Chapped Lips, or, could it be Something More?

Tis the season for the flaking, cracking, and dry lips, right? Of course! But did you know that a fungus or bacteria could actually be the culprit? 

Angular Cheilitis is a condition that typically begins with redness and slight scaling around the corners of the mouth.  It often quickly progresses to surround your lips with an inflammatory flaky perimeter which can be tingly, itchy, or even painful for some. Although most patients typically go for Aquaphor, Chap Stick, or Vaseline as a first line treatment, these are rarely helpful to relieve the inflammation.

So just where does it come from? 

 Maceration, or the breakdown of skin due to moisture is the most common cause of angular cheilitis. This makes sense as we tend to drool and produce saliva that can gather in these regions around our mouths. Due to the breakdown of the normal skin barrier, pathogenic (bad) organisms are given the chance to flourish. The typical culprits for angular cheilitis are a fungus named Candida Albicans, and a bacteria named Staphylococcus Aureus. Less commonly, it can be found due to Vitamin B or iron deficiency in underdeveloped countries. 

Who gets it?

Risk factors for developing this condition include licking your lips, having deep wrinkles around the mouth (moisture trapping), those with orthodontic devices or dentures, sensitive skin individuals, and immunocompromised patients. Once present, acidic or spicy foods can be very aggravating for patients as they create more inflammation when left on macerated skin following meals.

How do we treat it? 

Angular cheilitis is commonly treated with a topical combination medication containing both an antifungal agent along with a low potency topical steroid. At times, a topical antibiotic can also be used if Staphylococcus infection is a consideration. To prevent further cracking and fissuring of the lips it is often advised to keep the lips moist with Vaseline or Aquaphor to promote elasticity of the skin as well as creating a protective barrier.  Angular cheilitis can take a few weeks to resolve with prescription medications. Without treatment, it can persist for months to years! Having trouble getting your chapped lips under control? Maybe there is something more to it. You can see me at Dermatology and Skin Cancer Institute in either our Fort Washington, Pennsylvania office, or our Lansdale, Pennsylvania office. 

 Schedule an office visit with me, Charles Capaci, PA-C by calling 215-361-3376, option 1.