Cracks in the corners of the lips

Whenever cracks appear in the corners of the lips, we remember immunity. Indeed, such a problem is closely related to the state of our immune system, and it appears more often in the spring, when the defenses weaken and the body's vitamin reserves are depleted. By themselves, cracks, or seizures, are not a disease, although they cause considerable discomfort. It's just a signal from the body that something is wrong with it.

Epidemiology

Most often, cracks in the corners of the lips are due to the activation of a streptococcal or fungal infection. Patients with a weakened immune system and chronic pathologies, pregnant women and children (including adolescence) are at increased risk.

Both men and women are equally often ill, and especially those who cannot part with bad habits, such as smoking and drinking alcohol.

Causes of the cracks in the corners of the lips

There are a lot of factors that provoke the appearance of cracks in the corners of the oral cavity, but the true reason is most often the same - these are bacteria and other pathogenic microorganisms that enter the mucous membrane of the lips in different ways, after which they are activated. Most people are a little mistaken when they believe that cracks arise from excessive dryness of the skin or from beriberi: indeed, these factors take place, but without the presence of the microbial flora, the problem would not have happened.

Even the cracks that form on the background of acute respiratory viral infections or acute respiratory infections are not the result of a high body temperature, but a consequence of an infectious invasion. Moreover, most often, according to statistics, seizures are caused by streptococci and fungal flora, namely, epidermal streptococcus and yeast-like fungi belonging to the genus Candida. The infection provokes the development of an inflammatory process that occurs with damage to the surface skin tissues and mucous membranes.

Risk factors

A number of factors are known that can provoke the formation of cracks in the corners of the lips. Most often we are talking about these of them:

• the use of other people's unwashed glasses, cups, appliances;
• frequent biting and licking of the lips, especially in the cold season;
• non-observance of hygienic rules for the care of the oral cavity;
• general cooling of the body, or overheating;
• the use of low-quality food, unwashed greens, vegetables, berries, fruits;
• constant touching with dirty hands to the skin in the mouth area.

Contribute to the development of the infectious process factors such as:

• weak immunity;
• anemia of various etiologies;
• diabetes;
• insufficiency of liver function;
• lack of vitamins and minerals in the body;
• frequent or prolonged infectious processes;
• frequent or long periods of treatment with hormonal or cytostatic drugs, immunosuppressants.

Pathogenesis

There are such pathogenetic types of cracks in the corners of the lips:

• bacterial cracks that are provoked by streptococcal infection;
• fungal cracks that occur when the fungi of the genus Candida are activated.

It must be understood that these microorganisms - the causative agents of the disease - can normally be present on the skin of a healthy person. Their enhanced reproduction begins only with a combination of favorable circumstances for this:

• a sharp weakening of the immune system (malnutrition, illness, surgery, etc.);
• drop in the level of hemoglobin in the bloodstream;
• diseases of the oral cavity, teeth, upper respiratory tract;
• elevated blood sugar levels;
• intestinal dysbiosis.

Any malfunction in the body is stress in one form or another, which can give impetus to the development of infection. As a result, microorganisms that accumulate in the corners of the mouth activate their growth and development, an inflammatory reaction is triggered, which is accompanied by all the relevant signs: redness, pain, etc.

Symptoms of the cracks in the corners of the lips

The clinical symptoms of cracks in the corners of the lips may vary slightly, depending on the etiology of the disease. For example, the first signs can be described as follows:

• With bacterial cracks, there is initially slight redness and discomfort in the form of itching. After a while, small bubbles form in the corners of the lips, or one bubble with liquid contents: it is because of this symptom that many people confuse seizures with herpes. But after some time, the bubbles open, and a bloody crust forms, which can be both dry and wet, sometimes opening or bleeding. At this stage, pain joins, it becomes painful to open your mouth and, accordingly, speak and eat.
• With fungal cracks, an inflammatory process occurs, which in appearance resembles erosion. The outer crust does not form, and the cracks and redness in the corners of the lips themselves are distinguished by a reddish tint, often covered with a loose coating. If the mouth is closed, then the problem may remain invisible. But with an open mouth, seizures and cracks in the corners of the lips are exposed, pain of a cutting nature may occur.

In addition to the above options, there are also mixed cracks that carry signs of both microbial and fungal presence.

Cracks in the corners of the lips in a child

The most common factor leading to the appearance of cracks in the corners of the lips in children is the lack of B-group vitamins, which ensure the normal condition of the skin and mucous membranes. A deficiency of zinc and iron in the body can also be “to blame”. However, most often bacteria and fungi are activated against the background of a decrease in immune defense - for example, with tonsillitis, caries, frequent colds and SARS, with anemia, helminthic invasions.

