Cracks in the corners of the lips

Every time cracks appear in the corners of the lips, we remember about immunity. Indeed, such a problem is closely related to the state of our immune system, and it appears more often in the spring, when the immune system weakens and the body's vitamin reserves are depleted. Cracks, or angular cheilitis, are not a disease in themselves, although they cause considerable discomfort. This is simply a signal from the body that something is wrong with it.

Epidemiology

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

Both men and women get sick equally often, especially those who cannot give up bad habits such as smoking and alcohol abuse.

Causes cracked lip corners

There are many known factors that provoke the appearance of cracks in the corners of the mouth, but the true cause is most often one - bacteria and other pathogenic microorganisms that get on the mucous membrane of the lips in different ways, after which they become active. Most people are a little mistaken when they believe that cracks occur due to excessive dryness of the skin or vitamin deficiencies: 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. At the same time, most often, according to statistics, angular cheilitis is 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, which occurs with damage to the superficial skin tissues and mucous membrane.

Risk factors

There are a number of factors known to provoke the formation of cracks in the corners of the lips. Most often, we are talking about the following:

• using other people's unwashed glasses, cups, and utensils;
• frequent biting and licking of lips, especially in cold weather;
• failure to comply with hygiene rules for oral care;
• 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.

The following factors contribute to the development of the infectious process:

• weak immunity;
• anemia of various etiologies;
• diabetes mellitus;
• liver failure;
• lack of vitamins and minerals in the body;
• frequent or prolonged infectious processes;
• frequent or long periods of treatment with hormonal or cytostatic drugs, immunosuppressants.

Pathogenesis

The following pathogenetic types of cracks in the corners of the lips are distinguished:

• bacterial cracks, which are caused by streptococcal infection;
• fungal cracks that occur when Candida fungi become active.

It is important to understand that the above microorganisms – pathogens – can normally be present on the skin of a healthy person. Their increased reproduction begins only when favorable circumstances arise:

• a sharp weakening of the immune system (poor nutrition, illness, surgery, etc.);
• a drop in the level of hemoglobin in the bloodstream;
• diseases of the oral cavity, teeth, upper respiratory tract;
• high blood sugar levels;
• intestinal dysbacteriosis.

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

Symptoms cracked lip corners

The clinical symptoms of cracks in the corners of the lips may vary slightly, depending on the etiology of the disease. For example, the first signs can be described as follows:

• With bacterial cracks, at first there is slight redness and discomfort in the form of itching. After a while, small blisters form in the corners of the lips, or one blister with liquid contents: it is because of this symptom that many people confuse angular cheilitis with herpes. But after some time, the blisters open up, and a bloody crust forms, which can be either dry or wet, sometimes opening up or bleeding. At this stage, pain joins in, it becomes painful to open the mouth and, accordingly, to speak and eat.
• Fungal cracks cause an inflammatory process that looks like erosion. No outer crust forms, and the cracks and redness in the corners of the lips have a reddish tint, often covered with a thin coating. If the mouth is closed, the problem may remain unnoticed. But with the mouth open, the angular cheilitis and cracks in the corners of the lips are exposed, and cutting pain may occur.

In addition to the above options, there are also mixed cracks, which bear 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 B vitamins, which ensure the normal condition of the skin and mucous membranes. A deficiency of zinc and iron in the body may also be "to blame". However, most often bacteria and fungi are activated against the background of a decrease in immune protection - for example, with tonsillitis, caries, frequent colds and acute respiratory viral infections, anemia, helminthic invasions.

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

Cracks in the corners of the lips in childhood do not often bother, but if such a pathology occurs, it usually becomes long-term. The peak of childhood morbidity occurs in the spring, when the lack of vitamins against the background of a general decrease in immunity makes itself felt.

Cracked corners of the lips during pregnancy

Many chronic diseases are exacerbated during pregnancy, and this is mainly due to the sharply increasing load on the female body and a drop in immunity. The disease in pregnant women can proceed atypically, starting with the usual dry lips, ending with the formation of erosions mainly in the lower lip area.

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

Atypical symptoms of cracks can occur briefly and spontaneously, and also disappear abruptly. Remissions occur frequently, but the lips are predominantly peeling during this period. Dryness of the lips and skin on the face is characteristic.

Complications and consequences

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

Among the most unpleasant consequences, one can single out the formation of additional deep cracks, ulcerative and erosive elements, merging into one large lesion. The neglected process is characterized by pronounced discomfort, and with close contact there is a risk of transmitting the infection to other people.

