Cracks in the corners of the lips

Whenever cracks appear in the corners of the lips, we think about immunity. And indeed, such a problem is closely related to the state of our immune system, and it appears more often in the spring, when the defenses are weakened, and vitamin stores in the body are depleted. The cracks themselves, or aches, are not a disease, although they cause a lot of discomfort. It is simply the body's signal that everything is not all right.

Epidemiology

Most often cracks in the corners of the lips are caused by the activation of streptococcal or fungal infection. In the zone of increased risk are patients with weakened immunity and chronic pathologies, pregnant women and children (including adolescence).

Both men and women are equally often sick, and especially those who can not part with bad habits, such as smoking and alcohol abuse.

Causes of the cracked lip corners

Factors that provoke the appearance of cracks in the corners of the mouth, there are many known, but the true cause is most often one - it is bacteria and other pathogens that get on the mucosa of the lips in different ways, and then activated. Most people are a little mistaken when they think that cracks arise from excessive dryness of the skin or from avitaminosis: indeed, these factors take place, but without the presence of microbial flora, the problem would not have occurred.

Even cracks that form against the background of acute respiratory viral infections or acute respiratory infections are not the result of high body temperature, but a consequence of infectious invasion. In this case, most often, according to statistics, sores are caused by streptococci and fungal flora, namely - epidermal streptococcus and yeast-like fungi belonging to the genus Candida. The infection provokes the development of an inflammatory process that occurs with lesions of superficial skin tissues and mucous membranes.

Risk factors

There are a number of factors that can provoke the formation of cracks in the corners of the lips. Most often we are talking about such of them:

• using other people's unwashed glasses, cups, utensils;
• frequent biting and licking of the lips, especially in cold weather;
• Non-compliance with oral hygiene rules;
• general cooling of the body, or overheating;
• Consumption of poor quality food, unwashed greens, vegetables, berries, fruits;
• constant touching of the skin in the mouth area with dirty hands.

Contributing to the development of the infectious process are factors such as:

• weak immune system;
• anemia of various etiologies;
• diabetes;
• liver function failure;
• vitamin and mineral deficiencies in the body;
• frequent or prolonged infectious processes;
• frequent or prolonged periods of treatment with hormonal or cytostatic drugs, immunosuppressants.

Pathogenesis

Distinguish such pathogenetic types of cracks in the corners of the lips:

• Bacterial fissures that are provoked by streptococcal infection;
• fungal cracks that occur when Candida fungi become active.

It should be understood that these microorganisms - causative agents of the disease - can normally be present on the skin of a healthy person. Their increased multiplication begins only when circumstances favorable for this:

• sharp weakening of immunity (poor nutrition, illness, surgical interventions, etc.);
• a drop in hemoglobin levels in the bloodstream;
• diseases of the oral cavity, teeth, upper respiratory tract;
• of high blood sugar;
• intestinal dysbiosis.

Any malfunction in the body is a stress in one form or another, which can give rise to the development of infection. As a result, microorganisms that accumulate in the corners of the mouth, activate their growth and development, triggering an inflammatory reaction, which is accompanied by all the relevant signs: redness, pain, etc.

Symptoms of the cracked lip corners

Clinical symptoms of cracked lip corners may vary slightly, depending on the etiology of the disease. For example, the first signs can be described as follows:

• Bacterial fissures initially cause slight redness and discomfort in the form of itching. After a while, small bubbles form in the corners of the lips, or a single bubble with liquid content: it is because of this symptom that many people confuse itching with herpes. But after some time, the bubbles open up and a bloody crust is formed, which can be both dry and moist, sometimes opening or bleeding. At this stage, pain sets in and it becomes painful to open the mouth and, consequently, to speak and eat.
• With fungal fissures there is an inflammatory process, in appearance resembling an erosion. The outer crust is not formed, and the cracks themselves and redness in the corners of the lips are characterized by a reddish shade, often covered with a loose plaque. If the mouth is closed, the problem can remain unnoticeable. But when the mouth is open, sores and cracks in the corners of the lips are exposed, there may be pain of a cutting nature.

In addition to the above variants, there are also mixed fissures that carry signs of both microbial and fungal presence.

Cracks in the corners of the lips in a child

The most common factor leading to the appearance of cracks in the corners of the lips in children is a lack of vitamins B-group, which ensure the normal condition of the skin and mucous membranes. Also may be "guilty" of a deficiency of zinc and iron in the body. However, most often bacteria and fungi are activated against a background of reduced immune protection - for example, with tonsillitis, dental caries, frequent colds and acute respiratory infections, anemia, worm infestations.