In many children, the cause of excessive accumulation of bacteria in the corners of the lips is malocclusion, non-compliance with the rules of oral hygiene, and in small children, prolonged retention of nipples and pacifiers in the mouth. Allergic processes, other diseases and deviations contribute their additional contribution.

Cracks in the corners of the lips in childhood are not often disturbed, however, if such a pathology occurs, it acquires a predominantly long-term character. The peak of childhood morbidity occurs in the spring, when the lack of vitamins especially makes itself felt against the background of a general decrease in immunity.

Cracks in the corners of the lips during pregnancy

During pregnancy, many chronic diseases become aggravated, and this is mainly due to a sharply increasing load on the female body and a drop in immunity. The disease in pregnant women can proceed atypically, starting with the usual dryness of the lips, ending with the formation of erosions mainly in the lower lip.

It is not uncommon during pregnancy and cracks in the corners of the lips of an allergic origin. Such seizures are characterized by itchy and burning sensations, swelling and redness in the corresponding area of the face. Additional contact with the allergen leads to the formation of small bubbles that develop into erosive elements.

Atypical symptoms of cracks can occur briefly and spontaneously, and also disappear abruptly. Remissions occur frequently, but the lips mostly peel off in this period. Characterized by dryness of the lips and skin on the face.

Complications and consequences

Complications against the background of the appearance of cracks in the corners of the lips are extremely rare: usually the problem is cured at an early stage of development. In advanced cases, it is possible to spread the infection, increase the area of the inflammatory process with the involvement of healthy tissues (skin and mucous membranes).

Among the especially unpleasant consequences, one can single out the formation of additional deep cracks, ulcerative and erosive elements, merging into one large focus. The running process is characterized by severe discomfort, and with close contact there is a risk of transmitting the infection to other people.

If cracks in the corners of the lips do not heal for a long time, then it makes no sense to wait for the problem to disappear by itself: it is better to consult a doctor who will prescribe treatment in accordance with the detected pathogen. If the disease is left to chance, then self-healing against the background of weakened immunity is considered almost impossible. Treatment should be comprehensive, aimed at local effects on the inflammatory focus, as well as strengthening the immune defense.

Diagnostics of the cracks in the corners of the lips

In the vast majority of cases, the diagnosis of cracks is made based on a clinical examination and patient complaints. The symptomatology of the disease is typical, and in case of doubt, the data of the histological analysis of damaged tissues are considered.

In general, diagnostic stages can be distributed as follows:

• collection of complaints, examination of the patient;
• carrying out histological analyzes, skin tests with allergens;
• general laboratory tests to assess the state of the body (allow to exclude anemia, inflammatory diseases);
• instrumental diagnostic methods.

Laboratory and instrumental diagnostics are most often used in the differentiation of lip diseases. For example, a doctor may prescribe a peripheral blood test, cytological, bacteriological and virological examination of smears, ultrasound examination of the abdominal cavity or thyroid gland, etc.

Differential diagnosis

Differential diagnosis should be carried out with different types of cheilitis (exfoliative, glandular, meteorological, anular, candidal, eczematous type), with lupus erythematosus of the lips, macrocheilitis.

Treatment of the cracks in the corners of the lips

When treating cracks in the corners of the lips, it is better to provide an integrated approach, taking into account the individual characteristics of the treatment. It is also important to comply with general measures, which include:

• compliance with the rules of oral hygiene;
• regular sanitation of the oral cavity and teeth;
• dental treatment, timely removal of problematic teeth, getting rid of plaque;
• giving up bad habits (meaning not only smoking and alcohol abuse, but also biting lips, constantly licking them);
• providing mechanical protection of the lips (correction of the dentition, timely replacement of dental implants, etc.);
• fulfillment of all medical prescriptions.

Doctor's prescriptions may include recommendations for general and local therapy. External treatment involves the following activities:

• treatment with antiseptic solutions (hydrogen peroxide, Chlorhexidine, potassium permanganate solution);
• applying lotions with proteolytic enzymes (Trypsin, Chymotrypsin) to soften the crusts;
• lubrication with corticosteroid ointments (Lorinden A, Celestoderm, Lokoid) to inhibit the development of an inflammatory reaction, to eliminate swelling and other unpleasant symptoms.

Additionally, antihistamines can be used - for example, Suprastin, Loratadin, Cetirizine. In addition, a fortified diet, multivitamin and sedatives are recommended.

What to do with cracks in the corners of the lips?

When cracks appear in the corners of the lips, first of all, it is necessary to exclude the influence of factors that can exacerbate the course of the inflammatory process. Such factors are usually allergens, microbial effects, overheating and hypothermia, dehydration, etc.

It is not difficult to cure a disease after contacting a doctor, the main thing is to choose the right treatment and eliminate the root cause of the problem (for example, to neutralize bacteria or a fungal pathogen).

