The term, ‘skin cream,’ typically has positive connotations with the marketing terms often used to promote them: soothing, gentle, calming, pain-reducing, etc. And in the world of perleche, any angular cheilitis cream is designed for these purposes – to provide relief, hopefully instantaneous relief, and contribute towards healing.
You and your doctor can choose among the following angular cheilitis creams, but they’re listed in no order of preference. Of course, women who are pregnant and breast-feeding must especially weigh the pros and cons of any given treatment with their physician.
Angular Cheilitis Creams – Available by Prescription
1) Nystatin – This can be effective for those with fungi-caused angular cheilitis as Nystatin is an antifungal cream. This product seems well-tolerated by most and is therefore prescribed quite frequently. Some physicians prefer to offer a formulation where Nystatin is combined with a steroid, such as Triamcinolone Acetonide (Mycolog-II) to reduce concomitant inflammation.
2) Ketoconazole cream – Works to kill a fungal infection so this may be effective if offending fungi (not bacteria) have produced perleche. Ketoconazole may be prescribed with other agents that are anti-inflammatory in nature.
3) Alcortin A (gel) – This formulation contains 1% iodoquinol, 2% hydrocortisone acetate, and 1% aloe polysaccharides, each ingredient leading to a synergistic potency against perleche. The iodoquinol is anti-bacterial, thwarting the growth of bacteria, and can also exhibit antifungal properties; the hydrocortisone is anti-inflammatory and can relieve pain, itching and swelling; and the polysaccharides provide further soothing relief.
4) Bactroban Mupirocin – This is a popular antibacterial prescription although its not too popular among bacterial cultures, particularly Staphylococcus aureus, thought to be responsible for some bouts of angular cheilitis. This angular cheilitis cream would not be effective against fungal cheilitis.
5) Desonide cream – This formulation seems versatile as its often prescribed to treat eczema, psoriasis, dermatitis, and yes, the remnants of angular cheilitis. A steroid that is meant to be used sparingly and only for the short-term, this cream targets inflammation. How does it accomplish this feat? It simply stimulates anti-inflammatory enzymes.
Follow doctor’s orders and wean yourself off Desonide slowly as the original symptoms can abruptly reappear. However, the product does not really tackle the underlying bacterial or fungal issues of angular cheilitis.
And by the way, further research indicates that Desonide cream should only be used when the infection is under control. Therefore, the doctor may prescribe Desonide after first prescribing an antibacterial or antifungal agent.
Now there are many other prescription angular cheilitis creams available but they may or may not be effective depending on the source of your cheilitis (i.e., bacteria or fungi) and whether the product specifically targets the offender. Effectiveness will also depend on your immune system.
Angular Cheilitis Creams – Available Over-the-Counter
Here are some angular cheilitis cream over-the-counter choices:
1) Clotrimazole (brand name, Lotrimin) – Designed to sooth fungal infections, Lotrimin may be a useful ally in your fight against perleche. You should see results in a week or two, if it works. As with many angular cheilitis creams, do not abruptly stop the medication when symptoms seem to subside. Prematurely stopping the medication may make the offending fungi even more resilient.
2) Micatin (generic name, miconazole) – Looking to interfere with the synthesis of fungal cell membranes? Micatin is designed for this objective, and may even exhibit antibacterial and anti-parasitic properties.
3) Lamisil (generic name, terbinafine – This antifungal formulation targets the itching, burning, and cracking associated with perleche. Of course, before its application (applicable to all creams), ensure that the area is thoroughly clean and dry.
4) Tinactin (generic name, tolnaftate) – Yes, I know that you’ve heard this product is marketed to get rid of athlete’s foot, and as such, you may not want such a product to touch your lips. But realize, its antifungal prowess may just be that missing link in eliminating perleche.
5) Cortizone 10 (generic name, hydrocortisone / iodoquinol) – Many folks just use plain, old hydrocortisone to relieve the inflammation associated with cheilitis. Why not try a formulation that combines anti-inflammatory hydrocortisone with iodoquinol, a bacteria and fungal fighter? We not only want to relieve cheilitis symptoms but get rid of it altogether.
Now obtain your doctor’s angular cheilitis cream advice, and follow the suggested course of treatment. This may be a case of trial and error as individual response will vary. There is no guarantee that any cream will cream your perleche but they’re worth trying as long as you follow the treatment protocol.
Here’s hoping that at least one angular cheilitis cream mentioned above will work for you.