Which Vitamin Causes Angular Cheilitis? A Detailed Guide

December 11, 2025 •

4 min read

Nutritional deficiencies contribute to a notable percentage of angular cheilitis cases. Deficiencies in certain B-vitamins and iron are frequently linked to this painful condition, and can lead to cracked mouth corners. This guide will explore specific vitamins and minerals, associated factors, and effective treatment strategies.

Quick Summary

Examine the nutritional deficiencies, specifically B-vitamins and iron, that can lead to angular cheilitis, a condition causing cracked mouth corners. This article also covers other causes, symptoms, and treatment options to help manage and prevent this oral health issue.

Key Points

B-Vitamin Deficiency: Lack of riboflavin (B2) and cobalamin (B12) is a primary vitamin-related cause of angular cheilitis, leading to cracked, inflamed mouth corners.
Iron Deficiency: Iron deficiency anemia is also a significant nutritional cause, with angular cheilitis sometimes being the main symptom of low iron levels.
Nutritional vs. Infectious Causes: While nutrient deficiency is a root cause, angular cheilitis is often exacerbated by secondary fungal (Candida) or bacterial (Staphylococcus) infections that thrive in the compromised skin.
Contributing Factors: Other triggers include excessive saliva, ill-fitting dentures, lip licking, and systemic diseases like diabetes.
Multi-faceted Treatment: Effective treatment requires a combination of addressing the nutritional deficiency through diet or supplements, treating any secondary infection with topical creams, and managing local irritants.
Prevention is Possible: Maintaining a balanced diet rich in B-vitamins and iron, practicing good oral hygiene, and managing systemic conditions can help prevent recurrence.

Understanding Angular Cheilitis

Angular cheilitis, also known as perleche or angular stomatitis, is an inflammatory condition causing red, swollen patches at one or both corners of the mouth. It can cause cracking, blistering, and bleeding. While often caused by a fungal or bacterial infection, nutritional deficiencies significantly contribute, especially in those with limited nutrient access. The warmth and moisture in the mouth corners can create the right environment for opportunistic infections, but skin health is often compromised by lacking essential nutrients.

The B-Vitamin Link to Angular Cheilitis

Several B-vitamins are crucial for healthy skin and mucosal membranes. A deficiency in these can impact the tissue at the mouth corners, making it susceptible to cracking and inflammation.

Riboflavin (Vitamin B2): Frequently cited as the main B-vitamin linked with angular cheilitis. A lack of riboflavin, also known as ariboflavinosis, can cause cheilosis and angular stomatitis.
Cobalamin (Vitamin B12): A deficiency in vitamin B12 can lead to megaloblastic anemia and is linked to angular cheilitis and glossitis (inflammation of the tongue). Vegans and vegetarians are particularly at risk for B12 deficiency.
Folate (Vitamin B9): Like B12, a folate deficiency can cause megaloblastic anemia and contribute to angular cheilitis and oral ulcers.
Pyridoxine (Vitamin B6): Less commonly, a lack of vitamin B6 can result in seborrheic dermatitis, cheilosis, and angular stomatitis.

The Role of Iron and Other Nutrients

Beyond B-vitamins, other nutrients play a critical role in preventing angular cheilitis. Iron deficiency is particularly common and has a strong association with the condition.

Iron: Iron deficiency anemia is a well-established cause of angular cheilitis, which can manifest as the primary symptom in some cases. It is especially prevalent in women of childbearing age.
Zinc: Deficiencies in zinc have also been linked to angular cheilitis, along with other symptoms like dermatitis and alopecia. Zinc is vital for wound healing and immune function.

Other Factors Contributing to Angular Cheilitis

While nutritional issues are key, other factors can predispose an individual to angular cheilitis or exacerbate an existing condition.

Infections: Fungal infections, particularly Candida albicans, and bacterial infections like Staphylococcus aureus are the most common immediate causes, thriving in the moist, cracked tissue.
Local Irritation: Chronic lip licking, ill-fitting dentures, or orthodontic braces can trap moisture and saliva, leading to constant irritation.
Medical Conditions: Systemic diseases such as diabetes, inflammatory bowel disease (Crohn's disease), or immune deficiencies can increase susceptibility.
Medications: Certain drugs, like oral retinoids, can cause excessive dryness and increase the risk.
Anatomical Issues: Overclosure of the mouth, common in denture wearers or older adults with sagging facial skin, can create deep furrows where saliva pools.

