Q: My skin cracks at the corners of my mouth. It gets better, and then returns for no apparent reason. This has been going on for more than a year. What could be causing this condition?
A: It sounds like you have a condition called angular cheilitis. It's also known as angular stomatitis or perleche. In addition to skin cracking at the corners of your mouth, there can also be redness and scaling. The cause is frequent or persistent saliva touching the skin outside the mouth.
Have a poor seal of the lips at the angles of the mouth
Have ill-fitting dentures, or
Frequently lick your lips
Angular cheilitis can also be from an allergic skin reaction to lipstick or face cream, or flossing your teeth too vigorously. But that's less common. And it's rarely caused by a vitamin or iron deficiency.
To help prevent angular cheilitis from coming back, try to avoid excessive moisture accumulating in the corners of your mouth. If it does come back, you can apply an over-the-counter antifungal cream or ointment. Then follow with a topical hydrocortisone 1 percent ointment an hour later. Do this 2-3 times per day. Some dermatologists prefer a prescription product that contains both hydrocortisone and an anti-infective agent (Vytone, for example).
Once the perleche heals, then use a protective lip product, similar to what you would use to treat chapped lips. It's probably best to pick one that's hypoallergenic. Make sure the corners of your mouth are dry before applying. Use it often. Consult your doctor if the problem persists.
(Howard LeWine, M.D., is a practicing internist at Brigham and Women's Hospital, Boston, Mass., and Chief Medical Editor of Internet Publishing at Harvard Health Publications, Harvard Medical School.)
(For additional consumer health information, please visit http://www.health.harvard.edu.)