In many children, the cause of excessive accumulation of bacteria in the corners of the lips is an improper bite, failure to observe the rules of oral hygiene, and in small children - prolonged retention of pacifiers and pacifiers in the mouth. Allergic processes, other diseases and abnormalities contribute their additional contribution.

Cracks in the corners of the lips in childhood do not often bother, but if such pathology occurs, it is mostly prolonged. The peak of children's morbidity is in the spring, when the lack of vitamins against the background of a general decline in immunity makes itself felt.

Cracks in the corners of the lips in pregnancy

During pregnancy, many chronic diseases worsen, and this is mainly due to the sharply increasing load on the female body and the decline in immunity. The disease in pregnant women can occur atypically, starting with the usual dryness of the lips, ending with the formation of erosions mainly in the lower lip area.

Cracks in the corners of the lips of allergic origin are not uncommon in pregnancy. Such sores are characterized by itching and burning sensations, swelling and redness in the corresponding area of the face. Additional contact with an allergen leads to the formation of small blisters that develop into erosive elements.

Atypical cracking symptoms can occur briefly and spontaneously and also disappear abruptly. Remissions occur frequently, but the lips are predominantly flaky even during this period. Dryness of the lips and facial skin is characteristic.

Complications and consequences

Complications against the background of cracks in the corners of the lips are extremely rare: usually the problem is cured at an early stage of development. In neglected cases, infection may spread, increase the area of the inflammatory process with the involvement of healthy tissues (skin and mucous membranes).

Among the particularly unpleasant consequences can be distinguished the formation of additional deep fissures, ulcerative and erosive elements, merging into one large focus. The neglected process is characterized by pronounced discomfort, and with close contact there is a risk of transmitting the infection to other people.

If for a long time do not heal cracks in the corners of the lips, there is no point in waiting for the problem to disappear by itself: it is better to consult a doctor, who will prescribe treatment in accordance with the detected pathogen of pathology. If the disease is left to fend for itself, then self-healing on the background of weakened immunity is considered almost impossible. Treatment should be complex, aimed at local action on the inflammatory focus, as well as strengthening immune defense.

Diagnostics of the cracked lip corners

In the vast majority of cases, the diagnosis of fissures is made based on clinical examination and complaints of the patient. Symptomatology of the disease is typical, and if there is any doubt, the data of histological analysis of damaged tissues are considered.

In general, the diagnostic steps can be categorized as follows:

• collecting complaints, examining the patient;
• histologic tests, skin tests with allergens;
• General laboratory tests to assess the state of the body (allows you to exclude anemia, inflammatory diseases);
• instrumental diagnostic methods.

Laboratory and instrumental diagnostics are most often used in the differentiation of lip diseases. For example, the doctor may prescribe peripheral blood tests, cytologic, bacteriologic and virologic smears, abdominal or thyroid ultrasound, and so on.

Differential diagnosis

Differential diagnosis should be carried out with different types of cheilitis (exfoliative, glendular, meteoric, anular, candidiasis, eczematous type), with lip lupus erythematosus, macrocheilitis.

Treatment of the cracked lip corners

When treating cracks in the corners of the lips, it is better to provide a comprehensive approach, taking into account the individual characteristics of treatment. It is also important to comply with general measures, which include:

• compliance with the rules of oral hygiene;
• regular oral and dental hygiene;
• dental treatment, timely removal of problem teeth, getting rid of plaque;
• refusal of bad habits (meaning not only smoking and alcohol abuse, but also biting the lips, constant licking them);
• mechanical protection of the lips (correction of dentition, timely replacement of dental implants, etc.);
• following all doctor's orders.

Doctor's prescriptions may include recommendations for general and local therapy. External treatment involves such measures:

• treatment with antiseptic solutions (hydrogen peroxide, chlorhexidine, potassium permanganate solution);
• Applying lotions with proteolytic enzymes (Trypsin, Chymotrypsin) to soften crusts;
• lubrication with corticosteroid ointments (Lorinden A, Celestoderm, Locoid) to inhibit the development of inflammatory reaction, to eliminate swelling and other unpleasant symptoms.

In addition, antihistamines may be used - for example, Suprastin, Loratadine, Cetirizine. In addition, a vitaminized diet, multivitamin and sedatives are recommended.

What to do in case of cracks in the corners of the lips?

In the appearance of cracks in the corners of the lips, first of all, it is necessary to exclude the influence of factors that can exacerbate the course of the inflammatory process. Such factors are usually allergens, microbial exposure, overheating and hypothermia, dehydration and so on.

It is not difficult to cure the disease after going to the doctor, the main thing is to choose the right treatment and eliminate the root cause of the problem (for example, neutralize bacteria or fungal pathogen).

