A Close Look at Angular Cheilitis and Oral Herpes
Angular cheilitis is often mistaken as oral herpes. Since the latter is highly contagious and thus, a lot more prevalent, it’s understandable that more people are familiar about it. But it’s very important to learn to distinguish between the two. Not only could confusion result in misdiagnosis, it can also lead to incorrect treatment. So that won’t happen, it’s best to educate yourself about the basics of these two mouth conditions.
Angular cheilitis is a chronic condition involving the corner of the mouth’s skin. It can be a fungal, bacterial or viral infection. It may occur only on one side of the mouth or on both sides. It doesn’t choose its victim, as it affects both genders and all ages. There’s a slight increase of risk, however, among children, elderly and people who have compromised immune resistance. This condition, which can last for a few weeks and then heal on its own, affects movement of the mouth, making talking, eating and smiling a challenge.
Various factors can trigger the onset of angular cheilitis. The most common causes include nutritional deficiency, poor-fitting dentures, use of expired cosmetic products, certain medical conditions, use of pacifier or feeding bottles among babies, thumb-sucking or fingernail-biting habits, cold weather, stress, and chapped lips.
The bottom line is this: any activity that causes accumulation of skin-drying saliva on the corners of the mouth (poor-fitting dentures, use of pacifier, or thumb sucking) that results in crack formation combined with any factor that weakens the immune system, making a person susceptible to infection (iron or vitamin B deficiency, stress, or sickness), can cause angular cheilitis.
The most obvious symptom of this inflammatory skin condition is the appearance of open lesions on the corners of the mouth. These open lesions usually start from dry, flaky and chapped skin. Eventually, they turn into deep cracks or splits. When saliva or any other source of bacteria or fungi come into contact with those cracks and splits, and penetrate into them, that’s when infection happens.
Soon, the area will become inflamed and red. These are signs that the body’s immune system is trying to fight off the invaders. If that works, the redness and swelling will go away after a few days or weeks. If not, the cracks will turn into ulcers, which may bleed whenever the mouth is opened.
To diagnose angular cheilitis, a culture test is performed. It determines if the condition is a result of a fungal, bacterial or viral infection. A doctor will perform the test by getting a swab from the affected area of the mouth. This will then be tested for traces of microbes like Candida albicans and Staphylococcus aureus.
Treatment is usually a combination of topical ointment or cream (antibacterial or fungal) and elimination of the trigger. Even if you manage to combat the fungi or bacteria causing the infection but fail to get rid of the primary cause of the condition, it’s likely to recur. For example, if you’re suffering from a certain medical condition that makes your immune resistance weak, then you’ll probably get the infection over and over.
This is why, you need to strengthen your immune defense with proper diet and exercise. If you’re deficient in certain vitamins or minerals, especially vitamin B12 or iron, it’s a must to get nutritional supplements to fight the problem more effectively. You also need to get immediate medical care if you’re suffering from any underlying condition that’s causing your angular cheilitis.
Compared to angular cheilitis, oral herpes is a lot more common. It affects over 50 percent of the adult population in the United States. It’s probably because this skin condition is highly contagious. It can easily be transmitted from one person to another by sharing items or coming into close contact (e.g. kissing).
This mouth disorder, which is marked by red and swollen blisters around the mouth, can go away without treatment in two to four weeks. It can go through three stages: primary infection, latency and recurrence. During the first stage, the virus enters the skin and reproduces, creating cold sores accompanied by fever. If it doesn’t occur with any sores or other symptoms, it’s referred to as the asymptomatic type of infection.
During the latency stage, the virus moves from the site of infection to a nerve tissue mass located in the spine called the dorsal root ganglion. Here, it reproduces again before deactivating. By this time, you’ll find yourself relieved of symptoms. But when the body undergoes emotional or physical stress, the virus reactivates and this is known as the third stage or recurrence.
This condition, otherwise known as cold sores, can affect all ages at any time of the year. It is caused by a virus called by herpes simplex virus. This virus comes in two types: HSV-1 and HSV-2. HSV-1 is accountable for 80 percent of oral herpes cases.
As for the symptoms, the first one is the appearance of painful sores on the lips, tongue, gums, roof of the mouth, and inside the cheeks. These can be painful, burning and itchy. These may be accompanied by fever, muscle aches, exhaustion, irritability and gray coating on the tongue or tonsils. When the blisters erupt, they form shallow gray ulcers before turning into dry scabs.
Doctors can easily identify oral herpes based on the physical appearance of the blisters. But if the condition requires a more definitive diagnosis, your doctor will perform laboratory tests including culture analysis, antigen and antibody studies, blood sampling, and staining test (Tzanck smear).
Alleviating the symptoms is one of the first treatment steps for oral herpes. For fever and muscle pain, acetaminophen like Tylenol or ibuprofen such as Advil, Excedrin or Motrin is given. The doctor will also advice intake of plenty of fluids for dehydration prevention. Oral or intravenous medications for oral herpes are only advised for people with severe infections and extremely weak immune systems.
As you can see, these two mouth conditions have countless differences. Although they may look similar, they have different causes, symptoms and treatment methods.