Torn corners of the mouth

Synonyms: lazy corners, angular cheilitis, angular cheilitis, angulus infectiosus (oris) or perlèche

General

Torn, red, scaly corners of the mouth can have a variety of causes, from local and completely harmless to severe systemic diseases. Many people are affected by angular cheilitis and sometimes suffer very badly from the painful skin changes, which is why therapy is always indicated, even if the actual reason for the formation of the tears is harmless.

causes

There are a variety of causes of angular cheek disease, which can be divided into two broad groups: local and systemic causes. Local reasons for cracks in the corner of the mouth include both dry skin or a to Dry lips as well as too damp Corner of the mouththat can arise, for example, from the fact that you often lick it or even when one Overproduction of saliva (Hypersalivation) is present. A strong formation of wrinkles in the area of ​​the corners of the mouth, caused for example by a Tooth loss can cause more fluid to accumulate here, which also favors the formation of rhagades. Also one Denturethat does not fit well or that is even allergic to can be the cause of torn corners of the mouth.

Often there are also angular infections local infections the lining of the mouth, for example due to an infection Herpes Simplex Viruses, certain bacteria (most of time Streptococci, especially in children) or by the fungus Candida albicans. In addition to these local infections, systemic infections such as treponemas (syphilis) or HIV, lead to angular rhinitis.

Other systemic causes are Deficiency symptoms (such as a lack of vitamins Riboflavin or vitamin B12, Zinc deficiency or Iron deficiency) or an excessive intake of Vitamin A (Retinol). Metabolic disorders like that Diabetes mellitus, Parkinson's disease, Down syndrom, Cirrhosis of the liver, certain autoimmune diseases like that Sjogren's syndrome, psoriasis (psoriasis), Neurodermatitis (or more rarely others Eczema as the seborrheic eczema) can be a possible cause of angular mouth arthritis.

Allergies, especially Contact allergies, for example against nickel (These become particularly evident when patients frequently put objects in their mouths that contain the substance that causes the allergy, for example ballpoint pens with nickel), can cause angular mouth infections.

Also a Drug eruption can sometimes manifest as torn corners of the mouth.

In principle, the occurrence of angular cheilitis is also always facilitated when the Immune system (For example, by taking certain medications such as Cortisone or certain diseases like HIV) or previous damage to the skin, for example as part of a Neurodermatitis or one Sunburn, is present.

Fungi as the cause

In addition to the infection of torn corners of the mouth with bacteria or viruses, fungi can also get into the wound and lead to a fungal infection. This is mostly due to yeasts like that Candida albicans. Patients express pain when eating, drinking and also at rest. In addition, a strong, unpleasant itch develops. In extreme cases, there can also be a white coating, a so-called thrush, arise. thrush and Leukoplakia express themselves as a tight white coating on the tongue or the oral mucosa. This can come off while eating or deliberately scraping it off and lead to bleeding. However, this occurs much more frequently with a fungal infection in the oral cavity. Erosion and blisters can form on the infected area of ​​skin, which eventually lead to deeper wounds. Fungal infections often affect patients who generally suffer from immunosuppressive diseases. These include diseases like Diabetes mellitus, Tumor diseases, tuberculosis, HIV or those that require radiation or chemotherapeutic therapy. Fungal infections can also develop during treatment with antibiotics and cytostatics. The infection should then come with a Antifungal agent, which can be obtained from the pharmacy after consultation with a dermatologist, in order not least to avoid the formation of scar tissue.

Symptoms

The characteristic symptoms of angular cheek disease are corners of the mouth that torn, reddened and ignited are.
Sometimes the cracks also form in the area Tissue defects (Erosions), the skin may become flaky and / or covered with a whitish, milky, crusty coating of fibrin, especially if an infection is caused Candida albicans present.

These cracks (Fissures) go along in most cases Pain which can typically be amplified by touch. In addition, these complaints are increasingly perceived when eating food with a high content of acid (how Lemons or vinegar) or very spicy food is recorded.

Many sufferers also complain about one Feeling of tension or more rarely over one Foreign body sensation in the corners of the mouth. Due to the pain, facial expressions or the consumption of solid food may be impaired in some patients. All of these symptoms usually occur more or less symmetrical on, certain causes (such as syphilis) also predispose to a one-sided infestation.

