Can Low Iron Cause Sores? Understanding Iron Deficiency's Link to Mouth Ulcers and Skin Cracks

October 31, 2025 •

4 min read

Iron deficiency is the most common nutritional deficiency worldwide, and it can affect far more than just your energy levels. One surprising manifestation is the development of sores, particularly in and around the mouth, leading many to question: can low iron cause sores? The answer is yes, as inadequate iron levels impact tissue repair and immune function, making the body more susceptible to painful lesions.

Quick Summary

Iron deficiency can cause painful sores, including oral ulcers, a sore tongue (atrophic glossitis), and cracks at the corners of the mouth (angular cheilitis). This occurs because low iron hinders cell repair and immune response. Recognizing these signs is key to proper diagnosis and treatment, which typically involves dietary changes and supplements to correct the deficiency.

Key Points

Low Iron Causes Oral Sores: Iron deficiency is a recognized cause of mouth sores, including ulcers, sore tongue (glossitis), and painful cracks at the corners of the mouth (angular cheilitis).
Impact on Tissue Health: Inadequate iron restricts oxygen and energy to rapidly regenerating tissues like skin and mucous membranes, making them prone to damage and inflammation.
Angular Cheilitis Connection: Iron deficiency weakens the skin at the mouth's corners, predisposing it to infection by yeast or bacteria that cause angular cheilitis.
Diagnosis is Key: Blood tests measuring ferritin and hemoglobin are necessary to confirm an iron deficiency, as other conditions can cause similar symptoms.
Treatment Resolves Symptoms: Restoring iron levels through diet and supplements often resolves the associated sores and skin issues.
Impaired Wound Healing: Low iron can delay wound healing due to its role in collagen synthesis and tissue repair.

The Connection Between Iron and Sores

Iron is an essential mineral vital for numerous bodily functions, including oxygen transport, DNA synthesis, and cellular growth. When iron levels are insufficient, the body prioritizes iron distribution to essential functions, leaving rapidly regenerating tissues like the skin and mucous membranes with a deficit. This leads to a breakdown in tissue integrity, making these areas vulnerable to inflammation, cracking, and ulceration.

Oral Sores Caused by Iron Deficiency

Iron deficiency is a well-documented cause of several oral health issues that manifest as sores. These can be painful and persistent, significantly impacting a person's quality of life.

Angular Cheilitis: This condition is characterized by painful, red erosions, fissuring, and crusting at one or both corners of the mouth. It often occurs alongside a yeast (Candida) or bacterial infection, which takes advantage of the weakened mucosal tissue caused by iron deficiency. Correcting the iron deficiency is crucial for effective long-term treatment.
Atrophic Glossitis: Also known as a smooth or bald tongue, this condition involves the atrophy of the filiform and fungiform papillae, the small bumps covering the tongue. This results in a smooth, red, and often swollen or painful tongue. A smooth tongue is not only a cosmetic issue but can also cause a burning sensation and alter the sense of taste, compromising eating and drinking.
Recurrent Aphthous Ulcers (Canker Sores): Several studies have found a correlation between low iron and recurrent mouth ulcers. These small, round ulcers with a yellow-gray center and red border can occur more frequently and persist longer in individuals with iron deficiency.

Other Skin Sores and Complications

Beyond the oral cavity, low iron can contribute to other skin-related issues and hinder wound healing throughout the body.

Impaired Wound Healing: Iron plays a critical role in collagen synthesis and tissue repair. A deficiency can slow the re-epithelialization process, causing wounds to take longer to heal and increasing the risk of infection.
Dry and Itchy Skin (Pruritus): Chronic iron deficiency can diminish keratinocyte proliferation, weakening the skin's barrier function. This can lead to persistent dry, flaky, and itchy skin, sometimes resulting in a rash-like appearance from scratching.
Brittle Nails (Koilonychia): While not a sore, this classic sign of severe, long-standing iron deficiency is a related manifestation of poor tissue health. It involves the thinning and concavity of the nail plate, causing the characteristic spoon-shaped nails.

Diagnosis and Treatment

If you suspect that your sores are related to an iron deficiency, it is crucial to consult a healthcare professional for a proper diagnosis. A simple blood test can measure your hemoglobin, ferritin (iron stores), and other indicators to determine your iron status.

