Treating mouth sores

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Treating Mouth Sores

Don’t suffer with painful mouth sores. Dr Cindy Pan explains how to tackle this annoying ailment.

Treating Mouth Sores

(Q) For a couple of months now the corners of my mouth (on my lips) have been sore. I’ve been putting everything on it from Paw Paw cream to Carmex. The latter helps but when I stop using it the problem comes back. What causes this and can it be fixed permanently?

Treating Mouth Sores

(A) What you are describing sounds like a condition called angular stomatitis (also known as ‘angular cheilitis’) where irritation and fissuring in the skin occurs at the corners of the lips. It can be a very annoying condition since every time you eat, smile, talk or laugh, the skin tends to crack, interrupting healing. If small fragments of food get into the wound or fissure, it can further impair healing and increase the risk of secondary infection.

Treating Mouth Sores

Angular stomatitis is very common in children, especially if they have the habit of licking their lips frequently. In adults and children it can be an indication of a nutritional deficiency such as iron deficiency anaemia. We need sufficient iron for cell replication and repair. If there is a lack of iron due to excessive blood loss or insufficient dietary intake, this can result in ineffective repair and regeneration of epithelial cells, in particular those around the mouth and lips, resulting in angular stomatitis. Angular stomatitis can also be caused by a B group vitamin deficiency. It could be a deficiency of B2 (riboflavin), B3 (niacin), B6 (pyridoxine), B9 (folic acid) or B12 (cyanocobalamin). In fact, any condition or situation in which there is poor diet, malnutrition or malabsorption (for example coeliac disease) can potentially result in angular stomatitis.

Treating Mouth Sores

Another possible cause is a fungal skin infection such as Candida albicans or a bacterium such as Staphylococcus aureus. Sometimes the skin may have broken down due to another cause such as eczema, contact dermatitis or allergy, or even a cold sore (herpes simplex) and a secondary bacterial infection may subsequently ensue, prolonging and exacerbating the original condition.

Treating Mouth Sores

People who wear dentures, especially ill-fitting ones, tend to be prone to this condition too, since saliva tends to collect in skin furrows and this moist environment tends to welcome infection. It tends to be worse in winter too, when the skin has a tendency to become dry, chapped and cracked and can peel easily, especially if idle fingers cannot resist playing with the dry cracked skin!

In terms of what to do about it, it is a good idea to talk to your GP who can examine your mouth and skin carefully, and make an assessment of your overall health. Your GP can then help you determine the likely underlying cause of your problem and advise you on how to manage it. You may need to avoid irritating foods (such as spicy foods) or sharp foods (like tacos and chips) and take care with oral hygiene, especially after eating.

Your doctor can help you identify if you have any dietary or nutritional deficiencies that need correcting or if there may be an infection present that requires treatment with an antifungal (if Candida albicans is present), an antiviral (if Herpes simplex is present) or an antibiotic (if there is a bacterial skin infection such as Staphylococcus aureus).
Sometimes a steroid based preparation may be recommended, if an allergic or eczema-type skin condition is identified. If you have tried a number of over the counter or home remedies without success I would strongly suggest seeing your GP as soon as possible.

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