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Angular Cheilitis (Perleche) Home Remedies

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Q. I struggled with a condition called angular cheilitis for 60 years. From the time I was five years old until two years ago I had redness, irritation and cracks at the corners of my mouth.

When my family doctor tested my vitamin D level the result came back showing that I was highly deficient. My score was 12. I believe 20 is considered barely normal and 30 to 50 is optimal.

My doctor had me start taking 2,000 IU of the vitamin D3 and the first thing I noticed was that the corners of my mouth were no longer cracking and sore or bleeding. Since then I have continued to take 2,000 IUs and have had a flare-up only once, when I was traveling and neglected to take my pills.

I mentioned the connection between vitamin D and angular cheilitis on a recent visit to a dermatologist, and he dismissed what I told him, saying it was rare for vitamin D to help something like this. Perhaps I am a rare bird, but I swear that taking vitamin D has healed what was a lifelong problem for me.

A. Cracks in the corner of the mouth can be incredibly uncomfortable. These splits can crust over or bleed if they go deep enough. The medical terms for this condition include:

• Angular cheilitis
• Perleche
• Cheilosis
• Angular stomatitis

It is not entirely clear what causes these fissures to form, though nutritional deficiencies are sometimes blamed. Low levels of vitamin B2 (riboflavin) are sometimes suspected as a contributing factor. Ditto for zinc and iron. We have not heard of a link between low levels of vitamin D and angular cheilitis. We did find one fascinating study, however, demonstrating that a vitamin D ointment called calcipotriol (Dovonex) that is used to treat psoriasis worked extremely well to treat a somewhat similar condition called leukoplakia (white patches on gums or tongue).

Doctors also believe that a fungal infection (Candida albicans) may contribute to both angular cheilitis and leukoplakia. Bacteria may also play a role in the lesions in the corner of the mouth. That may be why Listerine with its high alcohol content and anti-fungal essential oils may help some people. Here are some other stories from visitors to this site:

"I used to suffer from these painful, raw cracks in corners of my mouth. My dentist suggested I use an inexpensive over-the-counter anti-fungus cream (such as athlete's foot cream). Within a week the cracks healed, and I haven't been bothered since."
Phyllis

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"I have had angular cheilitis for about a year and a half now. I went to my Dr. after 3 months of trying numerous things to heal my mouth. I told her that I thought it was angular cheilitis after researching it. She laughed at me and said that the last time she saw something like that, it was an allergy to some food. She gave me an antibiotic which did nothing and then another prescription (I don't even remember what it was) that also did nothing. I was miserable.

"I went for my regular dental check up and told my dentist. She told me that it was angular cheilitis and gave me a prescription for nystatin and triamcinolone acetonide. It cleared it up right away. She also told me that many people that get this seem to be low in iron. I had already started taking a multivitamin with iron. The medication cleared it up but it continually comes back. I would really like to get rid of it for good. I take Vitamin B Complex every morning and a multivitamin with iron at night.

"I have tried all kinds of "remedies" including: apple cider vinegar on the corners of my mouth, Mentholatum on them, changing my toothbrush and my toothpaste, using moisturizer on my lips, cold sore medication, and anything else I've read. This condition is miserable and I would love to get rid of it permanently."
Laura

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"I had the same problem & found that each morning I could put rubbing alcohol on a tissue and blot each mouth corner and I still do this 1 or 2 times a week & have had no re-occurrence in the last 4-5 years."
L.H.

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"Several decades ago, my grandmother suffered from cracked skin at the corners of her mouth. She was found to be deficient in riboflavin, as I recall."
Linda

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"I used to have this all the time until I started using the cracks as a indicator that I needed more Vit B - now if cracks start to develop I take one "balanced B" vitamin and by the next day the cracks are either gone or on their way out."
MAM

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"Suggestion: put on Listerine (or Vicks VapoRub - outside/external area) mouth wash several time a day on the craks. It is both antifungal and antibacterial. After a week or so the problem should be gone."
C.P.M.T.

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"I tried many lip soothers, sticks, and balms, for months to heal chapped, cracked lips. I even got a prescription for Duke's 'Magic Mouthwash.' Nothing completely healed my lips. I read your newspaper article about Mentholatum ointment and I tried it on my cracked, chapped, sore lower lip for about a week. It healed it and the lip looks and feels normal."
M.V.

