Angular Cheilitis and Its Treatment.

Angular Cheilitis or AC occurs when the corners of the mouth or lips become inflamed. There are two major forms of the disease differentiated by their location on the skin: Facial AC and Mucosal AC.

                                                                               

Figure 1 : Mucosal AC                                                                                       Figure 2 : Facial AC

 

Self-Diagnosis : How To Know If You Have Angular Chielitis.

1. It is always a good strategy to confirm whether the legions are on both sides of the mouth or on one side, since this can come in handy when deducing the cause of the infection.

2. Observe the extent of the spread of the lesions on the face. Greater spread of the lesions, for example towards the cheeks show more severity and require immediate attention.

3.  Search the effected skin specifically for Golden coloration which signifies a bacterial infection. This information can be paramount in deciding which type of treatment to be used.

4. In the worst cases one may spot pus formation or scaling. In such a scenario going straight to a doctor is highly recommended.

5. In order to prevent misdiagnoses search the skin for scarring, Itching, pain or burning at the corners of the mouth.

 Other Factors to be Observed that help in deciding treatment.

1. Loss of lower face height “AND” the use of dentures.

2. Swollen tongue “OR” or known nutritional deficiencies of Iron (or anemia) Vitamin B (and its variants e.g B12 and B7) and Zinc.

The Treatment to the disease is cause specific and therefore it is necessary to first find out the cause to the disease.

Causes

The disease is a primarily caused by opportunistic infections of fungi, bacteria and very rarely viruses. However 25% of cases maybe due to allergens. Opportunistic infections are infections that are harmless under normal conditions but become harmful when the immunity or oral hygiene of the individual is low.

Pooling of Saliva causes a major fungal bloom and is especially deterring in the corners of the mouth. Using ill-designed or wornout dentures may lead to saliva pooling in the mouth. Some other habits which lead to saliva pooling include Lip licking, Thumb sucking, chewing gum, Hyper salivation, drooling and mouth breathing. Furthermore some lip balms may degrade over time and act as havens for fungal populations.

The Selection of Treatment.

There are 3 ways in which people can approach treatment.

1. Natural Healing

2. Self-Treatment.

3. Consulting a doctor.

Natural Healing : The mouth’s regenerative capabilities are one of the finest and the fastest the disease can be dealt with naturally is 18 hours although the average is 3 days. Unfortunately the disease can prolong for entire months if the proper precautions are not taken. It is therefore Recommended to move on to self-treatment if the situation is not improving.

Self-Treatment :  This is only advised for mild cases where the disease is merely an annoyance than a real threat. For successful treatment it is essential that a correct diagnoses is performed which derives the correct source of the Disease.

Step 1 : Perform Diagnoses.
Step 2 : Check Whether disease is Mild or severe. In case of severity contact a doctor. If The disease is but Mild move on to Step 3.

Step 3 : check for golden coloration which signifies bacterial infection.
Step 4 : Does the affected person use dentures. What about their nutritional status. Do they have low oral hygiene.

Once the following questions are answered it can be determined whether the problem is due to a bacterial infection or a fungal one and whether it is being intensified by malnutrition or low personal hygiene.

Treatment

Infection due to Dentures : Have the dentures properly fitted and disinfected. The Latter can be done manually by soaking the denture in a concentrated bleach solution (“THE DENTURE NEEDS TO BE OF A PLASTIC NATURE”) followed by rinsing with water. The denture must be cleaned daily and not worn while sleeping.

Infection due to Malnutrition : Iron, Vitamin B and zinc Supplements or their natural alternatives should be taken. These will not cure the disease but will speed up the natural process of recovery. Vitamin B is highly recommended against infectious diseases since it boosts the body’s immune system.

Success Rate 66 %

Available Medicine : Since the disease can be caused by Bacteria and Fungus both, therefore it is advised to use a Combination of Fungal Cream and Antibiotics. Antibiotics are highly recommend in-case golden coloration is spotted however it has greater side effects compared to the fungal cream which has a greater success rate since more infections are of fungal origin.

Other Un-Orthodox Treatments :

1.  Baking Soda : has many medicinal properties but in the case of AC only acts as a pain reliever.
Success Rate 38%

2. Chapstick : Only provides temporary relief and may have negative effects.
Success Rate 14%

3.  Rubbing alcohol : A very painful procedure which has mixed results since it can clean wounds and kill micro-organisms. 51% success rate.

4. Tea Tree Oil : A very potent and traditional home remedy. Unfortunately it does not have any medical research behind it but a lot of practical data which says that it might just work.

Success rate 58%

5.  Bathing in Saltwater (The Ocean or Sea) and Basking in Sunlight are both natural remedies against bacterial and fungal infections since the saltwater can de-hydrate bacterial cells and fungal cells prosper in dark environments. 

Implantation bleeding

Implantation is the prologue of pregnancy.  If there’s no implantation, there would be no pregnancy that will occur.  Implantation happens after ovulation and fertilization, where the fertilized egg becomes a cluster of cells called the “blastocyst”.  The blastocyst undergoes several phases while it travels from the fallopian tube to the uterus where it subsequently becomes the embryo.  The embryo penetrates and implants itself in the lining of the uterus, instantaneously triggering the production of the hormone hCG and other hormones, giving rise to the placenta, which will sustain the embryo.  The embryo then starts to receive the essential nourishment from the mother and it will dwell there, eventually becoming the foetus, for over 9 months until its delivery.

            Implantation happens six to eight days after the egg is fertilized, and it lasts for a couple of days.  In some women, it triggers discomfort and other symptoms.  The hormone progesterone is responsible for the thickening of the uterine lining, as it prepares the uterus for the incoming embryo that will be nurtured.  Once the embryo implants itself to the thick and blood-rich uterine lining, it can irritate the lining and cause it to move.  A small amount of blood may be let out by the uterine lining during implantation.  This is called implantation bleeding or implantation spotting.  Other signs of implantation include slight cramps or tenderness and sudden drop followed by a sharp rise of the basal body temperature.  Since there are only a handful of signals of implantation, it is very easy to go unnoticed unless the woman takes an early pregnancy test.  Most women may mistake the symptoms as the beginning of their period and they do not realize they are already pregnant.

            Implantation bleeding is a very pale, light, spotting, which might be experienced right after the embryo implants itself in the lining of the uterus.  It can be mistaken as a start of a period because it is typically blood, and the color, at a fist glance, is the same pale brown, pale red color.  Implantation bleeding differs from a period because it is spottier, more smeared, and lighter than a normal menstrual period.  While some women may take this as the beginning of the period, they will find out that it is not because implantation bleeding does not last long.  The typical implantation bleeding can last for less than a day but not longer than a couple of days.

            Not every pregnant woman experiences implantation bleeding.  Only 5 to 30 percent of pregnant women notice implantation bleeding but not experiencing it does not mean that a woman is not pregnant. Confusion whether a woman is experiencing implantation bleeding or just the start of her period can be cleared by taking a pregnancy test.  If a normal period does not occur after a few days or the test did not have a convincing positive pregnancy test result, the doctor should be consulted for there can be a lot of unseen factors which might have caused the bleeding.