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

Diagnostics cracked lip corners

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

In general, the diagnostic stages can be divided as follows:

• collection of complaints, examination of the patient;
• conducting histological analyses, skin tests with allergens;
• general laboratory tests to assess the condition of the body (allows to exclude anemia, inflammatory diseases);
• instrumental diagnostic methods.

Laboratory and instrumental diagnostics are most often used to differentiate lip diseases. For example, a doctor may prescribe a peripheral blood test, cytological, bacteriological and virological examination of smears, ultrasound examination of the abdominal cavity or thyroid gland, etc.

Differential diagnosis

Differential diagnostics should be carried out with different types of cheilitis (exfoliative, glandular, meteorological, anular, candidal, eczematous type), with lupus erythematosus of the lips, macrocheilitis.

Treatment 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 the treatment. It is also important to follow general measures, which include:

• compliance with oral hygiene rules;
• regular sanitation of the oral cavity and teeth;
• dental treatment, timely removal of problem teeth, removal of plaque;
• giving up bad habits (this means not only smoking and alcohol abuse, but also biting your lips and constantly licking them);
• providing mechanical protection for the lips (correction of the dentition, timely replacement of dental implants, etc.);
• Compliance with all medical orders.

The doctor's prescription may include recommendations for general and local therapy. External treatment involves the following measures:

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

Additionally, antihistamines can be used, such as Suprastin, Loratadine, Cetirizine. In addition, a vitamin-rich diet, taking multivitamins and sedatives are recommended.

What to do if you have cracks in the corners of your lips?

When cracks appear in the corners of the lips, first of all, it is necessary to exclude the influence of factors that can aggravate the inflammatory process. Such factors usually include allergens, microbial effects, overheating and hypothermia, dehydration, etc.

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

Both local and systemic treatments, or a combination of both, are suitable. Equally important is careful adherence to all rules of oral, facial and hand hygiene.

What is the therapy usually aimed at? Moisturizing and softening the skin, accelerating wound healing, preventing re-infection. For this, antimicrobial and antifungal systemic and external drugs are successfully used.

Medicines that a doctor may prescribe

Chlorhexidine	An antimicrobial and antiseptic solution that is used to treat cracks and wounds three times a day. The product is low-toxic and safe, but its internal use should be avoided. In high concentrations, the product can cause a burn of the mucous tissue.
Aevit	A combined vitamin preparation that can be used both internally and externally. Take one capsule of the preparation per day. Additionally, lubricate the affected areas in the corners of the lips with the contents of the capsule. This treatment has no contraindications and promotes faster recovery.
Loratadine	An antihistamine that has antiallergic and antipruritic properties. Prevents the development of edema, alleviates the inflammatory process. Loratadine is taken orally at 10 mg once a day. Among the most common side effects are headache, drowsiness, irritability.
Fukortsin	Antiseptic and disinfectant with broad antimicrobial and antifungal activity. The preparation is applied to wounds 1-3 times a day until clinical recovery. Side effects associated with the use of the preparation: temporary reddish skin coloration, epithelial desquamation.
Echinacea extract	An immunostimulant that increases the phagocytic activity of macrophages and neutrophils. Usually take 20-40 drops of extract three times a day, no more than 2 months in a row. Local application of the drug is also possible. Possible side effects - allergy.

Ointments for cracked corners of the lips

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

Levomekol ointment, which contains an antibiotic, is excellent as an antiseptic. Such ointments as Actovegin and Solcoseryl, which stimulate healing processes, have proven themselves to be good. In addition, the healing effect of Bepanten, Methyluracil, and Dexpanthenol ointments should be noted.

In case of fungal infection, it is appropriate to use Clotrimazole, Exoderil, etc. ointments.

Other ointments your doctor may prescribe include:

• Celestoderm-B with Garamicin is a combination of a corticosteroid and an antibacterial component, used in complex inflammatory processes, with the addition of a purulent infection. This remedy is not prescribed for fungal infections. The ointment is applied to the damaged area in the morning and evening - that is, twice a day. Duration of therapy is 1-2 weeks.
• Lorinden S is a combination ointment with antipruritic, anti-inflammatory, anti-allergic, and anti-edematous effects. Apply no more than twice a day for no more than two weeks.

Balm for cracked corners of the lips

If the crack is just beginning to form, you can use the well-known Rescuer balm. This preparation is used externally, accelerating the healing reaction of wounds and injuries. The peculiarity of the product 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 oils, calendula extract, beeswax, turpentine, naphthalene oil, vitamin solutions and essential oils.

The balm is applied directly to the cracks, several times a day (usually three times). Contraindications to use may include allergic processes.

Side effects are rare and include the development of an allergy to the drug.

