I sometimes get sores at the corners of my mouth that are quite painful but fortunately go away after a few days. What might they be, and should I be concerned?
It sounds like angular cheilitis, a relatively benign inflammatory condition that affects one or both corners of the mouth with symptoms of redness, cracking (which can result in bleeding), and scaling of the skin. It’s called “angular” because it occurs at the angle of the mouth, while cheilitis derives from the Greek word chilos, meaning lips. So it’s an inflammation (itis) of the lips at the angle of the mouth.
In some cases, it may look minor, but as you’ve experienced, it can be quite painful. That’s not too surprising considering that every time you open your mouth to eat and chew, or even talk, the tender area is stretched, leading to discomfort, especially if there is cracking and bleeding.
Angular cheilitis is typically caused by too much moisture—such as saliva pooling in the corners of the mouth or from chronic lip licking—and a breakdown or softening of the skin because of prolonged contact with the enzymes in saliva. But there can also be a fungal infection caused by a type of yeast called Candida albicans that’s normally present in the mouth, or less likely caused by bacteria (Staphylococcus aureus) that can invade the cracked skin tissues.
Several factors can lead to saliva pooling in in the corners of the mouth. These include changes in the structure of the face accompanying aging, such as a loss of skin elasticity (which can cause the corners of the mouth to droop) or deep wrinkles at the corners of the mouth. Tooth loss or poorly fitting dentures can also cause saliva to pool there.
Though angular cheilitis can affect anyone, the above reasons explain why older adults are often vulnerable to developing it. It’s pretty common in children, too—if they suck their thumb. According to some estimates, the condition occurs in fewer than 1 percent of people in the U.S. overall, but rises to about 10 percent in older people and even higher (28 percent) in those who wear dentures.
Other risk factors for angular cheilitis include having diabetes (since that results in higher glucose levels in saliva, which promotes the growth of Candida) and being immunocompromised (since that also is associated with an overgrowth of Candida). Nutritional deficiencies, such as of various B vitamins, can also contribute to angular cheilitis.
Treating angular cheilitis involves controlling what’s causing it—whether it’s saliva collecting (for example, because of poorly fitting dentures or teeth being misaligned), a yeast infection (such as from Candida), or chronic lip licking. Whatever the cause, applying a petroleum-based barrier ointment (like Vaseline or Aquaphor) is often recommended. Even when the condition has cleared up—depending on how severe it is, it may take a few days to a couple of weeks—you may want to continue to apply the ointment at night to the corners of your mouth to prevent recurrence. If there’s a yeast or bacterial infection, a topical antifungal or antibacterial ointment, respectively, would be prescribed by your doctor. And if the condition doesn’t respond to conventional treatments, you should consult a dermatologist—there may be other less-common underlying causes.
