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Truth time! The explanations for why some people get cracks at the corners of their mouths and other people avoid this affliction leave us dissatisfied. Dermatologists have lots of fancy terms for this condition. Angular cheilitis means irritation and inflammation at the corners of the mouth (labial commissures). Other names include perlèche (inflammation with fissures or cracks), cheilosis or angular stomatitis. Whatever the derms call it, sufferers may find it a challenging condition. What most people want to know is how to cure angular cheilitis and keep it away. This reader reports fast success with a combination of an antifungal and corticosteroid cream.
Cure Angular Cheilitis with Monistat and Hydrocortisone:
Q. I had cracked lips with sores at the corners of my mouth. My dermatologist recommended a 1:1 mixture of OTC hydrocortisone cream and Monistat cream.
I put a tiny dab of each on my finger and rubbed them together then applied to the sores and red areas around my lips. That worked great! The sores started healing in a few days.
A. The cause of the painful cracks at the corners of the mouth remains somewhat mysterious. Some experts blame a deficiency in B vitamins or minerals like zinc or iron for angular cheilitis. Others believe the fissures of perlèche are triggered by a yeast overgrowth.
Over-the-counter antifungal creams such as miconazole (Monistat) plus a topical hydrocortisone cream are standard treatments (Journal of the Canadian Dental Association, May 9, 2013). We’re glad this combination worked so well for you.
This readers says Vaseline did not help:
Q. I have cracks and scabbing in the corners of my mouth. Though I’ve tried a lot of things, I haven’t found a cure. This is very painful.
I am using Vaseline, but it isn’t helping. I’d welcome a suggestion.
A. What you are describing sounds a lot like angular cheilitis. There are many potential triggers for this common condition. B vitamin deficiencies may contribute. Sometimes, this irritation at the corners of the mouth is associated with a bacterial or yeast infection.
You could ask your doctor to test for vitamin deficiencies or an infection. The results could influence the treatment strategy: vitamin supplementation and/or antifungal or antibacterial ointments. Some people report benefit from applying amber Listerine. This old-fashioned mouthwash combats both kinds of infection.
Avoiding SLS-containing toothpaste (sodium lauryl sulfate) may also be helpful. This ingredient can be irritating to sensitive tissues.
Here is another account from a reader:
Q. I saw my doctor because the corners of my mouth were cracked and extremely sore. Imagine my surprise when I read on the prescription label “diaper cream.”
As a former child-care provider, I am aware that lots of diaper rashes are caused by a fungal infection. The cream helped clear up my mouth within a few weeks.
My doctor also recommended a B-complex vitamin. Since starting it, I have had no further problems with the corners of my mouth.
A. There is no single explanation for those very painful cracks at the corners of the mouth. Doctors may blame them on yeast overgrowth or a vitamin deficiency. Antifungal creams such as miconazole are often effective. OTC hydrocortisone may also speed healing.
Aquaphor for Bleeding Cracks:
Q. My son had angular cheilitis for a couple of years. Sometimes it would get so bad that the corners of his mouth would bleed during the night.
I read about using Aquaphor, an over-the-counter lip balm, for this. It worked beautifully! My son was at the dentist recently when we noticed that he was getting it again and the dentist recommended Aquaphor. I told him we had several tubes at home. Once again, it did the job!
A. Sometimes these sores at the corners of the mouth are caused by yeast overgrowth. Sealing out moisture can help, and your lip moisturizer should do that. Aquaphor Lip Repair Ointment contains castor oil, shea butter and beeswax as well as vitamin E, vitamin C, magnesium and a chamomile compound, bisabolol, along with moisturizers.
Castor oil discourages the growth of yeast (Candida albicans) and some bacteria (BMC Research Notes, Dec. 1, 2017). Bisabolol also has antifungal activity (World Journal of Microbiology & Biotechnology, March 2017).
Another reader found that a change in diet provided a cure for angular cheilitis:
“Nothing worked for me until for unrelated reasons I completely cut added sugar from my diet. Then the symptoms just went away. Interestingly, over time my toenail fungus also disappeared – as did many other minor ailments.”
Reducing sugar in the diet may make skin less vulnerable to yeast infections.
