I have had SS since 1992, and angular cheilitis is in the top 3 of my worst problems.
The problem is painful cracks at the corners of the mouth. This subject has been covered before in this forum, but this was years ago.
As my SS has progressively worsened (especially this year), the cheilitis has become a real problem. It is very irritating and unsightly.
I have seen numerous physicians about this, and they are usually puzzled (including Rheumatologists).
Treatment has been a real problem, & nothing helps.
I have tried all of these: corticosteroid cream, antifungals, antibiotic cream, lip balm and Zinc creams.
Has anyone been successful at treating this problem?
:P
My doctor ordered Triamcinolone Acetonide Ointment for me and I think it works great! 2 to 3 applications daily. It is kind of waterproof and stays on pretty good.
I feel for you!
Kathy
After using EVERY type of lip cream (over about a 20 year period) a dental hygienist quietly announced I had fungus. I couldn't believe it. Looks the same. I now have an Rx for Nystatin Ointment. It will come back...and when it starts back, I barely recognize it's the fungus. Back to the ointment. What Kathy said and I use, try either...and whichever works, there's our dx.
ccc
I understand what you are going through. It can be so painful!
I have found that you can never really get over and cure angular cheilits, but you have to work at it daily to control it. I use lotrisone, a prescription cream combining a corticosteroid and antifungal. I try to remember to put it on daily. When I get lazy and don't put it on, my angular chelitis comes right back.
I also found that the days I have talked a lot, it is much worse. When I'm home and not talking, I'm generally ok. But if I go out with friends and converse, my entire mouth and lips are so painful. I should just stay home everyday ???? (Fine with me!)
I have found a new, but expensive, lip balm that also has been helping. It is Clinique Superbalm Lip Treatment. $17. It has helped my lips but I still need to use the lotrisone cream.
Liz D.
I'm sure the above suggestions are excellent, I've also seen online that ordinary petroleum jelly can help keep the sore place protected from saliva and give it time to heal. Maybe worth a try.
Another possible approach is treatment with Vitamin B12, since this and other oral lesions can sometimes be caused by B12 deficiency.
I've lucky enough that I don't experience chelitis often, but when it starts, I increase my B12 intake and it usually resolves quickly without becoming severe.
If it is a common occurrence, maybe your doctor could run Vitamin B12 levels for you.
I deal with it also and the Clinique lip balm helped a lot as did taking liquid b12 (under the tongue). If I keep it moisturized and don't eat high histamine foods or anything pretty acidic I do okay...or it comes right back!
You might want to research the vitamins and mineral supplements. I know that I recently read something about treating skin issues with vitamins/minerals. Also, the yeast/fungus treatment sounds very logical. So many of u8s have a lone grade yeast infection going on in our mouth all the time so the side of the mouth and the lips could involved. Good luck.Irish
I posted the original question. This last weekend I spent 10 hours researching this subject on Physician sites and PubMed.
I was hoping to publish a detailed synopsis on these forums. But actually, there is not much out there.
Briefly, there is very little in the scientific literature about this problem. My brief take on all this research:
1) This is a common problem in SS and other chronic diseases
2) Often resistant to treatment.
3) Can be painful and unsightly.
4) There are a few positive findings of treatments:
a) stay hydrated. • Sip water or sugarless drinks often
b) keep your oral cavity moist using Biotene. Keep Biotene in your purse and use it often
c) regularly use antifungal/steroid creams on the lesions
d) use lip balm at night (I prefer Burts Bees)
e) have your doctor check for Iron, Vitamin B12 and Folate deficiency
f) use Xylimelts at night
g) chew gum with xylitol
h) keep your teeth healthy
i) use a humidifier at night.
Please add your personal favorites to this list
(My Rheumatologists are at Scripps Clinic San Diego and UCLA)
Oddly I haven't suffered from this much until recently. Although I attended a talk by a
Sjögren's rheumatologist who showed slides of it as part of the common skin manifestations of SS. I felt relieved not to have this but then suddenly one corner of my mouth suddenly developed a crack out of the blue. I decided on a nappy cream having first rubbed the tiniest bit of Tea Tree oil on the affected area. Within a few days it disappeared. I don't know if this was just lucky but I've just done the same with extremely itchy inner ears and this too has cleared. I'm in the UK so this may not be very useful but the brand of nappy cream I use is Sudocreme - a family favourite.