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Angular Cheilitis OTC Over-the –counter medicines for Treatment

Angular Cheilitis is a clinical name for an infection which affects corners of your mouth forming lesions and cracks in that area. Cracked and/or chapped lips may also be visible due to which lips have intense burning  sensation as if lips are on fire. Mild bleeding may occur in some cases. Angular Cheilitis can either be a bacterial infection or a fungal infection or both. The lips can become dry and may be covered with scaly outer skin which may foliate and bleed occasionally. The cracked corners of the mouth would be painful to such an extent that when you try to open your mouth to speak, eat or drink, you would get tears in your eyes. In addition, with the crack appearing in the vicinity of your mouth, you certainly look unattractive. People around you would think about it and talk-this will drive you to despair.

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Causes of angular cheilitis: Dehydration, ill-fitting dentures, vitamin deficiency, involuntary habit of licking of lips and extremely cold weather. Weak immune system can also cause angular cheilitis. The angular cheilitis can affect people with all ages. Persons suffering from Diabetes Mellitus and people having habit of pooling of saliva around your mouth can also develop angular cheilitis. Deficiencies of iron and vitamin B-12 are also known to cause Angular Cheilitis.

Like most other ailments, there are many over-the-counter medications which can be used to combat outbreak of Angular Cheilitis. The only precaution needed is these should be used on doctor’s advice only.

Over-the –counter medicines:

1)      Petroleum Jelly: This is recommended often for Angular Cheilitis. It should be applied liberally on the affected areas. It is even more useful before venturing out in cold and dry weather. The application provides a layer to your lips which protects your lips from extreme climates effectively.

2)      Aquafor: This ointment should be applied gently on the skin for obtaining relief from angular cheilitis.

3)      Hydrocortisone 1 %: Apply this to the angles of your mouth but please ensure that it does not get into your mouth even by accident.

4)      Vitamin E Oil: This oil will be seen to be working wonderfully if you are suffering from Angular Cheilitis.

5)      Olive Oil: If you are unable to find Vitamin E Oil, then just a drop of Olive oil would come handy.

6)      Nystatin: Ointments containing this topical ingredient can be easily found at any chemist shop.

7)      Clotrimazole:  This is another useful ointment which will offer immediate relief from symptoms of Angular Cheilitis.

8)      Econazole: Use this cream by applying it twice a day on corners of your mouth and allow it to stay so that it does its action properly.

9)      Turmeric: In Indian scenario, you could use any cream made up using Turmeric as its primary ingredient. Turmeric is very effective on many skin disorders including Angular Cheilitis.

10)   Last but not the least: Water can not be classified as an Over the counter remedy, but actually it is so very useful in treatment of Angular Cheilitis. Keeping yourself hydrated is the an important step while treating Angular Cheilitis with any method you may choose.

Angular Cheilitis FAQ

The following are the FREQUENTLY ASKED QUESTIONS in respect of Angular Cheilitis:-

1)      Is Angular Cheilitis Contagious?: No, it is not contagious. The symptoms of Angular Cheilitis are similar to the symptoms associated with AIDS, Cold Sores and hence one can be easily mistaken.

2)      What is Angular Cheilitis?: Angular Cheilitis is an infection caused by bacteria residing in the corners of the mouth due to dampness in the area.

3)      Is Angular Cheilitis occur due to HIV?: There is no connection between Angular Cheilitis and HIV, though the symptoms are almost similar.

4)      Could Angular Cheilitis be cured using Neosporin?: People ask if Neosporin is helpful in the treatment of Angular Cheilitis? Answer is NO. Do not be your own doctor-Use Neosporin Ointment only when recommended by a doctor.

5)      Can Vitamin B cure Angular Cheilitis? : A lot of researchers over the years have maintained that Angular Cheilitis is caused by Vitamin B deficiency. Recently a group proved that this is not exactly the case. Opinions differ but one thing is certain-Vitamin B certainly ensures overall good health and builds up body resistance to fight a lot of ailments.

