You’ve read online that steroid creams provide relief for a multitude of skin conditions so you’re wondering whether the use of steroid treatment can launch a counter-offensive against your angular cheilitis. And if it works, how long will it take before angular cheilitis symptoms disappear?
First, what are steroid creams? Addressing inflammation and swelling, steroid creams are synthetic hormones topically applied to the skin. While long-term use is a taboo, its short-term use can have a dramatic positive effect on an inflamed dermis.
Such creams exhibit anti-inflammatory properties by the following mechanism. They constrict problematic, dilating capillaries making the skin less red, swollen, and warm. Of interest, chronic use of topical steroids can contribute to broken capillaries and make symptoms appear worse.
Steroid creams also interact with cell nucleus DNA. Proteins called lipocortins are created which inhibit the development of the chemical arachidonic acid, responsible for inflammation to result. Less arachidonic acid means less inflammation.
The use of these creams also present a double-edged sword. Our white blood cells do not readily recognize the skin’s foreign invaders leading to a favorable, less inflammatory condition. However, we also want our innate immune systems to kill off the microbes that are responsible for the angular cheilitis. Therefore, while steroid creams help to reduce red, swollen cracks, our white blood cells may become less efficient in thwarting the underlying cause of the cheilitis.
This is why many dermatologists suggest a topical prescription where a steroid is combined with antifungal medicine. One popular prescription is Mycolog-II which combines potent nystatin, an antifungal treatment with triamcinolone, a strong corticosteroid/steroid. This cream or ointment should be applied sparingly and not covered with a band aid. Of course, careful application and caution must be exercised to ensure that this is not ingested. You have to abandon the habit of licking lips.
Pregnant or nursing mothers should discuss any possible risks of this medication with their physician. Children should not use this medication as its safety has not been established for this demographic.
This corticosteroid or any steroid cream may produce the following symptoms (not an exhaustive list): dryness, burning, irritation, acne-like cysts or other eruptions, contact dermatitis, etc. (This is why no covering should be used as increased absorption may lead to an increased likelihood of adverse reactions.) It’s advisable to keep an open dialogue with your physician to report and address and possible side effects.
In regards to its efficacy, Mycolog-II and similar prescription creams/ointments may reduce or eliminate the symptoms within a few days. However, physicians recommend that the full course of treatment be employed even if you cannot see the cheilitis. Your doctor will advise you on the time and manner in which you need to apply the medication. You should not take it longer than 25 days, however, if symptoms still persist.
After all, these prescription treatments and their over-the-counter counterparts may not even work. A steroid by itself will not defeat the underlying cheilitis bacteria or fungi. In addition, medications, such as Mycolog-II, will prove ineffective if you have bacterial cheilitis as opposed to fungi-caused perleche.
A doctor may alternatively try a topical antibiotic, such as bactroban mupirocin, with a prescription-strength steroid preparation if he/she feels that your cheilitis has a bacterial component. Again, it should only take a few days to see a gradual improvement of the condition if this medication works.
All in all, topical steroid creams may be very helpful in providing a quick fix in addressing the inflammatory nature of cheilitis, but unless it is combined with an antifungal or antibiotic preparation, the perleche will linger.