perleche or angular cheilitis, cracks in the corners of the mouth

Q. For years I suffered from chronic angular cheilitis (painful cracks at the corners of my mouth). I also had chronic irritable syndrome (IBS).

Doctor after doctor dismissed any relationship between the two. I finally saw a nutritionist and she correlated the problem with B vitamin malabsorption because of the IBS.

I started taking sublingual (under the tongue) B vitamins. This bypasses the GI tract and allows for absorption. I have not had any cheilitis for more than a year and a half. I also started a gluten-free diet that has stopped my IBS symptoms.

After 20 years of symptoms and countless doctors, one nutritionist knew the answers.

A. Angular cheilitis (also called perleche) can be extremely painful. We have heard from people who were healed when they corrected their vitamin D deficiency. Low levels of zinc, iron or B vitamins, especially riboflavin, are also thought to contribute to this problem.

Not everyone with IBS will benefit from a gluten-free diet, but it may well be worth a try. First, sufferers should discuss the possibility of celiac disease with their primary care provider. Going gluten free prior to testing for celiac disease could throw off the accuracy of the test and contribute to a delay in diagnosis. Some people who do not have celiac disease are sensitive to the gluten protein found in wheat, barley and rye. They also benefit from adopting a gluten-free diet, just as you have.

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  1. Sutton

    I also have been suffering from angular chelitis for a couple years. My dermatologist has prescribed a couple cream medications, first for a vitamin E sensitivity and had me discontinue my chap stick which contained E) when that didn’t work, I started using oxistat cream which is a yeast or fungal problem. It works for a bit and then corners crack again while still using it. I tested negative for Celiac.
    I also have peeling skin around my thumbs (very sore!) and the thumb nail looks slightly lifted and thickened. She has just dx’d this as focal parakeratosis (nail Psoriasis)and has prescribed Clobetasol 0.05%. Do you think there is a connection between the angular chelitis and the nail Psoriasis? I would like to try vitamin B supplements but have Interstitial Cystitis and all the B’s create major bladder symptoms.
    Where and how do I get an rx for the sublinqual or the nasal spray? The derm can’t prescribe them for me. Would sublinqual bypass the bladder? I hope you can help me sort through these issues! Thank you so much.
    Sutton, 60 yr old female.

  2. Jane

    The cracks at the corners of the mouth are definitely a symptom of celiac as are cancer sores in the mouth. The “cure” was the gluten-free diet, not the sublingual B.

  3. EPM

    I had had the same symptoms among others for several decades and was told that my problem was nerves and malabsorbtion. It was only when we lived in France in 2000 that I was properly diagnosed with celiac sprue. It sounds to me like this could very well be celiac. I would check it out. It could be familial. In my case, a daughter, granddaughter, and niece were also diagnosed with celiac well after my diagnosis was made.

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