I first learned about xylitol when I was desperately trying to avoid a possible root canal, in the quest to save my innocent tooth from salivating microbes. Derived from xylose, xylitol is a cousin to sugar – at least on a molecular level – and tastes all so sweet. Despite its sweetness, it’s not really sugar but a type of sugar alcohol with purported health benefits, especially in the realm of preventing tooth decay … and perhaps … angular cheilitis.

A question arises: How could xylitol serve as a preventative measure for a variety of conditions? Several studies have concluded that xylitol can inhibit bacterial growth and exert antifungal properties. This would make it ideal for use on teeth, and perhaps, on the cracked corners of your mouth.

It should be noted that not all folks are jumping on the xylitol bandwagon. While some assert that it is a viable, safe alternative – even to antibiotics – others aver that it is not as ‘natural’ as claimed (it’s processed with man-made chemicals) and adversely affects the digestive tract. As Grandma used to say, ‘You can go crazy with such conflicting information.’

To remain sane, it may make sense to use xylitol but in a way that does not pose too much risk. Let me explain how to achieve a moderate/high reward to negligible risk ratio.

Some alternative health care providers suggest ingesting a xylitol solution of say 4 grams of granular xylitol per 16 ounces of warm water. Instead of oral consumption, why not just use it topically? You can spray the above concocted solution on the angular cheilitis and see what, if any, effects materialize.

If you really want to experiment with xylitol, placing it in the mouth, instead of on the mouth, opt for xylitol gum and/or xylitol lozenges. You should know that there are possible side effects with ingesting xylitol, such as diarrhea, weight gain, fluctuation of blood sugar levels, and a host of others, but xylitol proponents point out that one would have to consume a great deal of it for such side effects to arise. As such, speak with your doctor before participating in any xylitol-based treatment for perleche.

Our recommendation is to only use xylitol as a topical angular cheilitis remedy or perhaps not use it at all. (Xylitol did not save my tooth, by the way, and it may exert little difference in your angular cheilitis symptoms.)

Others may counter that it is more a preventative measure than a healing one. Still, the concern is with the possible detrimental effects, regardless of its antibacterial and antifungal nature. Long term use has not even been established. (By the way, xylitol is particularly dangerous for dogs and cats as it can promote hypoglycemia and eventual liver damage.)

Our final word: As health-conscious folks, we’re not one to tout the benefits of any form of processed sugar, but xylitol’s antibacterial fighting power and antifungal efficacy makes it inviting to use in topical form. Therefore, we feel that topical xylitol is an option for angular cheilitis, and may stop perleche in its tracks

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