Inflamed corner of mouth

An inflammation of the corners of the mouth is also used in the jargon Angulus infectiosus oris or Angular cheilitis called. It arises when minor cracks to the Lips infect and then one inflammation developed from it. The typical signs of inflammation are Redness, swelling, pain and overheated skin. The cracks on the lips can occur for various reasons. Brittle and dry lipswhich can then tear quickly, especially through cold or very warm air caused. But can also continue conditioned air or that too frequent biting lead to minor wounds on the lower lip.

Often get bacteria how Streptococci or Staphylococci or Viruses by touching the lips with your hands or over other objects into the wound and triggering the inflammation. Also the Lack of nutrients and Vitamins or the excessive consumption of spicy food can irritate and roughen the skin on the lips.
The infected wound then becomes larger and may also gape slightly. Especially painful are then movements of the lips, especially when yawning, laughing and speaking. The feeling of tension can go through moisturizing ointments or Ointments be counteracted.

Angular rhinitis

Angular rhinitis will also be Angular cheilitis, Perlèche, Angulus infectiosus, or Lazy corner called. It refers to minor tears in the area of Corner of the mouththat can have various causes. They can arise from a severe wrinkling the skin, diseases with immunodeficiency or skin diseases such as Neurodermatitis and infections with bacteria, Viruses or Mushrooms. Patients with systemic diseases like Diabetes mellitus, Cirrhosis of the liver, Vitamin deficiency, Autoimmune diseases and treatments with Antibiotics or Cytostatic can more easily develop cracks in the corners of the mouth.

The affected areas of skin can reddened and eroded be. One is also possible crusty fibrin coating and classic Signs of inflammation. The lesions come on frequently symmetrical before, i.e. at both corners of the mouth. If, on the other hand, only one corner of the mouth is affected, this can be an indication of one Syphilis disease be. The patients have Pain, especially at Yawning, speaking or at eat can be uncomfortable. The irritated skin can additionally burn and itch. The complaints can be dealt with very well Zinc paste or fatty ointments be alleviated.

The symptoms can be treated very well yourself, if there is no improvement after a few days, the person concerned should visit a dermatologist for examination and advice. Using a smear, the doctor can determine the exact cause and initiate appropriate treatment. Treatment with antibiotics may be necessary for bacterial infection or antifungal treatment for fungal infection.

diagnosis

The diagnosis of angular cheekbones is usually a visual diagnosis. Due to the characteristic appearance, a doctor usually knows directly what the disease is.
After the diagnosis is made a detailed examination the corner of the mouth and its surroundings to check for any signs of infection (for example, small, clustered blisters in a Herpes infection or whitish deposits on the oral mucosa in the event of an infection Candida albicans) to recognize.

If the pathogen cannot be clearly identified, depending on the suspicion, a smear removed from an affected area, a Stool sample or blood be examined for the suspected pathogen. If, based on the medical history (anamnese), other symptoms in his patient or a non-effective therapy suspected a systemic underlying disease depending on the direction in which this suspicion goes, further investigations will follow. If an allergy is suspected, a Allergy test be carried out at Neurodermatitis or psoriasis you will look at the entire body to identify any other affected Skin areas to discover suspected diseases such as one Cirrhosis of the liver or one Diabetes mellitus can often be confirmed or rejected with the help of certain values ​​from a blood sample. When there is a reference to Dental problems a referral to the dentist can be useful.

therapy

The therapy of Angular rhinitis mainly depends on the underlying cause. If a systemic disease has caused the torn corners of the mouth, it must be treated appropriately.

With an appropriate therapy, the angular rhagades of the mouth almost always regress.
In addition, people who are generally prone to torn corners of their mouths should be careful to rule out any possible triggers or factors that may cause this condition. So you should like potential allergens nickel, sharp, acid and very hot food, toothpaste and irritating cosmetics avoid. In addition, patients should ensure that the skin around the corners of the mouth is well cared for, which in this case primarily means that it should be kept as dry as possible.
So you should be careful not to lick the torn areas as often. In addition, a certain paste (for example Zinc paste), which ensures that liquid is absorbed. Alternatively you can fatty ointments respectively vaseline can be used.
If a pathogen has been detected, these preparations can also be combined with a antibiotic, one antivirals or one Anti-fungal agents (Antifungal agent) can be enriched. So they have a double effect: Directly against the pathogen and by creating a dry climate in the corners of the mouth, in which any germs can in principle more difficult to settle.

If an adequate therapy is carried out consistently, the torn corners of the mouth usually disappear about three to five days. In the case of certain underlying diseases, especially for example diabetes mellitus, an immune deficiency or atopic eczema, the healing process can sometimes be a little longer. Such patients then often also tend to re-develop angular angular disease (Recurrences) to develop.