Vitamins

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

Vitamin A takes part in the processes of differentiation of epithelial cells in the superficial skin layer. It turns out that the cellular structures change chemically and functionally. With a lack of retinol, dryness appears, peeling increases, the stratum corneum thickens, and purulent processes can develop.

Deficiency of vitamins B ₂ and B ₆ causes damage to the skin epithelium and oral cavity. As a result, not only cracks in the corners of the mouth can occur, but also dermatitis of the nasolabial triangle, ears, face, etc. Vitamins of group B are always prescribed to accelerate the healing of wounds and ulcers, chronic dermatoses.

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

Physiotherapy treatment

Physiotherapy effectively complements basic treatment, helps to quickly eliminate painful symptoms and speed up healing.

The main procedures that a doctor may prescribe when cracks appear in the corners of the lips are the following:

• Laser treatment has anti-inflammatory, anti-edematous, and desensitizing effects.
• Electrophoresis of drugs - involves the use of corticosteroids or antihistamines.
• Phonophoresis with ointment preparations of corticosteroids.
• Ultra-high frequency treatment has anti-inflammatory properties and activates microcirculation and regeneration processes.
• Microwave therapy – improves blood supply and tissue nutrition, inhibits the development of inflammatory reactions, eliminates swelling, and has an anti-allergic effect.

By the way, physiotherapy procedures are not prescribed very often when cracks appear, but only in advanced and sluggish processes. The decision to prescribe them is made by a doctor.

Folk remedies

Folk remedies are always available and often have no less effect than pharmaceutical drugs. For example, the most common remedy for cracks in the corners of the lips is regular earwax - the same one that is usually carefully cleaned out of the ears with cotton swabs. This natural "ointment" is used to lubricate the cracks in the corners of the mouth. They say that the problem goes away within 1-2 days.

Thermal water is a good remedy for cracks in the corners of the lips. You can use it on its own, or lubricate your lips with a special cream or hygienic 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 the combined drug Aevit. Instead, melted beeswax, sea buckthorn or rosehip oil, honey, goose fat are also used.

Herbal treatment

Wiping the cracked areas at the corners of the lips with infusions of plants such as chamomile, celandine, calendula, sage, and succession helps well.

The next excellent remedy is to treat angular cheilitis with freshly squeezed juice obtained from aloe or Kalanchoe leaves, fresh celandine, plantain stems. You can lubricate the damaged skin with a cut clove of garlic or a slice of onion.

Infusions for treating wounds are prepared in the following ways:

• one teaspoon of dry chamomile flowers is poured with 200 ml of boiling water, infused under a lid for 40-45 minutes, filtered and used as directed;
• one tablespoon of calendula is poured with 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 is poured with a glass of boiling water, infused 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 individually selected dosages.

• Natrium muriaticum – eliminates even deep cracks in the corners of the lips, in the middle of the lips, as well as various types of hangnails.
• Petroleum - helps with bleeding wounds near the mouth, which are accompanied by burning and itching.
• Calcarea carbonica is prescribed for both superficial and deep cracks that occur mainly in winter.
• Graphites - used when wounds appear on the lips and in the spaces between the fingers.
• Hepar sulphuris calcareum – removes cracks covered with crusts.
• Acidum nitricum – helps with deep bleeding wounds that last a long time.
• Antimonium crudum is used for damaged skin in the corners of the mouth and in the nasolabial triangle.

Surgical treatment

The help of a surgeon is required only in isolated, especially neglected cases of cracks in the corners of the lips, with pronounced dysplasia. The following surgical methods are allowed:

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

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

Prevention

Even after successful treatment of cracks in the corners of the lips, it makes sense to take care of the prevention of recurrence of the disease in the future. Here is what such prevention consists of:

• carrying out hardening procedures;
• systematic and high-quality hygienic care of the oral cavity;
• using only proven and high-quality cosmetics;
• improving the quality of nutrition with an emphasis on plant foods, and avoiding sweets;
• getting rid of bad habits such as smoking, alcohol abuse;
• preventing 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, wash your hands regularly (or at least use wet wipes), try not to lick your lips or 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 goes away without serious consequences, within 3-5 days: at first, the discomfort increases, redness and visible cracks appear, the problem reaches its peak, after which the symptoms begin to gradually weaken. However, you should not wait for the trouble to go away on its own: sometimes this does not happen, especially if no measures are taken, and the disease begins to progress. It is believed that complete ignoring of treatment contributes to the spread of the inflammatory reaction and the formation of abscesses. In general, the prognosis can be voiced as favorable, but treatment is still necessary.