Both local and systemic treatment or a combination of both will be suitable. It is equally important to carefully observe all rules of oral, facial and hand hygiene.

What is the therapy usually aimed at? To moisturize and soften the skin, accelerate wound healing, prevent re-infection. For this purpose, antimicrobial and antifungal systemic and external preparations are successfully used.

Medicines that your doctor can prescribe

Chlorhexidine	An antimicrobial and antiseptic solution that is used to treat cracks and wounds three times a day. The remedy is low-toxic and safe, but its internal use should be avoided. In high concentrations, the product can cause burns of mucous tissue.
Aevit	A combined vitamin preparation that can be used both internally and externally. Internally, take one capsule of the drug per day. Additionally, lubricate the contents of the capsule with the affected areas in the corners of the lips. Such treatment has no contraindications, helps to accelerate recovery.
Loratadine	Antihistamine agent that has anti-allergic and antipruritic properties. Prevents the development of edema, alleviates the course of the inflammatory process. Loratadine is taken orally at 10 mg once a day. Among the most frequent side effects are headache, drowsiness, irritability.
Fucorcin	Antiseptic and disinfectant with broad antimicrobial and antifungal activity. The drug is used to lubricate wounds 1-3 times a day, until clinical recovery. Side effects on the background of the drug application: temporary reddish coloration of the skin, desquamation of the epithelium.
Echinacea extract	An immunostimulant agent that increases the phagocytic activity of macrophages and neutrophils. Usually take 20-40 drops of the extract three times a day, not more than 2 months in a row. Topical application of the drug is also possible. Probable side effects are allergies.

Ointments for cracked lip corners

Ointments are usually applied to damaged tissues 1-2 times a day: use preparations with antimicrobial, antifungal and wound-healing effect.

Levomekol ointment, which contains an antibiotic, is excellent as an antiseptic. Such ointments as Actovegin, Solcoseril, which stimulate healing processes, have proved to be quite good. In addition, it should be noted the healing effect of ointments Bepanthen, Methyluracil, Dexpanthenol.

With fungal infection, the use of ointments Clotrimazole, Exoderil, etc. Is relevant.

Other ointments the doctor may prescribe:

• Celestoderm-B with Garamycin is a combination of corticosteroid and antibacterial component, it is used in complex course of inflammatory process, with the accession of purulent infection. With fungal lesions, this remedy is not prescribed. Ointment is applied to the area of damage in the morning and evening - that is, twice a day. Duration of therapy - 1-2 weeks.
• Lorinden C is a combined ointment with antipruritic, anti-inflammatory, anti-allergic, anti-edematous effect. It is used no more than twice a day, for no more than two weeks.

Balm for cracked lip corners

If the formation of a crack is just beginning, you can use the well-known balm Spasatel. This preparation is used externally, accelerating the healing reaction of wounds and lesions. The peculiarity of the remedy is that it has a natural composition, without antibiotics and hormonal components. The balm is represented by such ingredients as ghee, sea buckthorn and olive oil, calendula extract, beeswax, turpentine, naphthalan oil, vitamin solutions and essential oils.

Balm is applied directly to the cracks, several times a day (usually - three times). Contraindications to use may be allergic processes.

Side effects are rare and are expressed in the development of allergy to the drug.

Vitamins

Vitamins and minerals are essential components for the prevention and treatment of virtually any dermatologic disease. Deficiency of certain essential substances can easily cause peeling, cracks in the corners of the lips, and even rashes. Avitaminosis or hypovitaminosis can be a decisive factor in the development of infectious dermatologic processes, become the cause of the transition of pathology from the acute stage to chronic.

Vitamin A participates in the processes of epithelial cell differentiation in the superficial skin layer. It turns out that cellular structures are chemically and functionally changed. In case of retinol deficiency, dryness is manifested, desquamation increases, the stratum corneum thickens, and purulent processes may develop.

Deficiency of vitamins _B2 and _B6 causes damage to the skin epithelium and the oral cavity. As a result, not only cracks in the corners of the mouth, but also dermatitis of the nasolabial triangle, ears, face, etc. May occur. B-group vitamins are always prescribed to accelerate the healing of wounds and ulcers, chronic dermatoses.

Ascorbic acid is a well-known immunomodulator that activates reserve defenses in the body, accelerating tissue repair. With a lack of ascorbic acid, wounds heal longer and worse. With the appearance of painful cracks in the corners of the mouth usually prescribe complex multivitamin preparations containing all the vitamin substances described above. The frequency of taking such medications, as well as their dosage is determined individually.

Physiotherapeutic treatment

Physical therapy effectively complements basic treatment, helps to quickly eliminate painful symptoms and accelerate healing.

