Cheilosis

Posted by Caroline on July 21, 1999 at 14:11:27
I was told that "cheilosis" is the condition causing the corners of my mouth to split open.  Is miconazole the correct cream to use to treat it, and is it normal for miconazole to cuase the skin to be extremely dry? It seems to cause the skin to split even more.

Posted by DERM M.D. on July 22, 1999 at 11:30:30
Caroline:
Splitting at the corners of the mouth is called "angular stomatitis."  It's also called "perleche," from the French for "milk," because babies get it too.  Although people often refer to these cracks as "cold sores," they have nothing to do with herpes.
Textbooks say this problem is caused by yeast organisms from the mouth which set up shop wherever there's moisture.  In my own experience, anti-yeast creams, like miconazole, often don't do the trick.  Rather than making you dry, the cream is probably just not making you better.
Suggestion: get some over-the-counter hydrocortisone 1% and apply that right over the miconazole.  Apply each twice or three times a day.
If that doesn't doesn't help in a week or two, I suggest, like they say in the ads, "If symptoms persist, see your doctor."
Yeasty or not, the condition is not contagious, by the way.
Good luck.
Dr. R
P.S. "Cheilitis" means inflammation of the lip, not just the corners.
Keywords: candida, perleche, cheilitis, lip, Rockoff
Keywords: candida, perleche, stomatitis, cold sores, herpes

Posted by Pam on July 22, 1999 at 15:44:48
I'm sitting here with a crack on the corner of my mouth that just won't heal.  It has gotten a little better, but not great.  Now I'm afraid it's going to scar.  I will head to the drugstore right after work, and if it's not better by Monday, I'll see my doc.
Thanks for inadvertently enlightening me!  That's one of the perks of sights like these--the occasional, "Hey, I didn't know that!"
-)

Posted by DERM M.D. ASR on July 22, 1999 at 15:53:19
Pam:
By all means, have your doc check it out, but don't worry --  it won't scar.
Thanks.
Dr.R
Posted by Caroline on July 26, 1999 at 16:27:42
I tried the suggestion about 1% cortizone on top of the miconazole...and IT WORKED!!  THANK YOU!!!

Posted by DERM M.D. ASR on July 26, 1999 at 18:00:51
You're welcome.  Thanks for telling me about it.
Best.
Dr. R