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"I asked my dentist to prescribe something after suffering for a couple of weeks with cracks in the corner or my mouth. I had been using Aquaphor a medicated salve. He prescribed an anti fungal cream. So the Listerine and Vicks sound like a good answer. I take a multi B vitamin every day so don't think I have a deficiency."
Pauline

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"I don't have any immune problems and am a 31-yr-old healthy individual. I however occasionally suffer from angular cheilitis (I've had 3 episodes in the last 3 or 4 years). I think I am just prone to this type of fungal infection.

By sheer luck and experimentation I learned that applying old-fashioned amber Listerine to the affected area helps clear up the problem within a few days. I once got a prescription for anti-fungal cream from a doctor and Listerine even outperformed that!"
J.S.

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If you would like to learn more about vitamin D and the way to test for deficiency of this nutrient and optimal levels to take, we offer our Guide to Vitamin D Deficiency. It is available for download for $2. You may also find our Guide to Unique Uses of Vicks of value.

We would love to hear your story about tips for healing dry lips and angular cheilitis. You can comment below so others can benefit from your experience.

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MANY years ago I had cracks in the corner of my mouth. I don't remember the diagnosis (doc did scrapings of corner of mouth) but my Doctor gave me samples of an antifungal cream which cleared this up.

Now when I feel a crack coming on, I just spray a little antifungal spray (1%tolnaftate) (over the counter) and with my finger, dab on the corners of my mouth. It stings a bit but after a day or so, the cracks go away.

Maybe a cream version of this wouldn't sting, but I have a container of the spray and just use that.

Vitamin A and fish oil for skin cracks.

I used to get that and B Complex helped. Most Doctors do dismiss vitamins and supplements.

Several decades ago I had a persistent problem with cracks at the corners of my mouth. My dentist prescribed a very expensive topical ointment, which temporarily relieved the condition.

When it was brought to my GP's attention, he said it was caused by a vitamin B deficiency and prescribed prenatal vitamins for me. This resolved the problem. However ... when I asked my doctor how I could have a vitamin deficiency even though I ate a well-rounded diet and loved fruits and vegetables, he said that some of us do not absorb nutrients as well as others.

It turns out that he was right (I also had slight anemia and some other bothersome chronic problems), but did not go nearly far enough in trying to uncover the root cause.

Twenty years later, while living in France and being treated for a kidney stone, my French doctors, just by chance, found that I had celiac sprue. This almost immediately cleared up the myriad problems I had been wrestling with for many, many years. My American doctors had been treating me for celiac symptoms for about thirty years without looking for the cause of the symptoms. When I returned to the U.S. in 2000, I asked my American doctor, who was well-credentialed and worked for a really good clinic, to verify the French sprue diagnosis. His response was puzzlement at the name "celiac sprue" as if I had mentioned some rare exotic disease. He also said he did not know how to test for it!

One of many lessons here: If you have persistent vitamin or mineral deficiencies, check for malabsorption to try to establish a root cause.

PEOPLE'S PHARMACY RESPONSE:

EPM,

Thank you so much for sharing this powerful story. We have been writing about and interviewing experts about celiac disease for decades. It is so frustrating to learn that this surprisingly common condition is still considered rare.

Because this autoimmune condition makes it hard to absorb crucial nutrients from the digestive tract people can suffer for years from a range of symptoms. That can include a terribly itchy skin rash, digestive distress, memory problems (including dementia-like illness), weakened bones, anemia and so much more.

Anyone who would like to learn more about celiac disease will find our radio interview with top experts of value. We also provide additional details in our Guide to Digestive Disorders.

https://store.peoplespharmacy.com/guides/digestive-disorders.html

Interviews:

Radio Show # 856: Celiac Disease Update:
http://www.peoplespharmacy.com/2012/05/05/856-celiac-disease-update/

Radio Show # 727: Celiac Disease
http://www.peoplespharmacy.com/2009/06/12/727-celiac-dise/

Radio Show # 558: Controlling Celiac Disease
http://www.peoplespharmacy.com/2006/05/16/controlling-cel/

In a stressful period of life as a young mother of two and finishing chiropractic school, I pushed further into a vegetarian diet. During exams [ more stress], I developed angular cheilitis. I immediately realized it was the b deficiency! It cleared up amazingly quickly on resuming moderate meat consumption.

I had the same symptoms as described above, never knew the name of condition.
My dentist told me to take Vitamin C with ROSE HIPS which I have been taking for over 40 years. No problems unless I go for several weeks without taking.

