Angular Cheilitis - Symptoms, Causes and Treatment

Angular cheilitis, popularly referred to as mouthwash, is that common painful wound that occurs in the corner of the mouth. The mouthwash is a common acne, characterized by inflammation and fissure of the angle of the lips.

Several situations can lead to the appearance of the mouthpiece, the most common are the use of dental appliances or dentures.

If the causes are not attacked, the injury can be perpetuated, becoming chronic.

Angular cheilitis symptoms
Angular cheilitis symptoms

What is angular cheilitis?

Angular cheilitis is a wound that occurs due to an inflammatory process at the angle of the mouth. The lesions may be unilateral or bilateral. Elderly people are the most affected, but mouthwash can also occur in young people and children.

The accumulation of saliva in the corner of the mouth seems to be the main triggering factor, facilitating maceration of the skin, formation of fissures and contamination of the wound by bacteria or fungi.

Situations that favor the accumulation of saliva at the angle of the mouth, trauma or infection of the skin around the mouth are the main risk factors for angular cheilitis. We can cite some risk situations:
  • Natural process of aging, which causes the skin to fall in the corners of the mouth, favoring the accumulation of saliva in this region
  • Absence of teeth, which changes the angulation of the mouth, provoking effect similar to aging
  • Use of maladaptive dentures
  • Use of dental appliances
  • Oral candidiasis
  • Poor oral hygiene
  • Allergy to toothpaste or other dental products
  • Skin problems that cause injury around the mouth, such as atopic dermatitis, psoriasis or seborrheic dermatitis
  • Resected lips, which favor the appearance of wounds
  • Use of mouthwashing drugs, such as isotretinoin
  • Compulsion for licking lips, keeping them always moist and exposed to germs of the mouth
  • Excessive consumption of sugar rich foods, which favors the growth of candidal fungus
  • Use of inhaled corticosteroids, which favors the growth of germs in the oral cavity

Patients with impaired immune system, whether due to immunosuppressive drugs or diseases, are also at higher risk of developing angular cheilitis. These cases include patients with HIV, cancer, neutropenia, diabetes mellitus, anorexia or organ transplants.

Less often, mouthwash can be caused by nutritional deficiencies, such as lack of vitamin B, iron or folic acid.


Angular cheilitis may present as a cleft, crack, ulceration, redness or crust at the corner of the mouth. The lesions do not enter into the mouth, limiting to the joining of the skin with the mucosa of the lips.

As the skin of the lip angle is injured, the simple action of opening the mouth can cause intense pain and burning. The lesions of angular cheilitis do not usually bleed, but they can become infected, becoming well inflamed and with a crust of pus.

Angular cheilitis can become a chronic and persistent lesion or show periods of improvement alternated with worsening and return of the lesions.


The first part of the treatment to cure the mouthpiece is to try to eliminate or correct problems that are causing it to appear. In many cases the simple elimination of risk factors is sufficient to cure angular cheilitis. In the elderly, the use of a suitable dental prosthesis may be the only necessary measure.

In many cases, however, we can only cure the mouthpiece with medicines. The use of ointments can solve the problem, but it is necessary to investigate the presence of bacteria or fungi in the lesions, since the composition of the ointments changes according to the germ that is to be treated.

If there is no bacterial or fungal infection, moisturizing and anti-inflammatory ointments such as zinc oxide (present in Hypoglossus) or Omcilon A Orabase are useful. Vaseline-based creams are also an option.

If fungal infection occurs, ointments with cotrimazole, nystatin, or miconazole may be used. In some cases, your doctor may recommend the use of fluconazole tablets to help eliminate fungal damage. If there is bacterial infection, ointments such as mupirocin are indicated. The mouthwash treatment with ointments is usually done for 1 to 3 weeks.

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