Treatment for iron deficiency typically involves:

Dietary Adjustments: Increasing your intake of iron-rich foods, such as red meat, poultry, fish, beans, fortified cereals, and leafy green vegetables like spinach, is a fundamental step. Pairing iron-rich foods with a source of vitamin C (e.g., orange juice, tomatoes, bell peppers) can also significantly improve iron absorption.
Iron Supplements: Your doctor may recommend oral iron supplements, like ferrous sulfate, to quickly increase iron levels. Adhering to the prescribed dosage is important, as excessive iron can be harmful. For individuals with severe deficiency, malabsorption issues, or intolerance to oral supplements, intravenous iron may be necessary.
Addressing Underlying Causes: Iron deficiency can be caused by various factors, including blood loss (e.g., heavy menstruation, stomach ulcers), malabsorption issues (e.g., celiac disease), or a vegetarian or vegan diet. Treating the root cause is essential for preventing recurrence.

Iron Deficiency vs. Other Causes of Sores

It is important to differentiate iron deficiency from other common causes of sores. The following table highlights some key differences:


Feature	Sores from Iron Deficiency	Sores from Common Causes (e.g., infection)
Appearance	Angular cheilitis often has fissuring/crusting. Glossitis results in a smooth, red tongue.	Oral herpes (cold sores) present as vesicles that crust and heal. Canker sores can be round with a white-yellow center.
Associated Symptoms	Often accompanied by fatigue, paleness, brittle nails, and cold hands/feet.	Can be accompanied by fever or localized pain, but not typically systemic anemia symptoms.
Persistence	Chronic and recurrent, often not responding to standard topical treatments for infections alone.	Typically resolve within 1-2 weeks with or without treatment. Recurrence can happen, but not necessarily linked to systemic issues.
Diagnostic Test	Confirmed via a blood test measuring ferritin, hemoglobin, and red blood cell count.	Diagnosis is often clinical. Lab tests for infections may be done if indicated.

Conclusion

Yes, low iron can cause sores, particularly in the form of painful mouth ulcers, a sore tongue (atrophic glossitis), and cracks at the corners of the mouth (angular cheilitis). This occurs because iron is crucial for maintaining the health of rapidly dividing cells that line the skin and mouth. When iron stores are depleted, these tissues become fragile and prone to damage. Furthermore, the body's impaired immune response can allow opportunistic infections to take hold, exacerbating the problem. Recognizing these symptoms is key to getting a proper diagnosis, which involves blood tests to check your iron levels. Treatment, including iron supplementation and dietary changes, can effectively resolve these painful symptoms and improve your overall health. Always consult a healthcare professional to confirm an iron deficiency and determine the best course of action.

Resources

Cleveland Clinic: Anemia Rash: Symptoms, Causes and Treatment
Medscape: Iron Deficiency Anemia Treatment & Management

Frequently Asked Questions

Yes, low iron can be a contributing factor to mouth ulcers, also known as recurrent aphthous ulcers or canker sores. Studies have shown a positive correlation between low ferritin levels (indicating low iron stores) and the frequency of oral ulcerations.

The most common oral sores associated with iron deficiency are angular cheilitis (painful cracks at the corners of the mouth), atrophic glossitis (a smooth, sore tongue), and recurrent aphthous ulcers.

Iron is necessary for cell growth and repair. A deficiency reduces oxygen delivery and impairs tissue synthesis, particularly in areas with rapid cell turnover like the mouth and skin. This leaves the tissues weakened and susceptible to inflammation, cracking, and secondary infection.

In many cases, yes. Once the underlying iron deficiency is treated with diet and supplements, the body's ability to repair tissue is restored, and the sores will often heal and recur less frequently. Topical treatments may also be used to manage acute symptoms.

Besides sores, iron deficiency can lead to pale skin (pallor), dry and itchy skin (pruritus), brittle nails, hair thinning, and slower wound healing.

You should not self-diagnose or start supplements without a doctor's guidance. A healthcare professional must confirm an iron deficiency with blood tests to ensure proper diagnosis and treatment, as other factors could be the cause.

Yes, atrophic glossitis, which can be caused by iron deficiency, is often accompanied by a burning or painful sensation on the tongue. The loss of papillae exposes nerve endings, leading to discomfort.