Torn corners of the mouth - causes, treatment and home remedies

angular cheilitis

Torn corners of the mouth and corresponding inflammations in the corner of the mouth are a relatively widespread, extremely annoying symptoms. While inflammatory changes usually do not pose a particular health threat, they may be a manifestation of more serious illnesses. A medical check-up is therefore recommended especially for badly healing cornerstone inflammations.

contents

• angular cheilitis
• definition
• symptoms
• Causes of the torn corners of the mouth
• Infections with herpes simplex
• Tears in the corner of the mouth due to iron deficiency
• Cause vitamin deficiency / hypovitaminosis
• Eczema and other skin diseases
• Mundwinkelrhagaden by anatomical features
• Cause diabetes mellitus
• cirrhosis
• Autoimmune diseases
• Other possible causes
• diagnosis
• Treatment of angular cheilitis
• Naturopathy and home remedy at torn corners of the mouth

definition

The colloquial term "lacerated corner of the mouth" includes not only the fissures (tears), but also the resulting inflammation in the corner of the mouth. The medical term for the symptoms is Mundwinkelrhagaden. Further used names are Perlèche or also Faulecken.

Torn corners of the mouth are usually very uncomfortable and heal only slowly. (Image: Victoria М / fotolia.com)

symptoms

Torn corners of the mouth are characterized by painful inflammation, which occurs in connection with fissures, superficial tissue defects (erosions) and deeper tissue damage (ulceration) in the corner of the mouth. The corners of the mouth appear red, cracked, flaky and often show a crust formation.

The pain is particularly noticeable when touched or when moving. Often the inflammations only heal very slowly and return again after a temporarily symptom-free period. Depending on the triggers, further complaints can be observed, which can vary significantly and are then briefly presented in connection with the causes of the angular cheilitis.

Causes of the torn corners of the mouth

Numerous factors can play a role in the development of angular cheilitis, ranging from anatomical features, infections and skin diseases to metabolic diseases, deficiency diseases and disorders of the internal organs.

Infections with herpes simplex

The tears often occur in connection with herpes in the mouth or on the lips. This is caused by an infection with herpes simplex virus or a reactivation of the herpes simplex virus. The - after an often asymptomatic primary infection - in the organism lingering viruses are reactivated by certain circumstances (for example, massive disgust or stress) and multiply especially in the transition region between skin and red lip.

On the lips or in the corners of the mouth form the typical herpes blisters and encrustations. The damage tears the corners of the mouth slightly and in the worst case further infections can follow as bacteria such as staphylococci spread in the wounds.

Tears in the corner of the mouth due to iron deficiency

A relatively common cause of angular cheilitis is iron deficiency. If the body is not supplied with enough iron through the diet, this can cause numerous other complaints. These include hair loss, brittle nails, chronic fatigue, dizziness and headache.

Occasionally, due to the undersupply, a so-called Plummer-Vinson syndrome develops, which brings with it further impairments such as mucosal defects, tongue or mouth burning and swallowing problems. Plummer-Vinson syndrome is considered a risk factor for the development of esophageal cancer, so the underlying iron deficiency should be urgently addressed.

Reason for the Mundwinkelhhagaden can be an iron deficiency. To make up for this, more ferrous foods such as legumes and green leafy vegetables should be eaten. (Image: ratmaner / fotolia.com)

Cause vitamin deficiency / hypovitaminosis

The lack of certain vitamins (for example, riboflavin or vitamin B2) is also associated with the formation of cracks in the corners of the mouth. The so-called ariboflavinosis (lack of riboflavin) is also to be mentioned as a possible cause of disorders of the metabolism and anemia (anemia). The accompanying symptoms can correspondingly be far-reaching. Characteristic of the Ariboflavinose is in addition to the Mundwinkelhhaden an itchy rash in the form of dermatitis and a tongue inflammation (Glossitis).

Sometimes, visual disturbances due to lens opacification and neurovegetative impairments are added. However, ariboflavinosis in normal diet is generally extremely rare. However, this does not apply to women in pregnancy. Vitamin B2 deficiency can be detected more often here. Even in alcoholics is increasingly observed an ariboflavinosis.

In addition to the lack of riboflavin, an excess or an excessive intake of vitamin A (retinol) may also be the cause. Such hypervitaminosis may be associated with other complaints such as headache, dizziness, loss of appetite, problems with muscle coordination, blurred vision, nausea and vomiting or even mucous membrane bleeding.

Eczema and other skin diseases

The symptoms may also be associated with atopic dermatitis or other skin diseases such as seborrheic dermatitis. As a rule, however, the torn corners of the mouth are only an annoying by-product of the general skin irritations which are generally to be observed.

In neurodermatitis, these are usually concentrated in the area of ​​the elbow, neck, popliteal fossa and face. In seborrheic dermatitis, the rash is mainly on the scalp - resulting in a corresponding head-itching - as well as in the area around the eyebrows, eyelids, chin and nose. The causes of the itchy skin rash have not yet been conclusively clarified in seborrhoeic eczema and atopic dermatitis, but it is assumed that there is a close correlation with a genetic disposition.

