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The Doctors share side-by-side photos of two very similar looking infections on the corners of the mouth. However, while you may assume both are cold sores, only the one on the left is. The one on the right is called angular cheilitis which is where the corners of the mouth start to crack, fissure and break down.
Cold sores are caused by the herpes simplex virus and two-thirds of the world population is infected by this virus. However, only a small percentage of people infected will actually see the blisters and vesicles on the mouth.
Angular cheilitis is completely different and caused by saliva pooling in the corners of the mouth resulting in a warm place for yeast and bacteria to overgrow. This perpetuates the infection. This condition is common in people who have dental appliances, braces or are more susceptible to infection and skin breakdown like diabetics.
Angular cheilitis is best treated by simply using an ointment, like petroleum jelly, to keep it hydrated. People can also use an antibacterial or anti-yeast agent. If it persists, a doctor should perform a culture.
For cold sore treatment there are antiviral over-the-counter products or for some, a pill-based antiviral may be needed. ER physician Dr. Travis Stork notes that cold sore treatment can actually still be effective if used on angular cheilitis and Dr. Batra agrees if it’s more of an ointment and not a gel-based product. However, if the cold sore product has a high alcohol content it will cause burning of the fissures in angular cheilitis.
Plastic surgeon Dr. Andrew Ordon points out that it is important to know what you have because cold sores can be highly contagious. Dr. Travis says there are blood tests you can take to check if you are exposed to the HSV-1 virus.