Perleche refers to inflammation at the corners of the lips. What is it due to? Is that bad ? Contagious ? How to cure it quickly? With what ointment? Photos and tips.
Perlèche designates inflammation at the corners of the lips (corners of the mouth) and may extend to the inside of the cheeks. How to recognize it? What is it due to? Is that bad ? Contagious ? How to cure it quickly? With what ointment?
Definition: what is a angular cheilitis?
In dermatology,a perlèche corresponds to angular cheilitis. Cheilitis is inflammation of the lips. Angular cheilitis is localized inflammation at the corner of the lips, immediately informs Pr Mahtab Samimi, dermatologist at the University Hospital of Tours, responsible for the specialized oral dermatologist consultation. The diagnosis of angular cheilitis is easily made by the doctor, and can correspond to multiple causes.”
What are the symptoms of angular cheilitis?
Perleches appear most often on both corners of the lips. The commissures become red, or more rarely whitish. “This redness, most often painful, can evolve into a crack that can ooze and become crusty, but this is not systematic“, indicates the dermatologist. The inflammation can remain localized at the corner of the lip or extend to the skin side of the cheek or inside the mouth.
Is angular cheilitis contagious?
No, angular cheilitis is not contagious.
Who are the people most at risk of having angular cheilitis?
Perlèches are quite common, particularly in three populations:
- children who suck their thumbs or lick their lips,
- young adults who are chronic carriers of Staphylococcus aureus : note that one third of young adults have intranasal carriage of Staphylococcus aureus,
- toothless old people or who have a dental prosthesis.
What are the possible causes of angular cheilitis?
► “Any irritant cause (very dry or too wet lips) can give angular cheilitis“, informs Professor Mahtab Samimi.
► The children who have a licking tic may have angular cheilitis due to too much moisture in the lips. This ground of humidity will then promote the occurrence of infectious causes.
► In the same way, old peoplewhose labial commissures sag, who are edentulous or have braces, which creates maceration of the lip fold, are also at risk.
► Staphylococcus. In children and young adults, it is a bacterial angular cheilitis, most often caused by staphylococcus aureus.
► Candidal angular cheilitis. In the elderly, it is more a question of mycotic angular cheilitis Candida albicans.
► A particular, somewhat bulging and painless angular cheilitis can be a sign of syphilis (this STI has been on the rise since the 2000s).
► Allergic contact eczema can lead to lip eczema, perioral and angular angular cheilitis.
► Chronic angular cheilitis can reveal iron or vitamin deficiency.
Is angular cheilitis a sign of HIV?
“A chronic or recurrent angular cheilitis, of infectious cause, in particular mycotic, raises the suspicion an immune deficiencyfor example HIV infection or diabetes. In addition, taking immunosuppressive drugs can also promote angular cheilitis, by this same mechanism.“, informs the dermatologist.
Is angular cheilitis a sign of cancer?
VSis rare but cancer can be a contributing factor to angular cheilitis. This does not mean that angular cheilitis is necessarily a sign of cancer.
Psychological cause: can stress cause angular cheilitis?
“Stress is not a cause of angular cheilitis, unlike other oral dermatological conditions for which stress has a well-known impact, for example the appearance of canker sores in adolescents before their school exams“says Dr. Mahtab Samimi.
What is the treatment for angular cheilitis?
Treatment for angular cheilitis depends on the cause:
► If angular cheilitis is linked to an irritant factor, this should be corrected:
- moisturize the lips if they are very dry with a moisturizing balm: “it is better to use a lip balm rather than a stick which is unhygienic and which, moreover, may contain perfumes, preservatives or even dyes“, recommends the dermatologist. Her advice: use a dermatological lip balm purchased in a drugstore.
- avoid lip moisture by stopping licking them,
- re-adapting a dental prosthesis…
► If the cause of angular cheilitis is infectious, the bacterium or fungus must be treated: apply “antibiotic ointment for one week or antifungal ointment for two to three weeks“, recommends our interlocutor
► If angular cheilitis is caused by a fungus: the inside of the mouth, or even the dental appliance, must also be treated with a mouthwash or an antifungal gel
In any case: it is not recommended to moisten the corners of the lips with the tongue to combat the dryness of wounds: this only delays healing and potentially leads to superinfection.
What are the best ointments for treating angular cheilitis?
If angular cheilitis is caused by bacteria, antibiotic or antifungal ointment should be used.econazole for example : MYCOSEDERMYL 1% / Terbinafine EG 1% / FENTICONAZOLE BAILLEUL 2%… It is recommended to seek advice from your doctor or pharmacist.
What to do in case of angular cheilitis during pregnancy?
“The causes of angular cheilitis are the same in a pregnant woman as in the general population. When a pregnant woman has angular cheilitis, it can be treated with a moisturizing balm worry-free. If this persists, she should consult your doctor. Any medication during pregnancy must be prescribed by a doctor.“, would like to remind the dermatologist.
- Avoid licking the edges of the mouth: humidification creates a favorable environment for the intrusion of bacteria and fungi. “In children who tend to lick their lips and in the elderly, the lip folds should be kept dry“, advises Professor Mahtab Samimi.
- Moisturize your lips regularly with a lip balm.
- Do not touch your lips as a preventionto avoid infectious contamination.
- Have good oral hygiene and regular dental care.
When to consult a doctor ?
“If angular cheilitis persists despite moisturizing treatment with lip balm, see a doctor as there may be a bacterial or fungal infection that needs to be treated“, concludes our expert.
Thank you to Pr Mahtab Samimi, dermatologist at the University Hospital of Tours, responsible for the specialized oral dermatologist consultation.