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What Causes Angular Cheilitis

Priyanka Kosta Sonkushre
Angular cheilitis is a condition that results in the inflammation of the corners of the mouth. The inflammation can last anywhere from a few days to several months. Highlighted below the various underlying causes behind the development of this painful and unpleasant condition.
We often come across people who have unsightly cracks and inflammation at both corners of their mouth. These cracks or inflammatory lesions are associated with a condition clinically known as angular cheilitis. It is also known as cheilosis, perlèche, or angular stomatitis.
This common problem affects the oral commissures or corners of the lips. When the condition is mild, it gets resolved on its own, with time. But when it is severe, it may persist for an infinite length of time and cause severe pain along with bleeding.
Deep cracks, shallow ulcers, or crusts formed due to angular cheilitis can be a very displeasing sight, thus affecting the physical appearance of a person. To prevent this problem from occurring, one has to first know the potential causes behind it.

Possible Causes of Angular Cheilitis

The actual reason behind angular cheilitis has not yet been established. However, several possible causes are identified and are listed below. These probable causes are not gender-specific and can occur in men as well as women.
  • One of the probable reasons for the development of this condition is nutritional deficiency. A person having riboflavin deficiency, iron deficiency, and/ or zinc deficiency is likely to develop angular cheilitis.
  • Anorexia nervosa and bulimia nervosa are related to malnutrition. People suffering from these problems are also prone to angular cheilitis.
  • Constant vomiting for a prolonged period involves irregular and frequent opening and closing of the mouth. The content thrown out of the stomach is also half-digested. This can moisten the corners of the mouth and make them susceptible to infection.
  • Loss of teeth is common in old age, due to which, old people face over-closure of mouth. Loss of support that teeth provide to the mouth may lead to cheilosis in the elderly.
  • Lips crack and turn dry in cold weather which can lead to this awful condition. This problem can be frequently observed in people residing in colder climes. Mild cases can occur in locations where winters are not so cold.
  • Constant licking and biting of lips is also a cause of angular cheilitis. Frequent licking and biting of lips all through the day, wears the upper surface of lips, leaving them dry and prone to this problem. People lick their lips to provide relief, without realizing that this actually worsens the condition.
  • Bacterial and fungal infections can trigger this problem in individuals. Fungal infections are common reason behind this condition as compared to bacterial infections. Microorganisms like Candida albicans, Staphylococcus aureus, and Herpes simplex are found when cultures of swabs are taken from lip corners of individuals suffering from angular cheilitis.
  • Certain medications that dry the skin, like isotretinoin for acne and acitretin for psoriasis, can be a cause of cheilosis in patients consuming these medications.
  • Though rare, excess vitamin A in the body can also result into lesions at the corner of lips. Excess intake can be due to over-consumption of vitamin supplements, cod liver oil, or other fish oils.
  • Ill-fitting dentures can also lead to angular cheilitis in people using them.
  • Sometimes, an individual's genetic predisposition can be such that it can cause this problem. People suffering from Down's syndrome fall under this category.
  • Excess sun and wind exposure can lead to dryness of the skin including the lip area. This leaves the lips with little moisture, resulting in chapping and irritation, and ultimately leading to perlèche or angular cheilitis.
  • Oozing saliva from the corners of the mouth while sleeping increases the chances of developing this condition. This is because, saliva keeps the lip corners moist all night long and give germs an opportunity to cause infection.
  • Improper and frequent opening and closing of mouth can create cracks or lesions on both corners of the lips.
  • Many people have the habit of wiping mouth frequently. Such people are also at risk to develop this problem.
  • Rarely, cheilosis can also occur in individuals with continuous usage of incompatible products like toothpaste, lipstick etc. Stopping the use of such products can prevent angular cheilitis.
  • Protein-calorie malnutrition is also one of the probable causes in 50% of elderly people residing in nursing homes in the United States.
The above likely reasons present a picture of people who are prone to develop this problem. People who know its causes, and are aware of their susceptibility to it, must take preventive measures.
Treatment of angular cheilitis can be carried out using simple home remedies. A person needs to be consistent in following the remedies so as to get rid of this problem without much difficulty.