6)      Is Vitamin Deficiency a cause of Angular Cheilitis?: Yes, Vitamin deficiency does play a big role in inviting Angular Cheilitis. Vitamins are found in nutritious food that we eat. For various reasons, it is possible that food that we consume may not be complete with nutrients that our body needs and hence we are required to take additional vitamins which provide the essential vitamins. In any case vitamins supplements will do more good than harm to our system. If it is possible we could consume those foods can provide natural vitamins-for instance, citrus fruits are a rich source of Vitamin C. Regular consumption of these fruits would normally take care of our Vitamin C requirement.

7)      Does Anti-fungal Cream work on Angular Cheilitis?: At times the anti-fungal creams, though known to be effective temporarily for curing most skin troubles, may actually aggravate angular cheilitis. The simple reason being, the infection may not really be a fungal infection and could be due to some other reason. On the other hand, if the angular cheilitis is a fungal infection, anti-fungal cream may actually work. That is why it is of paramount importance to consult a doctor and follow his advice rather than experimenting ourselves.

8)      What is the effect of Clotrimazole  while treating Angular Cheilitis?: Here again, Clotrimazole, which is basically an over-the-counter ointment, may work on angular cheilitis, in case the infection is indeed a fungal infection. It may not work if the infection is a bacterial one or a culmination of both fungal and bacterial infections.

9)      Can Angular Cheilitis spread?: No, it would not spread as would be the expected fear- in order to ensure safety, it is better to avoid contact to the best possible extent. In fact if you are suffering from angular cheilitis, the lesions will drive people away from you and try to avoid any physical contact.

10)   DO you get scars if you are suffering from Angular Cheilitis:  Scars which occur due to angular cheilitis may vanish but may re-occur if the diet is not improved upon. What is important is that the scar should be kept dry and clean at all times.

11)   Whaqt is role of vitamins in Angular Cheilitis? Researchers have come to a conclusion that lack of vitamins are one of the causes and proper  healthy diet, clean and hygienic life style coupled with supply of vitamins will prevent angular cheilitis.

12)   How to cure Angular Cheilitis in pregnancy: Application of lip balm is the first thing you should do. In addition, you may try to avoid excessive salt and sugar which are in any case not recommended during pregnancy.

13)   Does Vaseline have any effect on Angular Cheilitis: Vaseline could be applied on the lesions without any tensions. It not only softens the area but reduces chapped nature of the lips and works as a lubricant on the affected areas.

Symptoms of Angular Cheilitis

Symptoms of Angular Cheilitis are often confused with those of Cold Sores or with HIV and the related diseases. The moment we hear the word HIV, anyone is likely to panic and get worried.  The first reaction in the mind of a human being is when and how did I get it. It is better to first verify the condition through a medical professional. Before we examine the symptoms of Angular Cheilitis, we must remember that this is not a contagious infection nor is it fatal in any way. The lesions or cracks on the corners of the mouth do look ugly, at times with mild bleeding, but rest assured that the infection will not go beyond that. It starts and ends in the vicinity of mouth only. If one develop the lesions during winter, the pain could be much more.

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Let us now list the symptoms so that you could easily find out when someone contacts this infection merely by looking at the face of the patient.

1)      Onset of Angular Cheilitis is characterized by appearance of a thick grayish spot on the corner/s of the mouth which gradually develops into a crack or lesion. These cracks can not be hidden as these involve the human face, which is the first thing others would be looking at.

2)      Lesion of inflammatory type appearing on the corners of the mouth, It does not look dangerous or ugly at this point of time. An area with cracks and cuts which is at times reddish and slightly swollen would be seen. The lesions may appear on either side of the mouth in some cases but it is likely that some patients may be having lesions only on one side of their mouth. This is a very commonly found symptom.

3)      Immense difficulty in opening and closing of your mouth either while talking, eating, drinking or even yawning. The sharp pain that follows thereafter might bring tears to your eyes. The pain may not last long and would vanish as fast as it surfaced out in the first place. You may forget about it after a minute or so, till it happens once again.

4)      Cracked upper or lower lip which looks as if the lip is divided in two parts. This looks like a fissure or a vertical cut and bothers the patient with immense burning. At times you would feel that the lip is virtually on fire.

5)      Unbearable burning sensation of the lip, which can increase by touching it with your finger or when any liquid or food particle touches it.

