Angular cheilitis: cracked mouth corners, causes, treatment, dentures and children

What is angular cheilitis and how can you recognise it?

Angular cheilitis (Latin: cheilitis angularis) is inflammation where the facial skin meets the lining of the lips. The New Zealand dermatology resource DermNet describes it as a common, non-contagious condition causing painful cracks that worsen when the mouth opens, along with redness, erosions, oozing, crusting and bleeding.

It usually affects both sides symmetrically. Any child or adult can develop it. A review by Chiriac et al. (2024) describes two peaks: in childhood and adulthood, with increasing frequency as people get older.

The condition is common in denture wearers. In a Spanish study of 84 older denture wearers living in care homes or attending day centres, 34% had angular cheilitis, making it the most common denture-related lesion (Martori et al., 2014).

Angular cheilitis: causes and factors that keep it going

Several causes usually act together in angular cheilitis, and identifying them is the basis of effective treatment. According to DermNet, the most common factor is prolonged contact between the skin at the mouth corners and saliva and its enzymes, causing eczema-like irritation. Licking the lips makes the lesions worse.

Infection develops readily on irritated skin. In an Indian study of 40 people with angular cheilitis (Oza and Doshi, 2017), microorganisms were cultured in 82.5% of patients, most often Staphylococcus aureus, less often Candida yeasts and streptococci, in pure or mixed cultures. The table brings together causes described in reviews and measures that help.

Dentures and angular cheilitis: why does it keep coming back?

Denture-related angular cheilitis is often linked to reduced bite height: when dentures are too low or fit poorly, deep folds form at the mouth corners and trap saliva. Stoopler et al. (2013) write that poorly fitting dentures can cause this skin folding. In the study by Martori et al., angular cheilitis was associated with age, complete tooth loss, Candida in the mouth, unstable dentures and reduced bite height.

Denture-related angular cheilitis often coexists with oral thrush, which, according to the NHS, can itself cause cracks at the mouth corners. Stoopler et al. therefore recommend assessing denture fit, oral and denture hygiene, saliva production and oral fungal infection together.

If dentures are too low or loose, ointment alone will not remove the cause and the cracks return. Under the NFZ, Poland’s National Health Fund, a partial acrylic denture is available when at least 5 teeth are missing in one arch and a complete denture when an arch has no teeth left, as a rule once every 5 years; this time limit does not apply to people who have had tumours of the craniofacial region surgically removed. A complete indirect reline is available once every 2 years, separately for the upper and lower jaw (legal status as of 24 October 2026). A separate article explains relining in detail.

• Clean your dentures daily and remove them at night.
• Do not wear dentures that no longer fit; arrange a denture check.
• Attend regular check-ups even if you no longer have any natural teeth.

How is angular cheilitis treated? What treats it and what only soothes it?

Treatment depends on the cause: infection is treated with a topical antifungal, antibacterial or a combination, sometimes with a steroid, while the factors sustaining the lesions are addressed. This is the approach described by DermNet and Stoopler et al., who recommend a review after 2 weeks.

Evidence for individual ointments is limited. A 2020 review by Cabras et al. notes that although antifungals are most clinicians’ first choice, they are supported by only 2 randomised trials from the 1970s and 1980s. Other approaches, such as restoring bite height or supplementing B vitamins, are described mainly in case reports and small series.

A doctor or dentist chooses prescription treatment; ask a pharmacist to help you select an over-the-counter product. Many mild cases resolve on their own. DermNet reports that with treatment, improvement usually begins within the first few days and the condition most often clears within 2 weeks, although recurrence is common, especially when a risk factor cannot be removed.

• Avoid licking your lips, even when the corners sting.
• Apply a greasy ointment or lip balm to protect the skin from saliva.
• Drink enough fluids.
• Replace your toothbrush, as Stoopler et al. advise.
• Rinse your mouth with water after using an asthma inhaler.
• If you smoke, try to stop.

Angular cheilitis in children: what causes it and what should you do?

Angular cheilitis is not unusual in children: the 2024 review by Chiriac et al. describes the first peak in childhood. Dry, chapped lips, lip licking and atopic eczema contribute; DermNet lists these as risk factors.

For a child, the main measures are protecting the corners from saliva with a greasy ointment and helping them stop licking their lips. See a paediatrician if the lesions have not healed after about 2 weeks, spread onto the skin, ooze or develop thick crusts, because angular cheilitis can progress to impetigo, or if there are white patches inside the mouth.

Do not confuse angular cheilitis with cold sores. The NHS describes cold sores as beginning with tingling, itching or burning, followed by small fluid-filled blisters that burst and crust over. Cold sores are contagious from the first tingling until healing and should start to heal within 10 days.

When should you see a doctor, and when a dentist?

See a GP or dermatologist if angular cheilitis does not clear after about 2 weeks of skin protection and treatment, or keeps returning. Stoopler et al. advise looking for local and systemic causes in this situation and referring the patient to a doctor if a systemic condition is suspected.

A dentist is appropriate when the cracks occur with dentures or oral thrush, because poorly fitting dentures or reduced bite height may be responsible. A clinician may take a swab from the mouth corners for culture, as DermNet describes, and request laboratory tests to rule out deficiencies and systemic disease. Arrange an appointment if you have any of the signs listed.

• The cracks have not healed after about 2 weeks of treatment.
• Lesions return despite addressing obvious causes.
• Cracks spread onto the skin, ooze or develop thick crusts.
• White patches in the mouth or burning beneath a denture are also present.
• You have diabetes, reduced immunity or rapid weight loss.
• There is a lump on the lip or at a mouth corner (have it checked without waiting) or an ulcer that has not healed for more than 3 weeks.

Is angular cheilitis contagious, and how can it be prevented?

Angular cheilitis is not contagious: DermNet describes it as non-contagious inflammation, although yeasts and bacteria may be present in the lesions. Cold sores are different: according to the NHS, they spread easily to other people and other parts of the body.

Prevention involves addressing the factors that sustain the condition. DermNet lists reducing lip licking, good nutrition, stopping smoking, well-fitting dentures, applying greasy protection to the corners, rinsing after inhaled corticosteroids, oral and denture hygiene, and good blood sugar control in diabetes.

Angular cheilitis and dentures at DentalBlue

At DentalBlue in Białystok, a clinician assesses angular cheilitis associated with dentures or changes in the mouth during an examination; the clinic provides prosthodontics. In the clinic’s price list, “Konsultacja protetyczna” (prosthodontic consultation) costs 300 zł, “Podścielenie protezy” (denture relining) 450 zł, and “Wizyta bez bólu” (visit without pain, including a panoramic X-ray, consultation, examination and written treatment plan) 300 zł. The final scope and cost are agreed at the consultation, and prices may change. If the cause is systemic, a GP or dermatologist carries out further investigations. The clinic is open Monday to Friday from 8:00 to 20:00 and Saturdays from 8:00 to 16:00.