A skin disease that may be accompanied by chapped corners of the mouth is psoriasis, which can occur in various parts of the body. It is characterized by itching, the increased detachment of excess dander, redness and punctual bleeding of the affected skin areas.

Mundwinkelrhagaden by anatomical features

In some people anatomical features lead to repeated tearing of the corners of the mouth. Thus, for example, by mouth movements a pull effect on the corners of the mouth, which leads to tears. Likewise, increased wrinkling in the corner of the mouth can contribute to the formation of permanently moist areas which promote the development of inflammation.

Partly it comes as a result of a displacement of the bite (by wear or ill-fitting prostheses) on the lip closure to the unpleasant and painful tears.

In diabetics, the corners of the mouth break down very quickly due to the loss of skin elasticity. (Image: Printemps / fotolia.com)

Cause diabetes mellitus

Diabetics generally suffer more from torn corners of the mouth, and these are often difficult to treat. The connection between diabetes and the cracks is produced by impaired circulation and general metabolic disorders. The skin of the mouth loses its elasticity, becomes brittle and tears. Since the healing process in diabetics are significantly impaired, they often show particularly persistent recurrent inflammation.

cirrhosis

Cracked corners of the mouth are sometimes an expression of severe irreversible liver disease or liver cirrhosis. Accompanying this are often further skin changes, such as spider's nevi (reddish veined spots on the skin), redness of the palms or a yellowish discoloration of the skin.

Cirrhosis of the liver can also cause serious symptoms such as enlarged spleen, water in the stomach (ascites) or hepatic encephalopathy (dysfunction of the brain due to inadequate detoxification by the liver). The torn corners of the mouth are therefore usually accompanied by correspondingly clear symptoms in liver cirrhosis.

Autoimmune diseases

In rare cases autoimmune diseases such as the so-called Sjögren's syndrome come into consideration. In this, the salivary glands and lacrimal glands are attacked by the body's own immune cells. Typically, Sjögren's syndrome is accompanied by a pronounced dry mouth and increasingly dry eyes.

In addition, there is often a rheumatoid arthritis (also called chronic polyarthritis), which brings with it corresponding complaints such as joint pain and stiff joints. Furthermore, neurological impairments such as tingling in the limbs or numbness in the legs and arms associated with the autoimmune disease are possible.

From the field of autoimmune diseases, which can lead to torn corners of the mouth, the skin diseases from the group of blistering autoimmune dermatoses (for example, Epidermolysis bullosa acquisita) are mentioned, which, however, occur only rarely.

Other possible causes

Localized fungal infections and bacterial infections may also be the cause, as can a systemic infection, for example in the form of syphilis. Especially with one-sided Mundwinkelhhagaden the latter option should be considered.

Allergies and so-called drug eruptions (reactions to certain antibiotics and other medicines) are known as possible triggers. Some people also have the habit or the tic of chewing on the corners of their mouths, which can also cause tears and inflammation.

diagnosis

In order to determine the causes, it is first of all advisable to have a detailed survey of the patient's symptoms, possible concomitant symptoms and observed relationships. Subsequently, a swab should be used to investigate possible colonization of potential pathogens (viruses, bacteria, fungi).

A blood test is used to identify a possible iron or vitamin deficiency and the detection of metabolic diseases, liver cirrhosis or systemic infections, if there is a suspicion in this direction. An allergy test can provide information about allergies present. Skin diseases such as psoriasis or atopic dermatitis can usually be determined relatively clearly on the basis of the skin condition.

In the case of a herpes, zinc sulfate ointments are used to treat the chapped corners of the mouth. (Image: Janina Dierks / fotolia.com)

Treatment of angular cheilitis

Successful treatment of the torn corners of the mouth must always be based on the causes of the complaints. For example, in the case of iron deficiency, dietary changes to iron-containing foods and foods that improve iron absorption (such as vitamin C) are recommended. These include legumes, green vegetables, pumpkin seeds and red berries. If the undersupply can not be remedied in this way, there is the possibility of a drug therapy using iron supplements.

A similar procedure is suitable for an existing vitamin deficiency. The change in diet and targeted intake of vitamin supplements usually also allow successful therapy here.

For example, the situation is different when diabetes is the underlying cause. The metabolic diseases remains incurable until today. However, the degree of concomitant symptoms, which include the Mundwinkelhhaden, significantly reduced by an optimal adjustment of blood sugar levels.

If cold sores are the trigger, zinc sulfate ointments can speed up the healing process by dehydrating the typical herpes blisters. Even creams with disinfecting additives are used here. If the herpes has a particularly severe course, antiviral drugs for oral use or as short infusions can be administered. As a rule, the cold sores and, with it, the angular cheilitis, disappear after about two weeks, even without therapeutic treatment.