Both local and systemic therapeutic effects, or a combination of both, are suitable. It is equally important to carefully observe all the rules of hygiene of the oral cavity, face and hands.

Where is the therapy usually directed? Moisturizing and softening the skin, accelerating wound healing, preventing re-infection. For this, antimicrobial and antifungal systemic and external preparations are successfully used.

Medications that a doctor may prescribe

Chlorhexidine	Antimicrobial and antiseptic solution, which is used to treat cracks and wounds three times a day. The product is low-toxic and safe, but its internal use should be avoided. In high concentrations, the agent can cause burns to the mucous tissue.
Aevit	Combined vitamin preparation that can be used both internally and externally. Inside take one capsule of the drug per day. Additionally, the affected areas in the corners of the lips are lubricated with the contents of the capsule. Such treatment has no contraindications, helps to speed up recovery.
Loratadine	An antihistamine that has antiallergic and antipruritic properties. Prevents the development of edema, facilitates the course of the inflammatory process. Loratadine is taken orally 10 mg once a day. Among the most common side effects are headache, drowsiness, irritability.
Fukortsin	Antiseptic and disinfectant with broad antimicrobial and antifungal activity. The drug lubricates the wounds 1-3 times a day, until clinical recovery. Side effects on the background of the use of the drug: temporary staining of the skin in a reddish color, desquamation of the epithelium.
Echinacea extract	An immunostimulating agent that increases the phagocytic activity of macrophages and neutrophils. Usually take 20-40 drops of the extract three times a day, no more than 2 months in a row. Topical application of the drug is also possible. Possible side effects are allergies.

Ointments for cracks in the corners of the lips

Ointments are usually applied to damaged tissues 1-2 times a day: drugs with antimicrobial, antifungal and wound healing effects are used.

Levomekol ointment, which contains an antibiotic, is perfect as an antiseptic. Such ointments as Actovegin, Solcoseryl, which stimulate healing processes, have proven themselves well. In addition to them, it should be noted the healing effect of ointments Bepanten, Methyluracil, Dexpanthenol.

With a fungal infection, the use of ointments Clotrimazole, Exoderil, etc. Is relevant.

Other ointments your doctor may prescribe:

• Celestoderm-B with Garamycin is a combination of a corticosteroid and an antibacterial component, used in the complex course of the inflammatory process, with the addition of a purulent infection. With fungal infections, this remedy is not prescribed. The ointment is applied to the area of damage in the morning and evening - that is, twice a day. The duration of therapy is 1-2 weeks.
• Lorinden C is a combined ointment with antipruritic, anti-inflammatory, anti-allergic, anti-edema effect. Apply no more than twice a day, for no more than two weeks.

Balm for cracks in the corners of the lips

If the formation of a crack is just beginning, you can use the well-known Rescuer balm. This drug is used externally, accelerating the healing reaction of wounds and injuries. The peculiarity of the product is that it has a natural composition, without antibiotics and hormonal components. The balm is represented by such ingredients as ghee, sea buckthorn and olive oils, calendula extract, beeswax, turpentine, Naftalan oil, vitamin solutions and essential oils.

The balm is applied directly to the cracks, several times a day (usually three times). Allergic processes can become contraindications for use.

Side effects are rare and are expressed in the development of an allergy to the drug.

Vitamins

Vitamin and mineral substances are essential components for the prevention and treatment of almost any dermatological disease. A lack of certain essential nutrients can easily cause flaking, cracked lips, and even breakouts. Avitaminosis or hypovitaminosis can become a decisive factor in the development of infectious dermatological processes, cause the transition of the pathology from the acute stage to the chronic one.

Vitamin A takes part in the differentiation of epithelial cells in the superficial skin layer. It turns out that cell structures change chemically and functionally. With a lack of retinol, dryness appears, peeling increases, the stratum corneum thickens, and purulent processes may develop.

Lack of vitamins B ₂  and B ₆  causes damage to the skin epithelium and oral cavity. As a result, not only cracks in the corners of the mouth can occur, but also dermatitis of the nasolabial triangle, ears, face, etc. B-group vitamins are always prescribed to accelerate the healing of wounds and ulcers, chronic dermatosis.

Ascorbic acid is a well-known immunomodulator that activates reserve defenses in the body, accelerating tissue repair. With a lack of ascorbic acid, wounds heal longer and worse. When painful cracks appear in the corners of the mouth, complex multivitamin preparations containing all the vitamin substances described above are usually prescribed. The frequency of taking such medications, as well as their dosage, is determined individually.

Physiotherapy treatment

Physiotherapy effectively complements the basic treatment, helps to quickly eliminate painful symptoms and speed up healing.

