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How to Deal With Your Child’s Cracked, Bleeding Lips

Kristie Rivers, MD, FAAP, Board Certified Pediatrician
January 3, 2019 . 2 min read

Children often suffer from dry, chapped lips, especially in the cold winter season. But cracking at the corners of the mouth may indicate a different problem, known as angular cheilitis.

“Cheilitis” simply means an inflammation of the lips. Angular cheilitis is defined by redness, erosions, and cracking in the corners of the mouth. Many children experience a painful, burning sensation in the corners of their mouth. Often the cracking will be so severe it leads to bleeding.

In children, a variety of causes can contribute to this condition, including:

Lip licking

Drooling

Thumb sucking or pacifier use

Sensitivity to a substance the lips come in contact with

The cause of angular cheilitis is controversial, but most physicians believe a fungal or bacterial infection plays a role. Often, the first line of treatment will be an anti-bacterial or anti-fungal cream. If these are not successful in clearing up the problem, some physicians may try a low potency topical steroid for a few days. It is important to note that angular cheilitis is not caused from a herpes virus, the virus that causes the common cold sore, so over-the-counter preparations are not effective.

Angular cheilitis can also be seen in children with nutritional deficiencies. These include anemia and vitamin deficiencies, most commonly iron and vitamin B. If the cracking and ulcerations do not heal with standard treatments, further assessment may be required. Your child’s pediatrician may decide to order blood tests, including a complete blood count, folate, vitamin B levels, and other vitamin levels if indicated.

As a general rule, children should maintain good oral hygiene and a healthy diet to prevent angular cheilitis. Petroleum jelly can be used on the lips to help minimize lip licking. Pacifier use should be discouraged in young children who have recurrent angular cheilitis.

Sources:

  • American Academy of Pediatrics
  • Acquired Oral Findings.
    National Institutes of Health
  • Angular cheilitis.

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