What is the Best Treatment for Angular Cheilitis?

Fungal or bacterial infection on the corners of lips characterized by soreness, redness, painful cracks, bleeding, and blistering are termed as angular cheilitis.

It can occur in one corner of lips or on both. Earlier symptoms include soreness and swelling around the corners of lips. If left untreated, it may cause bleeding, blistering, cracking, itchy patch, scales, etc.

Cheilitis can cause a burning sensation in the mouth and lips. When the condition becomes severe, it may cause difficulty in eating.

The best treatment for angular cheilitis include maintaining hygiene, improving diet, proper fitting of dentures, taking nutrient supplements, use of antibiotics, by filler injections, changing toothbrush and with home remedies.

What is the Best Treatment for Angular Cheilitis?

Some times angular cheilitis need no treatment because it is a self-limiting disease. It can be diminished within a few days but after 3 days if a condition is not getting better, treatment is necessary.

Before having treatment it’s necessary to confirm it whether it’s due to bacteria or virus or fungus.

Fungus involved in angular cheilitis is Candida albicans
Bacteria involved in angular cheilitis is Staphylococcus aureus

Virus involved cab is Herpes simplex.

It’s better to visit a dermatologist for the better treatment of angular cheilitis. Treatment must be started after confirming the organism involved. There are different medication for bacteria, virus, and fungus.

Steps for angular cheilitis treatment

The best treatment plan for angular cheilitis must include the following steps

Home remedies
Use of antibiotics

Management
Follow up

Home Remedies for Angular Cheilitis

In case of minor to mild angular cheilitis, treatment can be done at home by some home remedies. Home remedies can cure angular cheilitis on earlier stages.

Garlic paste

Garlic has a natural Antifungal property. When applied topically on the angular cheilitis caused by Candida Albicans, it has positive effects.

For the treatment of angular cheilitis, make a fine paste of two garlic cloves. After cleaning the affected area with cotton, apply directly on the affected area. Remove off after 10 minutes of application. Apply twice a day. After removing garlic paste, must apply moisturizer or lip balm.

Apple cider vinegar

Apple cider vinegar has both antibacterial, antifungal properties. Due to its anti-inflammatory properties, it can be applied for the treatment of angular cheilitis because it can better prevent bacterial or fungal growth. It may cause irritation in concentrated form so must be diluted before application.

In a cup, add one teaspoon of apple cider vinegar and dilute it with water. With the help of a cotton ball, apply gently on the lip corners. You may feel burning sensation but it’s normal with apple cider vinegar. Leave for max 20minutes and then rinse off with fresh water. Apply moisturizer and apply once a day.

Neem oil

Neem oil is best known for an antifungal property. It has the ability to reduce inflammation by soothing the skin. It’s best for the treatment of angular cheilitis. It will moisturize your lip corners and also kills the fungus responsible for angular cheilitis.

With the help of a cotton ball, apply neem oil daily two or three times daily. Leave for 30 minutes and then remove with a cotton ball.

Saltwater

Salt has the antiseptic properties .or can prevent infection form further proceeding .it might cause a slight burning sensation but don’t worry, it’s good for your angular cheilitis.

Take a teaspoon of salt and mix in one cup of cold water. With the help of a cotton ball, apply on the affected area. Leave for 20 minutes and then clean the area with fresh water. Apply once daily.

Honey

Honey has antiseptic properties and can be used for the treatment of angular cheilitis. It helps in combating with the fungus and bacteria and with regular use can treat angular cheilitis.

After cleaning the affected area with a cotton ball, apply honey on it with a cotton ball. Leave for 20 minutes and then rinse off with water. After drying, apply a good moisturizer. Do this twice or thrice a day.

Alcohol

Many cases have been reported where the patient with angular cheilitis is treated with alcohol and within two weeks, there was no sign of angular cheilitis.

Use Antibiotics

When home remedies fail to treat angular cheilitis, then go for antibiotics.

Use of antibiotics depends upon the severity and condition of angular cheilitis.

At the initial stage, use topical antibiotics
In the case of oral infection, use both oral and topical antibiotics

In case of a severe condition, add systemic antibiotics.

Use of oral and topical antibiotics

In case of infection, when the condition becomes severe, the use of antibiotics is the first-line treatment. Inflammation symptoms include bleeding, pus, hotness of the infected area.

Take start from topical antibiotics, topical antifungal creams, and steroids. These antibiotics are available in the form of creams or ointments. They should be applied twice daily or with a recommendation of a dermatologist. Apply 2 or three layers of antibiotics ointment after proper cleaning of the lips corners.

Antifungal antibiotics include nystatin, ketokonazle, cotrimazole, miconazole. Antibacterial antibiotics contains mupirocin, fusidic acid .

In many cases of angular cheilitis, oral candidiasis is very common. In the case of oral candidiasis, along with topical antibiotic ointment, use of oral antibiotics is essential. Nystatin is a good option for oral and topical fungal infection. Gentian violet should be applied topically.

For the reduction of inflammation, the use of Corticosteroids is recommended along with anti-candidal ointments.