6)      Usually these cracks or lesions do not start bleeding profusely-at the most, there could be spot or tinge of reddishness or a tiny trickle of blood. In some cases however, the cracks may bleed when some force is applied on them.

7)      In some rare cases, neglected cracks or cuts may get transformed into fissures with pus and be very painful all he time.

8)      In a few cases, there could be an urge to scratch the lesions as there is a considerable itching around the area-this would only make the problem worse.

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Angular Cheilitis or Perleche Treatment

Angular Cheilitis is a condition wherein lips and or corners of the mouth get inflamed and mostly develop a deep crack or scar sort of mark thereupon. In some cases the cuts will be noticed in the center of the lips too. Sometimes, the cuts will be itchy and when touched there could be mild bleeding or redness.  Angular Cheilitis is in no way related to herpes. This condition could last for weeks depending upon whether or not it is treated in a timely fashion.

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Generally it is a combined effect of a fungal infection and a bacterial infection; In other words the lesions could be actually a result of many internal forces and certain traits or habits such as:

1)       Licking of lip: People who are less confident while in a group of people or speakers-orators have this trait. Some people develop this habit out of nervousness also.

2)       Under-nourished or mal-nutritional profile: People who are neglected and denied healthy living conditions would mostly fit in this category.

3)       Children who do not get proper care and diet: Poverty and large size of family with less bread earners could be one of the reasons.

4)       Habit of opening and closing of mouth: Involuntary habit found in many people. This habit is seen in some people even when they are not talking or consuming any food or drink.

5)       Incessant thirst or dry throat and/or dry mouth: Athletes, sports persons and people diagnosed with symptoms of diabetes would fall into this type.

6)       Drooling habit: Some people have the saliva dribbling out of their mouth, unknowingly. This habit could be seen more often in the people who are absent minded or in those people who are unkempt, untidy and unaware of their facial appearance.

7)       People using dentures: People undergoing treatment of fixing of dentures, through a dentist. Loose or ill-fitting dentures leave a gap and you are unable to close the mouth properly. This is the situation when saliva is released and accumulates in the mouth and stays in if not thrown out. The dampness then encourages the bacteria manifestation if the Cheilitis has already set in. It would be advisable to have the dentures re-fitted or adjusted to avoid reoccurrence of troubles due to untidy dentures .

8)       Later years of one’s life: Those who are very old and/or paralytic patients, can get affected much too easily.

9)       Extremely cold weather conditions are also one of the causes but it should be noted that it can affect you any time of the year. One gets affected more in the winter or cold weather because this is the time when your immune system is weakest as compared to other seasons.

10)   Hot weather can make you thirsty very often and leaves you dehydrated. The direct result of this could be chapped or cracked lips. The crack offer space for the bacteria to reside and grow, with the aid of moisture and dampness.

11)   Deficiency of Vitamin B and lack of iron content in your body is also another reason to get infected.

12)   Diabetics at times have been seen affected by this infection-in their case healing may take even longer.

13)   Lesions can be result of bouts of vomiting which have lasted for a week or more.

14)   Cracks are superficial but the cause of cracks could be some other serious illness, unknown to the patient. In such case, it is of vital importance to treat the other ailment first so that the angular cheilitis will vanish on its own.

Other possible causes:

1)       Vitamin B-12 deficiency.

2)       Iron and Folic acid Deficiency.

It has been observed that angular cheilitis is not contagious or does not spread due to skin contact with other healthy persons. The patient need not worry as it is not a life-threatening problem. This is not to mean that the treatment should be avoided. Any disorder must be treated with due care and Angular Cheilitis is not an exception. Since this problem appears on facial area, it is difficult to conceal it. Using the make-up to hide the cracks or lesions will not help as the problem will continue to persist beneath the make up and might flare-up again.

 

 

Symptoms:

1)       Fissures at the corners of mouth and /or on the lips. Anything touching the lips could lead to a burning sensation, as if the lips are on fire.

2)       Pus formation in the cracks or lesions.

3)       Soft tissues in the area of the mouth which are sensitive to touch.

4)       Burning sensation which lingers for some time at a stretch and then vanishes for a while.

5)       Ulceration of the oral cavity.