L-Lysine should work for many. my mother often had that problem and my sister's mother-in-law recommended l-lysine. Worked wonders. Of course that also works for oral ulcers.

I've had osteomalacia and treated with Vit D. During this treatment, cracks in the corners of my mouth disappeared and have not returned. Many things improved, remarkably, with Vit D treatment: my allergies, asthma, weight, strength, memory, cognitive processing in general, etc. It was pretty remarkable and unexpected since I was not told this would happen. As for the cracks, I read somewhere that Vit D affects tissues so that better absorption occurs. If that is the case, you're improvement can be explained by better B Vitamin absorption

Fish oil clears up this problem for me.

I went to a dermatologist for this problem, he explained that as we age the corners of the mouth droop and as we sleep we tend to drool, so basically just live with it (I no longer see him!). A friend researched this and told me to try vit B. It has helped, but not cleared up entirely. I'll try Vicks and listerine. Thanks

Vit D does amazing things for skin, so I'm not surprised it helps with the Angular Cheilitis.

Within a few months of my beginning Vit D supplementation, I found that it moderated several symptoms, including pain. It didn't make them go away, but they became much less severe. Since I take a fairly high dose, my doctor checks the levels in my blood regularly.

I had this annoying chelitis on and off for 8 months. Was given anti fungal creams to try with some results. Then I changed toothpastes as an after thought. It's cleared up and hasn't returned for over a year. Perhaps I developed a sensitivity to an ingredient in the toothpaste....one I liked a lot.

I have had those horrible cracks on and off for the last five yrs. My dermatologists nurse said nystatin cream would help and Prescribed it. It worked well for a couple of yrs and then it stopped!

So I tried taking a lysine capsule and using abreva from the drugstore and they are gone in 1 day! I don't understand why it seemed to change but if one approach doesn't work, try the other!

My doc suggested that I just needed to keep my sleep drool out of the corners of my mouth, and that I could use a waxy lip balm to do this. For the past couple of years, I've put Carmex on the corners of my mouth before bed and it's worked really well.

About 60 years ago I was having a tooth extracted from an oral surgeon. I had a mouth crack and he put some ointment on it and it was cured. Later when I went to him and told him how well it worked, he put some ointment on a piece of waxed paper and folded it over and gave it to me. I would put it on my cracks and when it finally ran out he gave me a prescription for nystatin triamcinolone. It lasted me for years. When I asked my MD years later about a refill (I had moved in the meantime), he said it wouldn't do any good and wouldn't give me one. I eeked out the old tube for quite a while. Later he said he had done some research and found that it might help. I have used it for, as I say, 60 years and I find it cures mouth cracks almost overnight. I wouldn't want to be without it.

I suffered from Angular Cheilitis on and off for about 15 years, tried B & multivitamins, anti fungal creams amongst others. 2 years ago for unrelated reasons I stopped eating any food with added sugar. Angular Cheilitis hasn't been back since. Giving up sugar also means I eat very little processed food, so not only have I cut sugar but all the chemicals & food additives that food manufacturers love, so I can't honestly say that sugar is the reason but I suspect it is.

I had this condition one time and I took B complex to cure it. It appears to be caused by B vitamin deficiency in most people and the B deficiency in turn is caused by systemic yeast which eats up the B vitamins in your system. Taking a B vitamin is a quick fix but you must get the yeast under control with a clean diet.

You're right it's the yeast which is fed by the sugar!

Our 7yo daughter had very painful cheilitis all around her mouth for over 1 year. Multiple pediatricians & dentists saw her. Responses varied from: (i) we were using too much chlorine in our pool (we had a salt-sanitation system and were chlorinating to the same recommended levels as always, and she'd never had any problem before; (ii) the wet/dry/hot/cold/sunny/cloudy weather was causing this (???); (iii) she had a yeast infection (although she tested negative; (iv) she was a compulsive "licker & picker"; (v) I was an overprotective mother/all kids get this; (vi) it was eczema/psoriasis..., etc.

She was given multiple prescriptions for anti-fungals, anti-bacterials, steroids, etc., and I tried multiple OTC and home remedies. I did some research online on my own and read about vitamin deficiencies. We are a health-conscious family who eats well, and I couldn't believe this could be the cause, but tried giving her a multi-vitamin, and (for a few months) her cheilitis improved dramatically.

