Angular cheilitis is the medical term for the inflamed, cracked, and sometimes bleeding lesions that appear at the corners of the mouth (oral commissures). This common condition is characterized by redness, scaling, and the breakdown of skin tissue where the upper and lower lips meet. The development of these painful fissures is often driven by a combination of factors, but a nutritional shortage is a frequently cited underlying trigger that affects the health of the delicate skin around the mouth.
Key Vitamin and Mineral Deficiencies
Deficiencies in certain micronutrients can significantly weaken the body’s mucosal defenses, making the corners of the mouth susceptible to breakdown. Riboflavin, known as Vitamin B2, plays a direct role in maintaining the health of the skin and mucous membranes. A lack of this vitamin, a condition called ariboflavinosis, can directly lead to the inflammation and fissuring characteristic of angular cheilitis. Iron deficiency, often resulting in anemia, is another significant factor linked to the development of these lesions, as a shortage impairs the integrity of the epithelial lining and makes the mucosal barrier vulnerable to secondary infections. Deficiencies in iron and B vitamins are estimated to be present in up to 25% of angular cheilitis cases.
Other B-complex vitamins, including Folate (B9) and Cobalamin (B12), are also recognized contributors, as they are central to cell division and tissue regeneration. A deficit in these vitamins can slow the repair process. Zinc is also an important trace mineral with functions in wound healing and immune response, and a lack of zinc can compromise the skin’s ability to repair itself and resist opportunistic pathogens.
Non-Nutritional Causes of Cracks
Even when nutritional status is adequate, angular cheilitis can develop due to local mechanical factors and the presence of infectious agents. The pooling of saliva at the mouth corners creates a consistently moist, warm environment that encourages the colonization of microbes. The digestive enzymes in saliva can also cause maceration, or softening and breakdown, of the skin tissue through chronic exposure. Fungal infections, most commonly caused by Candida albicans (the yeast responsible for oral thrush), frequently take advantage of this compromised skin barrier. Bacterial organisms, such as Staphylococcus aureus, can also infect the damaged tissue, leading to a mixed infection that complicates the condition.
Mechanical habits and structural issues often precipitate the initial skin trauma that starts the cycle of inflammation. Chronic lip licking, which people do to soothe dry lips, paradoxically worsens the condition by depositing more saliva and creating a wet-dry cycle that promotes cracking. Ill-fitting dental appliances, like dentures, can reduce the vertical dimension of the face, causing the mouth to overclose and creating deeper folds where saliva can collect and stagnate. Systemic conditions such as uncontrolled diabetes or states of immune suppression also increase susceptibility to fungal infections, making them common predisposing factors for persistent angular cheilitis.
Treatment and Prevention Strategies
Successful management of angular cheilitis requires addressing both the underlying cause and the resulting inflammation or infection. If a nutritional deficit is suspected, a healthcare professional may recommend blood tests to determine specific vitamin or mineral levels. Once a deficiency is confirmed, targeted supplementation is often initiated to restore the body’s internal resources and support tissue healing. Topical treatments are frequently employed to manage the local symptoms and microbial colonization. Barrier creams or simple emollients, such as petroleum jelly, can be applied to create a protective layer over the affected area to shield it from excess moisture and irritants.
If an infection is present, a doctor may prescribe a combination topical medication containing an antifungal agent, an antibiotic, or a mild steroid to reduce yeast or bacterial loads and control inflammation. Preventative measures focus on eliminating the local factors that cause moisture and trauma to the mouth corners. Habits like chronic lip licking must be consciously avoided to prevent the cycle of salivary maceration and drying. Maintaining good oral hygiene and ensuring that any dentures or orthodontic devices fit correctly can prevent the pooling of saliva in the oral commissures. Individuals with systemic conditions like diabetes can reduce their risk by maintaining stable blood glucose levels, which helps limit the opportunity for fungal overgrowth.