6)       Difficulty in opening and closing the mouth. This can happen while talking, yawning, eating and drinking. The area could be so painful that it will bring tears to your eyes. The pain will vanish quickly as the mouth is closed.

Precautions:

a)       Licking the cuts around your mouth with the tongue should be completely avoided. The salival wetness that will get coated on the cuts will only make the bacteria to multiply and spread in other areas. The bacteria will multiply in moist conditions and one needs to control this reflex action of licking the cuts and lesions with the tongue.

b)       The cuts or cracks are at times very sensitive-try to avoid spicy, hot foods as these will increase the burning sensation in that area.

c)       Boiling water, tea, coffee or any other acidic type of drinks should be avoided as well. Try to consume beverages after these have cooled down a bit. Room temperature is the most suitable for any intake of food or drink.

d)       Since the areas near the mouth are cracked/ chapped, the discomfort is a fall out and it can not be left untreated. The mouth can come in contact with many foreign substances such as dust, water, sunrays and it is likely that the problem may intensify after the contact.

e)       If you have a tendency to develop cracks surrounding the oral area, make it a habit to carry dry paper tissues to be used every time you feel there is any moisture in those areas. Use a different tissue each time.

Treatments:

A host of topical ointments, creams are available in the market but care should be taken while buying them; the best course of action is to consult your doctor and take his advice before purchasing the ointment. If the problem lies on the lips, a lip balm could be a solution in form of a First-Aid. A visit to a doctor is advised in any case so that the real cause of the problem could be identified and treated.

Since the angular cheilitis could be a result of various other disorders, it is for the doctor to suggest the best suitable ointment of the particular type of lesion or crack. All ointments or creams are not same and the chemical compositions differ with each formulation. If you feel that the symptoms have aggravated after using a particular ointment, report the development to your doctor immediately. Some chemical compositions can increase the irritation rather than actually offering a relief. It is imperative that the original cause is identified to discourage a relapse of symptoms.

Home Treatments:

The patients could choose the home remedies from the options discussed in the following spaces, but not without informing your doctor of your intention of using home remedies.

1)       Aloe Vera: This wonderful herb carries a natural anti-bacterial medicine and has tremendous healing properties. An extract of its fibrous leaves or the juice taken twice a day would be very beneficial. It will have its most famous double action over the lesions and cuts. It is available in gel form also. The gel could be applied on the affected areas thrice a day to obtain quick results.

2)       Salt Water at Room Temperature: This is another useful remedy in treatment of Angular Cheilitis. The salt has a tendency to kill germs in a natural way. The contact of salt water on the lesions initially may sting a little but you may rest assured that this simple commonplace remedy is going to work miraculously and swiftly too.

3)       Ointments are available to prevent chapping of lips which can be a parallel line of treatment under a doctor’s supervision. These applications will curtain spreading of the cracks in the least and may help the cuts to heal faster. These ointments will have anti-bacterial agents within their chemical composition too.

4)       Balanced Diet: Eat plenty of fresh green and leafy veggies, fresh fruits, food items made out of whole grains, vitamin supplements, lean proteins, dairy products. Avoid fast food at any cost. Cases who have had a history of mal-nutrition should be referred to a qualified dietician.

5)       Iron supplements: The capsules with iron supplements are readily available with chemists and could be used under doctor’s supervision. Liquid filled capsules get absorbed easily and should be consumed for faster action.

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Angular Cheilitis Vs Herpes

According to medical fraternity there is no connection between Angular Cheilitis and Herpes. We need to mention here that since the symptoms of both infections are somewhat similar, it is often misleading to non-medicos. The correct diagnosis can be done only by medical professionals.

The major difference between these two ailments is that Herpes is a viral infection whereas angular Cheilitis can be either due to a fungus infection or a bacterial infection or an effect of both.

If we talk about symptoms, in Angular Cheilitis, people develop cracks on the corners of mouth, there are some lesions in the area of the mouth. This infection is known to be as a result of mal-nutrition, deficiencies of Vitamin B and iron and other important nutrients over a period of time. Other causes are loose fitting dentures, yeast infection, people having a habit of licking their lips involuntarily, people who have diabetes or hepatitis and drooling mouth area, those who are suffering from paralytic stroke with a shifted jaw. Angular Cheilitis can affect you in extremely cold weather conditions. Accumulation of saliva near the corners of the mouth increases the danger of spreading of bacteria or fungus involving Angular Cheilitis.