Then it came back with a vengeance, she developed anemia, and, in exasperation, I demanded a full work-up. As it turns out, she has Crohn's Disease. Although she has not yet had the chronic diarrhea and similar symptoms typical of this disease, endoscopy showed multiple granulomas in her terminal ileum; the vitamin deficiencies were b/c her intestines were too inflamed to digest/absorb nutrients properly.

We had no reason to believe our sweet girl - who other than her chapped lips appeared to be the picture of health for months even while she was very sick - was ill (and apparently, neither did her docs/dentists). Docs can do simple blood tests (SED rate/CRP, etc.) to screen for inflammation markers if Crohn's is suspected.

I suffered from chronic angular cheilitis for years. I had chronic IBS also. Doctor after doctor dismissed the relationship between the two. I finally saw a nutritionist and she correlated the problem with a b vitamin malabsorption related to the IBS.

I started taking B vitamins SUBLINGUALLY - very important - leaves out the GI tract. I have not had any cheilitis for more than a year and a half. I also started a gluten free diet which has stopped my IBS symptoms. 20 years of symptoms - countless doctors - one nutritionist new all the answers (:

someone please help I've been suffering angular cheilitis for 8 years and am tired of this crap :'( someone please help!!!!! am tired of having this and not be able to do a lot of activities cause of this! :'(

I've found that applying turmeric on the corners of chapped/cracked lips, and applying turmeric as facial packs, and even consuming turmeric daily helps banish angular cheilitis and, apparently, loads of other ailments. Do try it! Best wishes.

I also was tested and discovered I also had extremely low vit D levels, I was prescribed a very large weekly dose of vit D and never put two and two together - but have not had problems with the dry skin and cracking around the corners of mouth since! Until just now I never made the connection!

Have had this condition for years, it won't go away, have gotten things from the doctors and none of them have helped, what's the strongest thing you can get from the doctors to most likely fix the condition??

I suffered from these cracks during high school but once I switched from Crest to another toothpaste I never had the problem again unless I used Crest! Guess mine was an acquired allergy.

Specific to the toothpaste theory, I whole-heartledly agree with that allergy, specifically to SLS or sodium lauryl sulfate.. Once I switched, things changed for me. Plenty of choices these days but certainly give it a try.

Thanks to this site, I tried switching toothpastes, or applying turmeric, anti-fungal cream, or antibiotic ointment, and the antibiotic definitely cured it in a few days.

My mother said that angular cheilitis, can be cured by fish oil capsules or by taking adequate amounts of Vitamin B complex.

Hi,

I am suffering from the same problem (Angular Cheilitis). I have had angular cheilitis for the past 12 years. pls anybody give me good suggestions.

Thanks...

I suffered from this condition for years, when there were no answers on the Web. At the time, I had poorly controlled rheumatoid arthritis, anemia from chronic disease, a weird thing called geographic tongue (e.g., a little cayenne could sear my tongue). I'd previously had thrush, as well. When my anemia didn't respond to iron supplements, a blood test showed I had a vitamin D deficiency. Ultimately, the perleche/cheilitis resolved after high-dose Rx vitamin D therapy and the initiation of stronger meds to control my inflammatory condition. I recently read that a toothpaste called Squigle can help people who have perleche b/c it's SLS-free. Good luck to those looking for answers. There are good suggestions on this page.

As a child, I had red cracks at the corners of my mouth, and was spreading.

My teacher told me to wash my face AFTER I brush my teeth.
Cured.

Even when I was a child I would get angular chelitis, though I didn't know that was the name of this condition. My mother would tell me it was because I did not wipe the corners of my mouth after eating, which was not true. Thank goodness after decades of suffering with this condition, I finally found the way to prevent it: B vitamins. After having some routine bloodwork done as part of a physical exam, I discovered my B vitamin level was extremely low. So I started taking B vitamins for that reason... and guess what: I stopped having angular chelitis outbreaks!

I take a B complex vitamin as well as B12 supplement every day. If I neglect to take these vitamins, even just for a couple of days, without fail the angular chelitis comes right back. I really hope this helps other people because having A.C. is just horrible. It physically hurts, but it also hurts your self confidence to have those ugly cracks on the side of your mouth.

I have the cracking at the corners every few years. It used to be that you could buy Riboflavin alone but for some reason you can't anymore so you have to buy the B-50 now. A couple days of that and they are gone for me for years. Until I found the Riboflavin treatment in an old Adele Davis(?) book nothing worked. I have given this tip to many people and it always worked.

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