Other Ways to Cure Angular Cheilitis:
Not all cases of perlèche or cheilosis are caused by a fungal infection. Sometimes a vitamin or mineral deficiency can be a contributing factor. Here are some anecdotes from readers:
Liz S. Offers this trial-and-error approach:
“Angular cheilitis (AC) has caused me persistent problems for about two years. I have tried many remedies and have finally found what works for me. I have tried everything from honey on my lips to probiotics to B supplements to D supplements. Everything helped a little for a little bit of time but the AC always came back.
“The raw local honey worked at first, then we went out of the country and I had like a 14 hour (dry air) flight. That left my lips in the worst condition ever. Plus I didn’t have access to local honey, so I thought what is honey high in. I purchased a B vitamin complex which did help, but it made me not be able to sleep (I later found out some of my B levels were too high because of the supplement).
“My doctor tested me for a D deficiency. I was extremely low with a level of 19. Vitamin D3 supplements helped somewhat, but my lips would still get bad on occasion. I started to mess around with different B vitamins that I didn’t have a high level while supplementing. As it turned out, vitamin B2 (riboflavin) helped a lot. I ran out and had to wait while some was being ordered, so I researched what foods are high in B2. Raw almonds, yogurt, and milk were all high. I’m not much of a milk drinker, so I started eating a lot of almonds and yogurt.
“I pretty much now eat a handful of almonds (10-12) every day and about a cup of Stonyfield farms organic vanilla yogurt. NO MORE LIP PROBLEMS!!! It was awful when I had it.
“No lip balm would work. They actually made it worse. I felt like I looked diseased.”
“I hope this helps someone else. If you do opt to supplement, have your doctor watch your levels. Too much of any vitamin can be a bad thing! Foods are the best source of vitamins.”
R.J. in California used old-fashioned rubbing alcohol:
“I tried rubbing alcohol on an annoying sore that I’d had on the corner of my mouth for about six weeks and it was gone within a week. I did apply the rubbing alcohol a few times a day using either a Q-tip or a cotton ball.”
Cathy in Toronto tried coconut oil for her picky eater:
“My seven-year-old has had this condition for well over a year. Sometimes it seemed to get better, but AC would always return. A doctor told her to put Vaseline on it, but that just made it worse.
“Her dentist thought it was a vitamin or iron deficiency causing it, and this makes sense since her diet is poor due to being a picky eater. On a whim, we decided to try putting coconut oil on it twice a day, after brushing. I had read about the many benefits of coconut oil. It has antiviral and antibacterial activity.
“The lesions started healing right away. If she doesn’t apply it, however, it seems to return, so we make sure to reapply twice a day. It has now been perhaps three months doing this, and the lesions are 95% healed. Until she starts eating better, we’ll continue applying the oil.”
Beware Some Lip Balms:
Visitors to this website have reported that some lip balms may actually make angular cheilitis worse. Lip licking is another contributor. Read about this Catch 22 at this link.
Castor Oil and Other Remedies to Cure Angular Cheilitis:
Here’s an odd remedy that several people report works: castor oil! We saw above that it is an important ingredient in Aquaphor Lip Repair Ointment, which helped a reader’s son.
Castor Oil Helps Cracked Fingertips and the Corners of the Mouth.
If you would like to read about other suggestions, here is a link to our most popular article on how to cure angular cheilitis with home remedies:
Angular Cheilitis (Perleche) Home Remedies
Share your own experience with a cure for angular cheilitis in the comment section below. Thanks for helping others find a solution to this vexing problem.
Cindy
I developed angular cheilitis a couple of years ago and could get it to heal, but then it would recur within 1 week of stopping treatment. When I thought back to when it started, I realized it coincided with beginning HRT 6 months prior for my hot flashes and other menopausal symptoms. I stopped the HRT, and after 1 week the angular cheilitis healed and has not returned over a year later.
Kamari
I have had angular cheilitis for years to the point where I just stopped counting. I need help. I’ve tried everything like Aquaphor and vaseline but they doesn’t work. I feel like I’ll have it forever but I hope not because it’s painful. This is why I’m doing research but everything is basically saying to keep my lips moist which I’m already doing. Do yall have any ideas to help me out?
Ines
Vicks Vaporub,as well as the generic version, always worked for me almost instantaneously.
Diane
I had angular cheilitis for years. I was diagnosed with Celiac disease. Once I went gluten-free the angular cheilitis went away. Angular cheilitis can be one of the many symptoms of celiac disease
Liz
My dentist gave me Nystatin cream, and it works like a charm. The cracks are gone within two days.
