Angular Cheilitis

Doses are oral and given for adults and children separately. Visit the Irish Medicines Board website for drug SPCs, dosage, contraindications, interactions, or IMF/BNF/BNFC/MIMS.

Comments from Expert Advisory Committee

This condition is most commonly seen in patients who have denture-relates stomatitis. It can also be associated with underlying systemic disease. It is usually associated with candida. In those without dentures it is more likely to be caused by infection with streptococci or staphylococci³.

Miconazole gel is effective against both candida and gram-positive cocci and is therefore appropriate to use for all patients. Where the condition is clearly fungal miconazole gel can be used and where it is bacterial in nature sodium fusidate cream or ointment can be used ^(3,4).

Note that creams are normally used on wet surfaces whereas ointments are normally used on dry surfaces.

Treatment

Treatment		Dose	TX Duration
		Adults and Children
First line	Miconazole* 20mg/g oral gel 40g tube	Apply to angles of mouth twice daily	Continue for 10 days after lesion has healed
	Sodium Fusidate 2% cream / ointment 15g tube	Apply to angles of mouth four times daily	Maximum 10 days
	Miconazole* 2% and Hydrocortisone 1% cream, 30g tube	Apply to angles of mouth twice daily	Maximum 7 days

*Do not prescribe for patients taking Statins³ Check for drug interactions before prescribing.

Patient Information

Visit HPSC Information Leaflets pages for the General Public, (MRSA, CRE, etc)

Reviewed Dec 2019