For skin diseases, such as eczema, psoriasis or seborrheic eczema healing of the disease on the basis of today's medical status is not possible. Appropriate therapy can, however, significantly alleviate the symptoms and achieve largely symptom-free phases.

Corticoid ointments are often used to combat the acute episodes of the disease, but due to the threatening side effects, these should only be used over a very limited period of time. Further alternative medical treatments for psoriasis, atopic dermatitis and seborrheic dermatitis can be found in the section "Naturopathy and home remedies".

If torn and inflamed corners of the mouth are the result of anatomical peculiarities, there is often limited room for treatment and therapy focuses on the prevention or prevention of excessive accumulation of moisture in the corners of the mouth. In case of doubt, an operative correction could also be made here, but in view of the rather harmless symptoms it seems hardly justified.

Shifts in the bite due to poorly fitting dentures or worn teeth, however, can usually be corrected by a dentist or maxillofacial surgeon in a relatively simple way.

If a badly fitting prosthesis is the reason for constantly torn corners of the mouth, the dentist can usually remedy the situation quickly. (Image: FS-Stock / fotolia.com)

If liver cirrhosis is the cause, any liver-damaging substances such as alcohol or certain medications should be avoided at all costs. Furthermore, the causes of the liver disease are to be determined in order to initiate an appropriately adapted treatment. This may range from withdrawal therapy for alcohol addiction to the administration of immunosuppressive drugs in a so-called autoimmune hepatitis or drug-based virus control in viral hepatitis to liver transplantation.

If the angular cheilitis is associated with an autoimmune disease, the use of immunosuppressants is often an essential part of the therapy. In addition, Sjögren syndrome is generally recommended for use in maintaining proper oral hygiene and adequate fluid intake to counteract symptoms in the mouth. Chewing gum can help here as it stimulates salivary flow. Sour foods serve a similar purpose. For the other symptoms of Sjögren's syndrome (eye problems, neurological impairments) appropriate remedies are available, and ultimately only a relief of the symptoms can be effected.

In case of a bacterial infection, antibiotics are usually used. They can be applied externally in the form of ointments against local superficial infections. If there is a so-called bacterial system infection, an oral intake is provided.

Fungal infections are treated in a similar way. Antifungal ointments are used in locally limited superficial skin infections, and oral remedies are used against more extensive fungal infections.

If an allergy is suspected as a trigger, the allergens should urgently be avoided to achieve a healing. In order to overcome the allergy as a whole, a so-called hyposensitization can be carried out, in which the immune system is gradually accustomed to the substances by the regular contact with small doses of the allergens and in this way the allergic reaction is avoided.

If the torn corners of the mouth are due to the intake of certain medicines, then together with the treating physician you should look for possible alternatives to avoid the symptoms.

Regardless of the causes, healing and anti-inflammatory ointments can be used, and the choice should be left to specialists to avoid unwanted side effects.

Naturopathy and home remedy at torn corners of the mouth

Naturopathy offers promising treatment approaches against most of the causes, however, certain diseases such as diabetes, autoimmune diseases or cirrhosis of the liver are not mentioned here.

Garlic is considered one of the most effective home remedies for herpes. (Image: Angela Rohde / fotolia.com)

In case of cold sores, for example, various herbal remedies from aloe vera, sun hat, taiga root and other medicinal plants promise relief. Tea tree oil is also widely used, but may cause long-term skin irritation. Dabbing the painful area with sliced ​​garlic cloves or lemon balm extract are other widely used home remedies for herpes.

Some sufferers have had good experiences with toothpaste. In the field of homeopathy are used in herpes, especially sodium chloratum, Cantharis and Rhu toxicodendron.

Against psoriasis in natural medicine of nutritional therapy is attributed a special meaning. Furthermore, methods of Traditional Chinese Medicine (TCM), such as acupuncture, are used.

Other naturopathic approaches to the treatment of psoriasis offer homeopathic and Schüssler salts. These also serve only to alleviate symptoms and their success is rather controversial in psoriasis.

Often creams and ointments based on plants are part of the naturopathic therapy of psoriasis, seborrheic dermatitis or atopic dermatitis. In addition, a variety of other practices of naturopathy can be used to alleviate the symptoms of chronic skin diseases, the selection should be made depending on the respective symptoms of the patient and may vary individually individually. Often offers a combination of naturopathic and conventional therapy.

A proven home remedy with torn corners of mouth is sage tea. For this pour over two teaspoons of sage leaves with a cup of boiling water and let the infusion draw for ten minutes. When the tea has cooled, dab it several times a day using a cotton pad on the affected areas.

Fast relief can bring about the application of honey, as it has an anti-inflammatory and antibacterial effect. Mix some honey and olive oil and apply the paste to the corners of the mouth in the morning and in the evening. (fp, nr, last updated on 28.5.2018)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)