Dave
My doctor just told me to use athlete’s feet cream (an anti-fungal). When I get a flare up I use that a couple of times over just a couple of days and it’s gone. Cause? I blame heredity. I remember my father with the red corners off his mouth, never gave it a thought as to what it was.
Barbara
Joe and Terry,
Perhaps AC is related to the cracks in the fingertips next to the corner of the nail (for me, the thumbnail) that a lot of folks get, especially in cold weather. Once the skin splits, it is hard to heal. I don’t know what this fingertip condition is called — please consider researching and writing an article on “Fingertip Cheilitis”. Thanks!
I can recommend my go-to remedy for “Fingertip Cheilitis” to the folks with AC. Chopsaver Lip Balm, available online, has many of the ingredients mentioned as having healing properties, in a convenient and easy to apply form.
https://www.chopsaver.com/faq/
A musician friend from my church created Chopsaver.
I have tried many products sold in health food stores, which are often better than drugstore / big box brands of lip balms — but in my experience, no competitive products come close to the healing properties of Chopsaver.
Yes, it is more expensive than most of its competitors but it works. I have no financial interest in this company, I just happen to know the owner AND am a very satisfied customer. Sure, I tried it in the beginning to help a friend, but continue to purchase it because it works better than any other lip balm.
Barbara
I rub a little bit of vitamin E in the corners of my mouth when this occurs, and it clears up quickly.
Dory
For some reason, I would get the cracks in the corners of my mouth only when I ate oranges. I have cut them out of my diet and it never returned.
Jeanne
This can be caused from your toothpaste! I had to switch brands to one without the ingredient that makes the product foam. Cracks healed rapidly.
Carol
i’ve used Carmex lip balm for a few years and it seems to prevent it if i use it every night. but i will try a few of these other remedies if it comes back.
Phyllis
I take a vitamin B complex and a B-12 everyday. At night I put an ointment on the corners of my mouth and use a lip cream on my lips. This has worked for me. No reoccurrences in over a year.
Bernell
I get these cracks if I don’t eat meat for a few days! Eating meat cures them quickly.
Sharon
Every time I got the sores at the corner of my mouth, I’d take an extra B Complex vitamin with breakfast. They were often gone by the following day!
Kathy
Sunscreen in lip balms can cause problems for some people. This happened when my son was in grade school. It took my being out of town and the the babysitter misplacing the balm for me to figure this out. My son’s lips cleared while I was away and flared up again when I returned and found the balm. Problems again. I compared the balm to the ointment and found the sunscreen. Good luck. Just remember, derm problems often require patience and persistence.
Kathy
I changed toothpaste, and the sore skin around my mouth began healing within a few days. After a week the sores and red chapped skin were gone.
Sue
A dermatologist gave me a prescription ointment, and he suggested I needed Botox to prevent cheilitis. The ointment would only work while I was using it. I stopped using that and began using a tea tree oil ointment. The cheilitis went a way quickly and never returned. I never went back to that doctor.
Elizabeth
I avoid sodium laurel sulphate, a foaming agent. I use a toothpaste that doesn’t have it. Some popular name-brand toothpaste versions don’t have it because it is promotes cold sores. It causes cracked lips whenever I use it.
Mary
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Barbara
I put vitamin E oil on the cracks, and it works wonderfully.
Rena
I had angular cheilitis that over a year morphed into very swollen lips. I finally figured out it was being caused by a soy allergy. Eliminating soy resolved my problem.
James
I have found that a dab of generic bacitracin ointment rapidly heals this condition, eliminating the cracks in the corner of my mouth. I dab it on every 2 or 3 hours and usually in less than a day I am healed! Packets of bacitracin ointment can be commonly found in first aid kits or purchased from the first aid aisle in a drugstore. This method is EXTREMELY inexpensive, and maybe your readers can give it a shot before moving on to more expensive treatments. I wish you all well!
Sharon
Don’t forget that keeping dentures clean will also prevent some of these issues.
SusanAnne
I use Vit A& D ointment. The cheilitis usually disappears in 48 hours or less.
Linda
Using toothpaste just once a day instead of twice eliminated it.
Barbara
In my case, the painful and sometimes bleeding cracks st the corners of my mouth were caused by toothpaste. Once I switched to Squigle the cracks completely stopped. In case I must use standard toothpaste, I’m careful to rinse the corners very thoroughly.