The main procedures that can be prescribed by a doctor in the appearance of cracks in the corners of the lips are considered such:

• Laser treatment - has anti-inflammatory, anti-edematous, desensitizing effect.
• Drug electrophoresis - involves the use of corticosteroid or antihistamine agents.
• Phonophoresis with ointment preparations of corticosteroids.
• Ultrahigh-frequency treatment - has anti-inflammatory properties, activates the processes of microcirculation and regeneration.
• Microwave therapy - helps improve blood supply and tissue nutrition, inhibits the development of inflammatory reaction, eliminates edema, has an anti-allergic effect.

By the way, physiotherapeutic procedures for the appearance of fissures are prescribed not so often, but only in neglected and sluggish processes. The decision to prescribe them is made by a doctor.

Folk treatment

Folk remedies are always available and often have no less effect than pharmacy drugs. For example, the most common remedy for cracks in the corners of the lips is ordinary earwax - the very one that is usually diligently cleaned out of the ears with cotton swabs. This natural "ointment" lubricate the places of zedes. It is said that the problem goes away within 1-2 days.

Thermal water is a good remedy for cracks in the corners of the lips. It can be used on its own, or lubricate the lips with a special cream or hygiene product prepared on the basis of such water.

An excellent way to get rid of cracks is to lubricate the affected areas with oil solutions of vitamins: you can use capsules of vitamins A or E, or a combined preparation of Aevit. Melted beeswax, sea buckthorn or rosehip oil, honey, goose fat are also used instead.

Herbal treatment

Wiping areas with cracks in the corners of the lips with infusions of plants such as chamomile flower, celandine, calendula, sage, succession helps well.

The next excellent remedy is the treatment of sores with freshly squeezed juice obtained from aloe or kalanchoe leaves, fresh celandine plant, plantain stalks. You can smear the damaged skin with a cut garlic clove or a slice of onion.

Infusions for the treatment of wounds are prepared in these ways:

• One teaspoon of dried chamomile color poured 200 ml of boiling water, insist under a lid for 40-45 minutes, filtered and used as directed;
• One tablespoon of calendula poured a glass of boiling water, kept under a lid for at least half an hour, then filtered and used for wiping;
• One tablespoon of sage poured a glass of boiling water, insist for an hour, then filtered and used for wiping and lotions.

Homeopathy

Appropriate homeopathic treatment is prescribed by selecting the optimal constitutional remedy. It is recommended to use the following remedies in individualized dosages.

• Natrium muriaticum - gets rid of even deep cracks in the corners of the lips, in the middle of the lips, as well as all kinds of hangnails.
• Petroleum - helps with bleeding wounds near the mouth that are accompanied by burning and itching.
• Calcarea carbonica is prescribed for both superficial and deep cracks, occurring mainly in winter.
• Graphites - used for sores on the lips and between the toes.
• Hepar sulfuris calcareum - gets rid of cracked, crusted skin.
• Acidum nitricum - helps with deep bleeding wounds characterized by a long course.
• Antimonium crudum - use for damaged skin at the corners of the mouth and in the nasolabial triangle.

Surgical treatment

The assistance of a surgeon is required only in isolated, particularly neglected cases of cracked lip corners, with pronounced phenomena of dysplasia. The following surgical methods may be used:

• laser treatment;
• photodynamic treatment;
• cryosurgery;
• wedge excision of the affected tissue;
• plastic surgery to correct and restore the lips.

However, let us repeat, surgery for fissures is rather an exception to the rules, since most often such treatment is not necessary.

Prevention

Even after successful treatment of cracked lip corners, it makes sense to take care to prevent future recurrence. This is what prevention is all about:

• hardening procedures;
• systematic and quality oral hygiene care;
• use of only proven and quality cosmetics;
• Improving the quality of nutrition with an emphasis on plant-based foods, avoiding sweets;
• getting rid of bad habits such as smoking, alcohol abuse;
• prevention of excessive dryness of the skin and mucous membranes, drinking enough fluids, using moisturizing hygiene products.

It is necessary to pay attention to the cleanliness of your own body, regularly wash your hands (or at least use wet wipes), try not to lick your lips and do not bite your nails.

Forecast

Cracks in the corners of the lips can bother at any age - both in childhood and in adulthood. In most patients, the problem passes without serious consequences, within 3-5 days: at first, discomfort increases, redness and visible cracks appear, the problem reaches its peak, after which the symptoms begin to gradually subside. However, you should not expect the discomfort to go away by itself: sometimes it does not happen, especially if no measures are taken and the disease begins to progress. It is believed that complete neglect of treatment contributes to the spread of the inflammatory reaction and the formation of pustules. In general, the prognosis can be voiced as favorable, but treatment is still necessary.