Q: I have a recurrent problem with the skin at the corners of my mouth. The skin gets irritated with small cracks. It gets better, then for no apparent reason returns. What could be causing this condition? Can I prevent it from recurring?
A: This condition is called angular cheilitis, also know as angular stomatitis or perlèche. The skin cracking at the corners of your mouth can be associated with redness and scaling. The cause is frequent or persistent saliva touching the skin outside the mouth. This can occur because of a poor seal of your lips at the angles of your mouth, braces, ill-fitting dentures, or because you frequently lick the area. Less commonly, this can be the result of an allergic skin reaction to lipstick or face cream, or too vigorous dental flossing. Rarely, the cause of angular cheilitis is a vitamin or iron deficiency.
The cracks in the skin and the excess moisture provide a fertile environment for yeast. The yeast causes a low-grade infection, which may make the corners of the mouth even more irritated.
While the angular cheilitis is active, you can apply an over-the-counter antifungal cream, such as clotrimazole, then a 1 percent topical hydrocortisone ointment an hour later. You can do this two to three times per day. Another option is a cream containing both hydrocortisone and the anti-infective agent iodoquinol (Vytone, also available as generic).
To help prevent a recurrence, don't lick your lips. You want to avoid letting excessive moisture accumulate in the corners of your mouth.
Once the angular cheilitis heals, then use a protective lip balm, preferably one that is hypoallergenic. Make sure the mouth corners are dry before applying, and use it often.
If the condition does not clear, see your physician for a prescription anti-yeast cream such as ketaconazole cream.
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