Chris
Nothing worked for me until for unrelated reasons I completely cut added sugar from my diet. Then the symptoms just went away. Interestingly, over time my toenail fungus also disappeared – as did many other minor ailments.
L A.
Michigan
Pure tea tree oil works like magic. It’s a natural antifungal remedy.
Barbara A.
WA
Lots of causes, lots of cures. I tend to get AC when I’m stressed, ill or exhausted. Super fast cure is a dab of antifungal athlete’s foot cream from a dollar store tube.
Kenneth (Wayne) S.
NC North Carolina
Vinegar worked immediately for me.
Ruth
MD
I rub a cocoa butter stick on my lips at bedtime, after brushing my teeth, and before putting on lipstick. I do blot my lips after the cocoa butter application if I’m going to put lipstick on. If I feel some cracking or soreness in a corner, I rub a little extra cocoa butter in the corner. Usually this takes care of it. I am not bothered by this too much.
Carole K.
Sydney, Australia
This is a very interesting thread, I have a very old vitamin book, and it said B2. Riboflavin. Over the years, I have come to see that there are many causes. But for teenagers, B2, and just 3 tiny tablets over 24 hours and it is gone in 24 hours. I posit that teenagers need more B2 for some element of their growth. I post this on Yahoo questions regularly. My qualifications…ha…ha, I’m a podiatrist, but my first job was dental assistant. Over the years have taken many naturopathic courses. {ANGULAR CHEILIITIS:
A deficiency of B2, Riboflavin. Very common on a modern Western diet. Don’t be a vegetarian! Don’t drink any kind of soda, cola, fizzy pop drinks. Take 1 x B2 + 1x multi-B tablet for a week, (!00 to 200mg) Recommended dose i
s 1.5 to 2 mg, this is much too low for young people. 100mg once a week thereafter or 10mg daily.
Source: Experience, Merck’s manual, Upjohn’s vitamin manual, the Nurient bible by Henry Osiecki. Newton’s pharmacy.
NHMRC riboflavin recommendations for Australian adults:
1. – RDI men: 1.3 mg/day – RDIwomen:1.1mg/day “The most common signs are pallor and maceration of the mucosa in the angle of the mouth (angular stomatitis) and vermilion surfaces of the lips (cheilosis), followed by superficial linear fissures that may leave scars when healed. When these lesions are infected by Candida albicans, greyish white exuberant lesions (perleche) result. The tongue may appear magenta/ Cutaneous lesions usually affect the nasolabial folds, alae nasi, ears, eyelids, scrotum and labia majora. These areas become red, scaly and greasy and sebaceous material acccumulates in hair follicles producing dyssebacia or shark skin. Treatment: 10 to 30 mg orally per day until a response is evident. Then 2 to 4 mg until recovery. Merck’s Manual 17th edition, section 1 Page 47 These statements have not been evaluated by the FDA. This information is not intended to diagnose, treat, cure or prevent any disease or condition.
From Earl Mindell’s vitamin bible: This is an easy to understand book for those with less science:
B2 Riboflavin. also known as vitamin G.
Deficiency is Arobflavinosis, sores and rashes around mouth, lips, skin and genitalia.
Found in Milk, Liver, kidneys, yeast, cheese leafy green vegetables, fish and eggs (so you can see why being a vegetarian is a bad idea.)
No known toxic effects. If you are taking the pill, pregnant or lactating, you need more.
It is the most common deficiency in the American diet. (I’m Australian, we eat lots of fish and lamb’s liver).
Destroyed by light, hormones and alcohol and food cooked in water which dissolves it out. US RDA is 1.2 to 1.6 milligrams (mg) per day. }
Sandy
Washington
If nothing else a person tries works to stop skin cracks, consider that it could be an allergic reaction to food or to toiletry or an environmental factor.
My mother gets cracks around her mouth if she eats too much citrus fruit. Stopping excess citrus heals her lip irritations.
I can get serious, deep and painful cracks on my fingers from just ONE (1) time washing my hands using most soaps provided in public restrooms and also from water in some people’s homes that is treated with water softeners. My brother gets the same skin cracks on his fingers from some water softener systems. (We experienced this in our mom’s house that had salt-based water softening.) I now carry my own soap in baggies in my purse at all times when traveling.