The main procedures that a doctor can prescribe when cracks appear in the corners of the lips are:

• Laser treatment - has anti-inflammatory, anti-edematous, desensitizing effect.
• Electrophoresis of drugs - involves the use of corticosteroid or antihistamines.
• Phonophoresis with ointment preparations of corticosteroids.
• Ultra-high-frequency treatment - has anti-inflammatory properties, activates the processes of microcirculation and regeneration.
• Microwave therapy improves blood supply and tissue nutrition, inhibits the development of an inflammatory reaction, eliminates edema, and has an anti-allergic effect.

By the way, physiotherapy procedures when cracks appear are not prescribed so often, but only with neglected and sluggish processes. The decision on their appointment is made by the doctor.

Alternative Treatment

Alternative remedies are always available and often have no less effect than pharmacy drugs. For example, the most common remedy for cracks in the corners of the lips is ordinary earwax - exactly the one that is usually carefully cleaned out of the ears with cotton swabs. This natural "ointment" lubricates the places of seizures. They say that the problem has been going on for 1-2 days.

Well helps from cracks in the corners of the lips thermal water. It can be used on its own, or lubricated with a special cream or hygiene product prepared on the basis of such water.

A great way to get rid of cracks is to lubricate the affected areas with oil solutions of vitamins: you can use capsules of vitamins A or E, or the combination drug Aevit. Melted beeswax, sea buckthorn or rosehip oil, honey, goose fat are also used instead.

Herbal treatment

Wiping the areas with cracks in the corners of the lips with infusions of plants, such as chamomile, celandine, calendula, sage, succession, helps well.

The next excellent remedy is the treatment of jams with freshly squeezed juice obtained from aloe or Kalanchoe leaves, from a fresh celandine plant, plantain stalks. You can lubricate the damaged skin with a cut clove of garlic or a slice of an onion.

Infusions for the treatment of wounds are prepared in the following ways:

• one teaspoon of dry chamomile color is poured into 200 ml of boiling water, insisted under the lid for 40-45 minutes, filtered and used for its intended purpose;
• one tablespoon of calendula is poured with a glass of boiling water, kept under the lid for at least half an hour, after which it is filtered and used for rubbing;
• one tablespoon of sage is poured into a glass of boiling water, infused for an hour, after which it is filtered and used for rubbing and lotions.

Homeopathy

A suitable homeopathic treatment is prescribed by selecting the optimal constitutional remedy. It is recommended to use the following agents in individually selected dosages.

• Natrum muriaticum - even eliminates deep cracks in the corners of the lips, in the middle of the lips, as well as all sorts of hangnails.
• Petroleum - helps with bleeding wounds near the mouth, which are accompanied by burning and itching.
• Calcarea carbonica is prescribed for both superficial and deep cracks that occur mainly in winter.
• Graphite - used when wounds appear on the lips and in the interdigital spaces.
• Gepar sulfuris calcareum - eliminates cracks covered with crusts.
• Acidum nitricum - helps with deep bleeding wounds, characterized by a long course.
• Antimonium krudum - used for damaged skin in the corners of the mouth and in the nasolabial triangle.

Surgery

The help of a surgeon is required only in a few especially neglected cases of cracks in the corners of the lips, with pronounced symptoms of dysplasia. The following surgical methods are allowed:

• laser treatment;
• photodynamic treatment;
• cryosurgery;
• wedge-shaped excision of affected tissues;
• plastic surgery for the correction and restoration of the lips.

However, we repeat, the operation for cracks is rather an exception to the rule, since most often there is no need for such treatment.

Prevention

Even after successful treatment of cracks in the corners of the lips, it makes sense to take care of the prevention of a recurrence of the disease in the future. Here is what such prevention is:

• carrying out hardening procedures;
• systematic and high-quality hygienic care of the oral cavity;
• use only proven and high-quality cosmetics;
• improving the quality of nutrition with an emphasis on plant foods, refusing to eat sweets;
• getting rid of bad habits, such as smoking, alcohol abuse;
• prevention of excessive dryness of the skin and mucous membranes, the use of a sufficient amount of liquid, the use of moisturizing hygiene products.

You need to pay attention to the cleanliness of your own body, wash your hands regularly (or at least use wet wipes), try not to lick your lips and not bite your nails.

Forecast

Cracks in the corners of the lips can disturb at any age - both in childhood and in adulthood. In most patients, the problem goes away without serious consequences, within 3-5 days: at first, discomfort increases, redness and visible cracks appear, the problem reaches a peak, after which the symptoms begin to gradually subside. However, one should not expect the trouble to go away on its own: sometimes this does not happen, especially if no measures are taken and the disease begins to progress. It is believed that the complete disregard for treatment contributes to the spread of the inflammatory reaction and the formation of ulcers. In general, the prognosis can be voiced as favorable, but treatment is still necessary.