Angular cheilitis, also known as perlèche, is an acute or chronic inflammation of the skin and contiguous labial mucosa located at the lateral commissures of the mouth. It typically presents with erythema, maceration, scaling, and fissuring at the corners of the mouth. Lesions are most often bilateral and may be painful.

Angular cheilitis is caused by excessive moisture and maceration from saliva and secondary infection with Candida albicans or, less commonly, Staphylococcus aureus . Angular cheilitis may occur at any age without sex predilection but is especially common in older individuals wearing dentures. Predisposing local factors include wearing orthodontic appliances or ill-fitting dentures, sicca symptoms (dry mouth), intraoral fungal infection, poor oral hygiene, and age-related anatomic changes of the mouth due to reduced vertical facial dimensions 

Diagnosis

Dr. Kamat will do the clinical diagnosis after looking at your skin. In some instances to rule out candida or other infections, we may take a swab and send it to the lab.

 

Treatment

In our community we have observed that one of the contributing factors is vitamin deficiency. So we ask patients to take multivitamins. Patients must also avoid smacking the lips. Patient can also  start using topical aloe vera, sun protection (hat),  topical hydrocortisone. If drooling is a contributing factor, please use vaseline before going to bed. Typically your inflammation must resolve in a week of treatment.

 

Prevention

  1. Continue taking multivitamins
  2. Improve oral hygeine
  3. Use moisturizer to avoid dry lips
  4. Improve denture  fit and cleaning(if using) 

Patient Questions:

  1. Where do I find a good Aloe Vera?

There are many Aloe Vera creams in the market. Look for something that has purer Aloe Vera and no fancy chemicals or mineral oils. Aloe vera is a moisturizer. Alcohol dries the skin. So if the product lists out alcohol along with Aloe Vera, it may not be very effective.   

You can get Aloe Vera at H-Mart in Aurora. You may also get this from other Asian and Mexican Markets.

If you buy Aloe Vera you can make Aloe Vera Gel at home following instructions from WellnessMama. (We have requested permission to share this link)