Nutritional Deficiencies vs. Other Causes: A Comparison

To highlight the different etiological factors, here is a comparison table:


Feature	Nutritional Deficiencies	Fungal/Bacterial Infection	Local Irritation/Moisture	Systemic Disease
Primary Cause	Lack of essential nutrients (B-vitamins, iron).	Overgrowth of Candida yeast or Staphylococcus bacteria.	Saliva pooling, lip licking, poor-fitting dentures.	Underlying health issues like diabetes or IBD.
Appearance	Often bilateral and symmetrical, may have associated symptoms like glossitis or anemia.	Can be unilateral or bilateral; may have honey-colored crusts (bacteria) or white patches (fungus).	Redness and fissuring, often directly related to mechanical stress.	May be one symptom among a broader set of health problems.
Diagnosis	Blood tests for vitamin and mineral levels.	Culture swab to identify the specific pathogen.	Clinical evaluation of oral habits and dental appliances.	Medical history review and further testing for underlying conditions.
Treatment	Dietary changes and supplementation.	Topical antifungal or antibacterial creams.	Topical barrier creams, behavioral changes, denture refitting.	Managing the primary illness.

Treatment and Management of Angular Cheilitis

Successful treatment of angular cheilitis involves addressing both the immediate symptoms and the underlying cause. If a vitamin deficiency is the root issue, correcting it is essential for preventing recurrence.

Correcting Nutritional Deficiencies: A doctor may order blood tests to check levels of B-vitamins, iron, and zinc. Based on the results, they might recommend dietary changes or oral supplements. Consuming foods rich in riboflavin (dairy, eggs, leafy greens) and iron (red meat, lentils, spinach) can be beneficial.
Topical Treatments: Antifungal or antibacterial creams can be applied directly to the affected area to clear up any secondary infection. A topical barrier cream, like petroleum jelly, can help protect the corners from further moisture and irritation.
Addressing Local Factors: For those with ill-fitting dentures, adjusting or replacing them is crucial. Practicing good oral hygiene and avoiding lip licking can also help.
Managing Underlying Conditions: Individuals with diabetes or other systemic issues should work with their healthcare provider to manage their condition, as this can have a significant impact on oral health.

Conclusion: A Holistic Approach is Key

While a deficiency in B-vitamins (especially B2 and B12) and iron is a common cause of angular cheilitis, a successful resolution requires a holistic approach. It involves not only correcting nutritional imbalances but also addressing infections and local irritants. Consulting a healthcare professional for an accurate diagnosis is the best way to determine the specific cause and create an effective treatment plan. Focusing on a balanced diet and proper oral care can help prevent this painful condition from recurring.

For more information, please consult the resource below:

Angular Cheilitis - StatPearls - NCBI Bookshelf(https://www.ncbi.nlm.nih.gov/books/NBK536929/)

Frequently Asked Questions

The most commonly cited vitamin deficiency is riboflavin (vitamin B2), although a lack of other B-vitamins like B12 and folate can also be a contributing factor.

Yes, iron deficiency anemia is a well-documented cause of angular cheilitis, and it can be a significant factor, especially in susceptible populations like women of childbearing age.

It is often a combination of both. A vitamin or mineral deficiency can weaken the skin at the mouth corners, making it more vulnerable to an opportunistic infection by fungi (like Candida) or bacteria (like Staphylococcus).

To prevent deficiency-related angular cheilitis, increase your intake of foods rich in B-vitamins and iron. This includes dairy products, eggs, lean meats, leafy greens, legumes, and fortified cereals.

A healthcare provider can order blood tests to check your levels of specific B-vitamins, iron, and zinc to confirm a deficiency. This is often done if initial antifungal or antibacterial treatments are unsuccessful.

While supplements can correct the underlying nutritional issue, they may not be enough if a secondary fungal or bacterial infection has already taken hold. A combination of supplements, topical creams, and other treatments is often necessary.

Yes. Other causes include excessive drooling, ill-fitting dentures, lip-licking habits, systemic diseases like diabetes, and certain medications. A healthcare provider will need to identify the specific cause for effective treatment.