Treatment with a cream / ointment

Patients who frequently have torn corners of their mouths should definitely have one See a doctor and the Find out the cause of this phenomenon to let. In many cases, the torn corners of the mouth are affected harmless causethat is quick to fix. In some patients, however, can also systemic diseases (for example Diabetes mellitus) be the cause.

Affected patients can already at home with simple means help yourself. Especially the regular application of one fatty cream can help treat the torn corner of the mouth and get relief quickly. As the attacked corners of the mouth usually badly dried out fatty substances help with this To accelerate the healing process.
When using a cream, however, make sure that one corner of the mouth is torn not too wet may be. On the contrary: in the presence of an angular cheek, the affected areas should kept particularly dry become. Straight Salivary fluid can due to the contained therein bacterial Pathogens cause the torn corners of the mouth infected and inflammation develops. A cream that contains a lot of fat can help create a barrier between the bacteria-rich saliva and the torn corner of the mouth. With regular application of the cream, the affected area is covered by a film that forms the Effectively roll off saliva leaves.

Straight in the winter can use a cream or a lip balm not just for treatment but especially for prevention serve from torn corners of the mouth. In addition, a Zinc-based cream help to speed up the healing process.

The attending physician should determine that a torn corner of the mouth is related to bacterial infections or a Fungal colonization stands, so it is Application of a special cream necessary. If bacterial pathogens are detected, the affected patient must apply a cream with a locally effective agent several times a day antibiotic Instruct. Fungal infections in the area of ​​the corner of the mouth can be caused by so-called Antifungal drugs to treat.

Home remedies for cracked corners of the mouth

There are many home remedies that can help against cracked corners of the mouth and that can be found in almost every household. Sore- and Healing ointments and –Creams (e.g. Bepanthen) or products with a high fat content (e.g. milking fat or petroleum jelly) are very effective and help the skin to heal quickly through regular application of cream. It is very important to take care that the corners of your mouth kept dry become.

It often helps to get the affected areas with you honey to grease. Honey has a mild anti-inflammatory and antiseptic effect and thus promotes healing. However, due to the sweet taste, this measure often leads to people licking their lips and corners of their mouths. This should definitely be avoided as it further promotes drying of the corners of the mouth and can worsen symptoms. Care should also be taken to avoid further skin irritation. Contact with sour, salty or spicy food and drinks should be restricted. Toothpaste can also cause further irritation.

Lies in the torn corners of the mouth Vitamin deficiency an attempt should be made to remedy it. Often no special products are required for this, but a healthy, balanced diet.

Naturopathy and homeopathy also offer some treatment options. For example, the Schüßler ointments No. 1 and 3 for external use. Both Schuessler salts become No. 1,3,8 and 11 recommended. Homeopathic treatment should always be discussed with an experienced alternative practitioner, homeopath or doctor and adapted to the patient's overall situation.

Torn corner of the mouth due to a lack of vitamins

A defect at different Vitamins in the body can lead to torn corners of the mouth. Vitamin B2 (Riboflavin) plays an important role in metabolism of man. Usually the daily requirement is around 1.2mg through normal, balanced nutrition covered. Riboflavin can be found in dairy products, eggs, fish, meat and whole grain products, for example.

In the pregnancy or at Alcoholics However, there are deficiencies. In these cases, or if not enough vitamin B2 is taken in, it is called a Ariboflavinosis, a lack of riboflavin.
As a result, the metabolism is disturbed and the corners of the mouth tear, among other things. Also skin rash, decreased visual acuity and increased sensitivity to light can occur.

Vitamin C (ascorbic acid) is also an essential vitamin for the body. It is required for the metabolism, the immune system and also promotes the Absorption of iron. One should be around 100mg Consume vitamin C daily. Citrus fruits are a good source for this. During pregnancy and breastfeeding women have an increased need for vitamin C. Even with smokers, the turnover is increased and more vitamin C has to be consumed. A vitamin C deficiency results in torn corners of the mouth, which in the worst case can lead to illness scurvy belong (with bleeding skin, mucous membranes and gums). Also Performance decrease and exhaustion are among the symptoms.

