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Fungi and bacteria can infect lip cornersDear Dr Reitz: For more than a month the corners of my lips have been red and sore. My lips are usually chapped and cracked during the winter, but this time it's gotten worse. Lip balm has not helped. Is there anything that will cure the sore corners of my mouth? - Joyce Dear Joyce: The fact that the lip lesions are on both sides of the mouth helps in making a diagnosis. From what you are describing it sounds like you are suffering from an infection termed angular cheilitis. The cold dry weather removes the moisture from your skin which can result in chapped and cracked lips. Cracks that occur in the corner of the mouth become great breeding areas for either bacteria or fungus. Visually, angular cheilitis looks the same whether it's caused by bacteria or fungi; however the difference is important when deciding the treatment. Bacteria and fungi are as different as cats and dogs. Although various strains of bacteria will live together and even help each other, bacteria and fungi don't get along. The small amounts of fungus (also called yeast) normally present in the mouth and on the skin are kept from proliferating by the presence of bacteria. If the fungus finds a moist crack in the corner of the mouth it can multiply and cause angular cheilitis. Once the fungus sets up residence, it eliminates the bacteria that were keeping it under control. Although most of the time it is the fungus Candida albicans that causes the problem, angular cheilitis can be caused by bacteria. If bacteria get an opportunity to hide in a moist crack in the lip they can also proliferate and cause the infection. In your case I would first suspect fungus as the culprit. I would begin by getting an over-the-counter anti-fungal cream and applying it to the corners of your mouth for five to seven days. If that doesn't work we can assume it was not fungus but bacteria. It will then be necessary to switch to an antibacterial cream. If the weaker over-the-counter type doesn't work, it will be necessary to ask your dentist or physician for a prescription antibacterial cream. The regular use of lip balm will help prevent your lips from cracking. Don't keep your lips moist by licking them, that usually makes the problem worse. Some studies have linked angular cheilitis with a vitamin B deficiency, so taking a vitamin B supplement or eating foods rich in vitamin B may prevent a reinfection. The column is written by John Reitz, DDS, and does not represent the opinion of the Pennsylvania State Dental Board. Dr Reitz answers questions from readers. E-mail them via his Web site at reitzdds.com or mail to John Reitz, DDS, 30 Commerce Drive, Wyomissing PA 19610 John
V. Reitz, D.D.S., F.A.G.D. Copyright
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