topical corticosteroid like hydrocortisone 1% cream for inflammation, applied sparingly twice daily for up to 7 days
- Supplementing with B vitamins, iron, and zinc to prevent recurrence, as nutritional deficiencies often contribute to angular cheilitis
- Avoiding licking the lips, as saliva can exacerbate the condition, and ensuring proper fitting and cleaning of dentures if worn. Most cases resolve within 1-3 weeks with appropriate treatment, but persistent or severe cases should prompt evaluation for underlying conditions like diabetes, immune disorders, or severe nutritional deficiencies 1.
From the Research
Treatment Guidelines for Angular Cheilitis
- The treatment of angular cheilitis depends on the underlying cause, which can be bacterial, fungal, or a combination of both 2.
- Antifungals are often considered the first-line treatment, but there is limited scientific evidence to support their reliability, with only two RCTs published between the 1970s and 1980s 3.
- Alternative topical treatments, such as 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, and anti-inflammatory properties 3.
- Nutritional, systemic, and drug-related factors can also contribute to the development of angular cheilitis, and establishing the underlying etiology is crucial to focus treatment efforts 4.
- Microbial analysis and antimicrobial treatment can be significant in the cure of angular cheilitis, with a study showing that 96% of patients who received ointments containing nystatin and/or fusidic acid had no sign of infection after 42 days of treatment 5.
- Factors such as increasing age, dry skin, and extended skinfolds at the corner of the mouth can affect the length of the healing process 5.
- Various techniques, such as occlusal vertical dimension restoration, B-vitamin supplementation, anti-drooling prosthetic device, and photodynamic therapy, have been experimented and proposed as treatment options, but further research is needed to assess their effectiveness 3.