Also a lack of the trace element iron leads to torn corners of the mouth. Iron plays a central role in that Transport of oxygen in blood. It is also very important for the muscles. The human body has stored around 4-5g of iron. Every day a lot of 5mg absorbed into the body from food. For example, iron is found in meat, fish and leafy green vegetables. Does the body have too little iron, for example in women who are strong Menstruation have, or in people who follow a vegetarian or vegan diet, torn corners of the mouth are one of the symptoms. Also, the people affected are often tired, suffer from dizziness and Difficulty concentrating and have brittle nails and Hair loss. An iron deficiency can also be found in the blood; Iron deficiency anemia on. Therefore, if you suspect iron deficiency, you should definitely consult a doctor to clarify this.

Read more about this Consequences of iron deficiency.

Another important trace element in the body is zinc. It is essential to the human immune system and also very important for the Fat-, Sugar- and Protein metabolism. Zinc is especially found in red meat, cheese, and seafood. The recommended daily dose is included 12 to 15mg. Zinc deficiency occurs Malnutrition on. A vegetarian diet can also lead to a zinc deficiency. Older people who have high zinc consumption also often suffer from the symptoms. These also include torn corners of the mouth Hair loss, brittle nails and a Underactive gonads (In the worst case this can lead to impotence in men).

Torn corner of the mouth during pregnancy

During the pregnancy the body makes very extreme changes in hormones. This change can lead to various reactions in the body. Among other things, many pregnant women are from torn corners of the mouth that occur suddenly during pregnancy. The cause of this is usually a Deficiency of various vitamins, Minerals and especially one Insufficient supply of the trace element iron (Anemia). Iron keeps hair, nails, and skin healthy. The body needs in particular during pregnancy twice as much iron as usual. In order to prevent tears, the lips should be used regularly humidity are supplied. Various care products such as Lip balmthat you can get in drugstores or pharmacies. In addition, during pregnancy, the iron content can be reduced to within a Blood test to be determined. The attending physician hires Iron deficiency notes, the patient can be prescribed various drugs that contain the Iron store rebuild the body. In some extreme cases, iron administration can also intravenous may be necessary by means of an infusion. In general, these drugs are safe and well tolerated during pregnancy.

Torn corners of the mouth in toddlers

Torn corners of the mouth are often caused by a bacterial infection in young children Streptococci or Staphylococci caused. You often bring many objects to your mouth and are not aware of the spread of bacteria and viruses. The tears are favored by frequent licking off areas of the skin that are already sore. The skin can also be irritated by excessive use of sweet beverages such as apple juice or spritzer. This should then be avoided during acute inflammation. For children and toddlers, torn corners of the mouth can be very uncomfortable because they discover a lot with their mouth during their development phase and accordingly move it a lot. In order to get the children symptom-free and to keep the skin supple and gentle, ointments can help very well. Zinc ointment, Bepanthen wound and healing ointment or lip healing cream such as Blistex can be applied particularly well to the irritated areas of the skin in the evening before going to sleep. It is recommended that children also drink sufficient fluids, ideally with water. A balanced diet with enough vitamins, minerals and trace elements can also help Angular rhinitis prevent or accelerate healing.

Torn corners of the mouth in the child

In children, the corners of the mouth are often torn. Often this is favored by moistening with the tongue. A common cause in young children is the friction that occurs when Suck on the pacifier arises. Children with previous illnesses such as neurodermatitis or diabetes mellitus are more prone to it. If the corners of the mouth are reddened and inflamed, it is very likely that there is a bacterial infection of the corners of the mouth. A fungal attack on the irritated areas is also possible.

Depending on the cause, you have to either Antibiotics against bacteria or Antifungal drugs given against fungi. If the torn corners of the mouth are due to another disease (neurodermatitis, diabetes mellitus), this cause must be treated so that the child can become symptom-free.

Because the inflammation in the corners of the mouth also in a chronic stage it is especially important in children that one Pediatrician is sought out who can initiate the appropriate treatment. Other Underlying diseases must be excluded and chronic tumor formation should be prevented. In addition, bacteria and fungi that have settled in the torn areas must be combated in good time.

prophylaxis

Prevention of angular cheekbones can be successful to a certain extent. This is focused on any risk factors (especially so too dry or to damp skin, ill-fitting dentures, Allergens or mechanical or. chemical irritation) as far as possible to avoid. You should also make sure to take good care of your skin and maintain a balanced diet that prevents deficiency symptoms. If there is a vitamin or iron deficiency that does not otherwise cause symptoms, one should still consider Food supplements to be consumed in order to avoid angular disease and other complications. However, all of these preventive measures are only partially effective as they are Infections educate in principle in everyone and some people are simply predisposed to develop angular angular disease.