I get raw spots in the corners of my lips, and this time, they won’t go away. Usually Blistex works, but they are very stubborn this time. I wonder what causes them? They are not cold sores, or sores on my lips — they are like cracked corners on my mouth, and very sore.
Redness with cracking, swelling and pain at the corners of the mouth has several medical names: perleche; angular cheilosis (cheilosis refers to the lips); or angular stomatitis (stomatitis refers to an opening in the body, in this case the mouth). This common condition occurs in people who maintain a lot of moisture in the corners or their mouths, either from frequent licking, or occasionally from ill-fitting dentures. Some cases are also associated with deficiency of the vitamin riboflavin, but vitamin deficiency is so rare in this country except in alcoholics or people eating fad diets that I would tend to dismiss vitamin deficiency as a cause for the condition you described.
Perleche is usually caused by a fungus of the candida family, the same fungus that causes thrush in infants, monilia or vaginal yeast infection in women, or itchy, painful infections in areas that rub together and are moist from sweat such as under large stomach folds, or under heavy breasts. Candida loves moist areas, and since it is a ubiquitous organism, meaning that it is all around us in the environment, it is always available to infect such an area. Candidal infections are more common in diabetics, where the higher sugar content in skin encourages its growth, and in people with reduced immunity. However, in my experience monilia in women and perleche in anyone can occur without any of these predisposing conditions. I have had perleche myself, and I am neither diabetic nor immune deficient.
Treatment with an over-the-counter antifungal cream such as clotrimazole (Lotrimin) or terbenafine (Lamisil AT) is usually rapidly effective. Since these creams are not designed for use in the mouth, try to apply them just to the inflamed corners, and don’t lick the cream off before it has a chance to sink into the inflamed skin. The inflammation should be gone in a couple of days.