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angular cheilitis
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angular cheilitis

I'm a 28 year old male with no major health problems and on no meds. For the last 4 months I have felt an irritation in one corner of my lips. (The other corner feels 100% normal.) Angular cheilitis, it seems. I've done as much research as I can (including reading all archived messages here) and been to the derm a few times now. My problem isn't huge, it's just annoyingly persistent and it worries me that it won't completely go away, which the docs keep saying it will. The lip corner has some slight redness and inflammation, but there has never been any blistering or skin breakage, nor does the irritation extend down or away from the lip. So, although it's not really a cosmetic thing, the problem is the constant and annoying feeling of irritation. It's usually like a rawness, though sometimes it's more like a tingling or burning. (No itching at all, though.)  The intensity, though usually mild, fluctuates quite a bit, sometimes based on environmental factors, but sometimes not.

I will speak to the doctor again next week but am looking for as much opinion as possible. We did topical Nizoral treatment for 4 weeks, followed by a break of a month or so to see if it would fade away, then eventually topical Bactroban for 2 weeks, again followed by a break. I've also been taking multivitamins just to be safe, and applying plenty of lip balm for protection from the cold environment I'm in. All of this has helped reduce the problem but not eliminate it completely, at least not to any kind of ignorable level. The Bactroban seems to have made the biggest difference.

In your opinion, what would you recommend as a next step? Should I do another round of topical antifungal? What about oral antibiotics or antifungals?

What are typical causes of this? I'm living in a new city with very cold weather. (This is what the docs are pointing to.) I'm not a lip licker. It's possible I sometimes drool in my sleep if my head is to the side, but not super heavily as far as I know. I was on a full course of Accutane ending in March 2001, but my lips have seemed generally ok since then. Finally, I know you get a lot of herpes-phobia, but is there any chance that it's herpes related?  I've read a few web sites that said angular cheilitis can sometimes be related to hsv, but I'm not sure if they simply refer to cold sores that cause a secondary infection, or something else maybe, or are just wrong. I have no history of cold sores, but a few days before this started I did kiss a girl who does. I'm probably just being paranoid, but I can't help but wonder about the timing. (p.s. - I'm definitely HIV-.)
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242489_tn?1210500813
Rashes at the corners of the mouth are rarely herpes, and yours certainly doesn't sound like herpes at all.

Inflammation at the corners of the mouth is very tough to get rid of.  The books say that anti-yeast creams (like Nizoral) do the job, but my experience says otherwise.  Your doctor may want to try a cortisone cream, or one of the noncortisone anti-inflammatory creams like Protopic or Elidel.  

You have to be empirical--trial and error--with this pesky condition, which is indeed aggravated by drooling and  saliva.  Nevertheless, aggravation yes, paranoia no.

Take care.

Dr. Rockoff
3 Comments
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Avatar_n_tn
hello,i am 16years old
i have had what i beleive is angular cheilitis  apear out of nowhere.It came last year then left.Wen i do not pay any attnetion to it it seems it just stays small but if i try to aply a cream or something to cure it seems as if it just gets bigger and more red and dried up,its as if it makes it worse.
since this is what happed last time i was wondering how i should go about getting rid of it now.Its still small and barely showing. My dentist said it would go away within time but i want to get rid of it for good.
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Avatar_n_tn
hello,i am 16years old
i have had what i beleive is angular cheilitis  apear out of nowhere.It came last year then left.Wen i do not pay any attnetion to it it seems it just stays small but if i try to aply a cream or something to cure it seems as if it just gets bigger and more red and dried up,its as if it makes it worse.
since this is what happed last time i was wondering how i should go about getting rid of it now.Its still small and barely showing. My dentist said it would go away within time but i want to get rid of it for good.
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