Angular Cheilitis is not anyway related to sexually transmitted disease where as Herpes is. The symptoms of Herpes are cold sores and fever blisters. The patient will develop a cracked lip which burns like fire. A spot may appear on the lip too. Herpes is very contagious when body fluids of the affected persons come in contact with other healthy persons.

Angular Cheilitis is normally treated with anti-fungal or anti-bacterial creams depending upon each case. Some doctors recommend application of Vaseline for offering fluid relief to the painful cracks around the corners of your mouth.  They are also recommended to in-take essential vitamin supplements and asked to keep themselves well hydrated by drinking plenty of water. The sooner Angular Cheilitis is treated, the faster you will be accepted in the society and there will be a lesser chance of social rejection.

Herpes needs to be treated quickly before allowing the virus to gain a firm ground within the body and it starts weakening the natural body resistance. One important thing that the patient should watch is resist the desire to touch the cold sore which has erupted due to herpes, by hand; this is the route herpes infection could take to proceed and spread to other parts of the body and in effect affect some one else who may be healthy. Here too the sores on the lips would make you less confident and give you an unhealthy look resulting in people around you talking about the ailment, which would certainly compel them to keep a distance from you for their own safety. Those people who have not done any sexual act out of ordinary need not worry about having contacted Herpes.

For both these infections, homeopathy promises to offer adequate treatment which will supposedly eradicate the disease from its root cause. In Indian scenario, Ayurveda also promises permanent solution to both these ailments.

We hope that we have enlightened you on the difference in Angular Cheilitis and Herpes to a reasonable level and that you will not be mistaken about the symptoms.

Angular Cheilitis Vs. Cold Sore

It is often confusing for any one to decide whether the symptoms point to cold sores or angular cheilitis. The symptoms are indeed similar and are bound to mislead a layman. Only medical professionals are equipped to pronounce the actual reason for the development of the symptoms. Having said this, very severe chapped or cracked lips may signify Angular Cheilitis.

cold-sore-vs-angular-cheilitisThe purpose of this article is to enable patients to identify a cold sore from angular cheilitis in the initial stages itself if in case it is not possible for them to visit a doctor right away and since these infections can not be left without treatment for more than a couple of days from the beginning.

Medical fraternity calls cold sore by the name Herpes Labialis. Herpes virus is the cause of a cold sore. A cold sore shows its presence in form of a blister on the lips and/or in the region of the mouth. Cold sore is very much painful and alarmingly visible. The blister will normally develop into a scab and will be followed by pus formation. The tenure of the cold sore is about ten to twelve days after which it would vanish on its own.

Treatment: Care should be taken by the patients suffering from cold sores to avoid oral contact with others as cold sores are very contagious and spread fast. A variety of anti-viral creams are available in the market which are known to accelerate the recovery from cold sores, of course under medical advice.

Angular Cheilitis on the other hand is characterized by inflammation of the lips and crack around the mouth. Lips will have a lot of burning and area of the mouth would be very painful when mouth is opened and closed for talking, eating or drinking. The cracks on the lips and around the corners of the mouth are naturally visible and at times very embarrassing to the patient.  The causes of angular cheilitis are traced to vitamin deficiencies, improper eating habits,  ill-fitting dentures, accumulation of the saliva at the corners of the mouth which makes a perfect ground for the bacteria to develop, extremely cold weather, dehydration, high fever, a weak immune system etc. Some people have a habit of licking their lips with their tongue too often-even these people could develop angular cheilitis. Those who are suffering from Diabetes or HIV are at times victims of angular cheilitis. Large proportion of patients suffering from Angular Cheilitis will be free of this infection in about three to four days. Angular Cheilitis could be the result of bacterial infection or a fungal infection or both.

Treatment: The causes of Angular Cheilits can be different and hence a medical professional has to treat the condition differently. Generally they treat the angular cheilitis with the help of topical anti-fungal ointments. Precautions include keeping the affected area clean and dry so as to control further spreading and keeping the body well-hydrated by drinking as much water as possible.