What is the initial management for angular cheilitis?

• A. Topical antifungals for 2 weeks; biopsy if not healed
• B. Oral antibiotics for 4 weeks
• C. Steroid cream only
• D. No treatment needed

Answer: (A)

Angular cheilitis is most often driven by a fungal overgrowth at the mouth corners, typically Candida, sometimes with a minor bacterial component. Starting with a topical antifungal applied to the affected areas for about two weeks directly targets the common cause and is effective without the risks of systemic therapy. Keeping the skin dry and protected with a barrier ointment further helps healing by reducing moisture that feeds the yeast. If there’s no improvement after this initial treatment, or if the presentation is unusual or persistent, a biopsy is then considered to rule out other conditions such as dermatitis or more serious lesions. Addressing contributing factors like drooling, lip licking, denture fit, and nutritional issues also supports resolution and reduces recurrence.