Louise
L.A.
My son had AC for a couple of years and it would get so bad that sometimes the corners of his mouth would bleed during the night. I read about using Aquaphor, an over-the-counter lip balm, for this and it worked beautifully! My son was at the dentist recently when we noticed that he was getting it again and the dentist recommended Aquaphor. I told him I have about 6 tubes of it at home. Once again, it did the job!
Sarah
North Carolina
I started using a good layer of petroleum jelly (Vaseline) on my lips and around my mouth at night. I keep a container of it beside my bed, and if I have to get up during the night, re-apply the petroleum jelly. I haven’t had any problems since starting this regiment.
Janet
NC
Ditto comments about toothpaste. I figured this out on my own. No more tartar control toothpaste. Also need to be careful about sensitivity toothpastes. I use the sensitivity toothpaste only once a day and make sure I wipe off toothpaste residue when I finish brushing.
IndianaHappyTraveler
Indiana
I was told by my dentist to try the anti-fungal creams or to look for a sauve with menthol in it. As my medical partner swore by Vick’s Salve (or generic equivalent), I thought to keep it simple and try Vick’s first, as it had the recommended menthol in it. Ta-dah! In no time (honestly) the cheilitis healed! As the base is petroleum jelly, it replaced my chap stick nightly application. I continue to use it almost nightly and have had no recurrence of the cheilitis for years now. Certainly worth one’s time and effort to try!
Mary
USA
I had this it is a lack vit b6, I used it 2 yrs. ago has not come back
John Fisher
NC
As a dentist I see angular cheilitis very often, mostly in elderly persons with old, worn-out dentures. The denture teeth are so worn that the bite is “closed” and this creates an excessive wrinkle in the corners of the mouth. Generally there is also a chronic fungal infection under the dentures as well. We prescribe an ointment with a mixture of an antifungal and a steroid. The idea of mixing Monostat with hydrocortisone is right on target. The ointment form works best. Of course you don’t have to be an old denture wearer to get angular cheilitis as your listeners know from experience. I know a lot of people like to use home remedies for lots of conditions, but in this case the “real” drugs work best.
Joanne
Westminster. MD
Cracked lips in the corners? I have found that if I don’t eat my fruits and vegetables for a few days the corners of my lips crack. It is a simple, healthy solution for me.
Sherri
PA
My skin doctor told me to stop buying toothpaste that had a tartar control element. My dentist agreed. I changed to Arm and Hammer without tarter control and the corner of my mouth healed up right away. It has now been several years since I had the problem.
Belinda
Idaho
When I had an AC problem two years ago, I put a tiny bit of Vick’s Vaporub on the corners of my mouth several times a day. It took a few weeks to totally heal, but I haven’t had a problem since. My research at that time suggested that a candida yeast infection might be the cause and that the Vaporub would help. In my case it did.
Maggie
WA
My dental hygienist suggested I might have Angular Cheilitis. I’d been dealing for years with solar keratosis and pre-cancers on my lips so I didn’t realize there could be yet another cause for the red and irritated skin. I bought a $2 tube of store brand anti-fungal cream, and that seems to have worked. After that I was at my dermy who said “Yeah, that could be AC!” She prescribed an additional anti-fungal cream, and for now it seems to have cleared up. The dental hygienist said it is caused saliva collecting in the corners of my mouth, probably when I sleep. I’m older and have lines at the corners of my mouth, so it sounds like I might be a candidate for a little “filler” work to eliminate the wrinkles that allow saliva to collect!
STAN
North Carolina
NYSTATIN WORKED FOR ME FOR YEARS. WHEN I STOPPED SMOKING A PIPE THE CHEILITIS WENT AWAY !!
Jeanine
Virginia
Since childhood I had been a frequent sufferer with AC (30+ years), but have not experienced even a single case since going gluten free 14 years ago.
Cara
Coupeville
I get this when I have something that is salty like potato chips. I use a tiny dab on neosporin on it, and it clears up in just a few hours.
Emily
I’ve had good luck supplementing with vitamin A, 10,000 IU/day until they’re gone.
Other times, I’ve added two drops each of essential oil of lavender, tea tree, and geranium to 1 tsp carrier oil and applied this mixture topically three times a day.
Wendy
San Diego
Listerine applied to the corners of my mouth several times per day took care of this problem for me. It only took about 48 hours to clear up.