In rare cases, when condition prolongs, use of hydrocortisone 1% and desonide are also recommended.

Use of systemic antibiotics

If oral and topical antibiotics fail to treat angular cheilitis or if the condition has been worsening, the use of systemic antibiotics is recommended. In case of oral or topical worsen candidiasis, Fluconazole through systemic route is recommended.

Dermatologist Treatment for Angular Cheilitis

Management is also the necessary step of angular cheilitis treatment. Management of angular cheilitis includes the following steps

Filler injections

Filler injections are used for increasing the volume of lips. If someone is repeatedly facing the problem of angular cheilitis, then filler injections are the good option. Because the patient has the problem with lips shape and volume and by adjusting the lip volumes, angular cheilitis can be prevented.

Maintain hygiene

Maintaining proper hygiene is the step of treatment of angular cheilitis. You must have to keep the area clean so that it can stop the further growth of bacteria or fungus.

Angular cheilitis starts from unhygienic conditions and the first line of treatment must include property hygiene .keep the lips corners dry as much as possible.

Clean them after every hour with surgical cotton. Don’t touch your fingers to clean or for any purpose to the affected area. Always use surgical cotton for cleanliness or for the application of medicinal products.

Maintain a proper diet

Diet plays an important role in the treatment of angular cheilitis. Eating spicy food, which can also increase body internal heat will worsen the condition. A healthy diet with vitamins and nutrients and antioxidants will help out in treating angular cheilitis.

Some food with high carbohydrate content like meat, the use of fried products can be harmful. This type of food can may irritate the skin around lips corners.

Use of chilled milk, fresh veggies and the fruits but avoid from citrus fruit like oranges, lemon can help in the treatment of angular cheilitis.

Eating of 10 to 12 almonds and a cup of Stonyfield farms organic vanilla yogurt are the magical food for angular cheilitis.

Proper fitting of the denture

The denture is the false teeth fitted snugly on the gums for the replacement of missing teeth. Sometimes with the passage of time or due to improperly fitting, denture not remains fitted properly. These improperly fitted dentures can be the cause of angular cheilitis.

Improper fitting of denture causes mechanical irritation and can also increase the risk of infection. In the moist crevices of lips angles, chances of irritation and infection increases several times with poorly fitting dentures.

Have a thorough examination of the denture by a dentist for treatment of angular cheilitis. Treatment of angular cheilitis is of no worth of denture fitting is not checked. It will cause repetitive angular cheilitis. So adjustment of faulty dentures is essential. Well, cleanliness of dentures is also necessary. Clean them properly twice a day is essential.

Take iron, zinc and vitamin B2 supplements

It has been reported that deficiency of iron, zinc, and riboflavin cause the angular cheilitis. For better treatment, treat the underlying cause. Take supplements of iron, zinc, and riboflavin to overcome the deficiency of these nutrients.

All of these nutrients can also be taken thought diet but it will take time to fulfill the deficiency. If the condition is mild take them through diet and if the condition is severe, supplements are the better option.

Use of lip balm

Lip balm of good quality should be applied to moisturize the lips. The appliance of lip balm can also help out in avoiding lip licking. It will minimize the chances of direct contact of saliva with the lips so prevent the bacteria or fungus to penetrate deep into the skin.

So can reduce the chances of infection. Quality of lip balm also matters a lot. Poor quality lip balm can instead of preventing infection, can cause irritation and promote infection. Lip balm with colorants and any other additives should be avoided.

Lip balm with medicinal agents is also available. They have soothing action and provide calm to your lips.

Change toothbrush

When angular cheilitis is diagnosed, change of toothbrush is necessary. A toothbrush can have the number of bacteria and Fungal colonies and may severe the reaction. Change of toothbrush may help out in treating angular cheilitis.

Drink plenty of water

Xerostomia, dry mouth initiates angular cheilitis. Those people who have dry mouth due to dehydration are at greater risk of developing angular cheilitis.

During winter, intake of water is reduced by people which cause dehydration. Due to dehydration, lips and lips corners becomes dry, cracked. Dry, cracked lips cause irritation. On the other hand, lips dryness also promote lip-licking habits. Both of these factors lead to angular cheilitis.

Drinking plenty of water on a daily basis in both cold and warm weather may help out in avoiding angular cheilitis and may help in treating it. So stay hydrated as much as possible.

Brushing twice a daily

For the prevention of infection, it’s too much necessary to brush your teeth twice a daily with a clean toothbrush. It will help out in maintaining oral hygiene.

Follow up

Follow up the treatment until the condition resolved is essential otherwise reversal of effects may occur. If the condition resolved, continuous monitoring is recommended for about two to three weeks.

In case if the condition is not resolving after three weeks, there might be any systemic illness and it’s better to consult with a primary physician for evaluation.

Final Words:

Angular cheilitis is a skin condition more than that of a disease. Medication is not enough for the treatment of angular cheilitis. People just focus on medication and ignore other points an claim that medications are not good enough to treat angular cheilitis.

No doubt medications have a role but the management of angular cheilitis is necessary. Without considering the other factors, you might not have good results.