Topic: Angular cheilitis (AC)

Hi Dr. Ettinger,

I forgot to ask you when I was there for my appointment about the cracked skin at the corner of my mouth. It wasn’t so bad then, but it has gotten worse. I have never in my life gotten this, so it’s a mystery. I’ve tried putting some skin repair cream on it, but It hasn’t helped that much. I know there’s a reason why this happens, but I seem to have forgotten. Is it some nutritional deficiency? any suggestions about getting rid of it?

Thanks a lot.



It’s called angular cheilitis or cheilosis.

Although the sores of angular cheilitis may become infected by the fungus Candida albicans (thrush), or other pathogens, studies have linked the initial onset of angular cheilitis with nutritional deficiencies, namely riboflavin (vitamin B2)[1][2] and iron deficiency anemia,[3] which in turn may be evidence of poor diets or malnutrition (e.g. celiac disease). Zinc deficiency has also been associated with angular cheilitis.[4] I have treated many patients for this issue and it usually responds very well to vitamin B2 supplementation. I recommend doing some blood work through a functional medicine practitioner (metabolic chemistry panel, CBC, ferritin, and homocysteine) at a minimum. Correct any needed, functional, imbalance. Additionally, HCl and trace minerals may also be needed, especially if a geographic tongue is also present.

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Dr. Marcus Ettinger, B.Sc., D.C.

1. Dorfman J, The Center for Special Dentistry.
2. MedlinePlus (2005-08-01). “Riboflavin (vitamin B2) deficiency (ariboflavinosis)”. National Institutes of Health.
3. Lu S, Wu H (2004). “Initial diagnosis of anemia from sore mouth and improved classification of anemias by MCV and RDW in 30 patients”. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98 (6): 679–85.
4. Gaveau D, Piette F, Cortot A, Dumur V, Bergoend H. (1987). “[Cutaneous manifestations of zinc deficiency in ethylic cirrhosis].”. Ann Dermatol Venereol. 114 (1): 39–53. PMID 3579131.

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