Cold sores are a symptom of oral herpes, which is caused by the herpes simplex virus. Angular cheilitis is less common and has several different causes. Each condition is treated differently.
Mouth sores are swollen, discolored bumps or blisters that affect the soft tissue of your mouth. This may include the lips, inside of your cheeks, gums, and tongue.
Oral herpes and angular cheilitis are two causes of mouth sores, but they’re two different conditions.
Oral herpes, commonly known as cold sores, is caused by the herpes simplex virus. Around 1 in 2 adults in the United States has cold sores.
Mouth sores caused by angular cheilitis are
While cold sores are caused by a virus, angular cheilitis can be caused by a number of different things, including fungal infections. Therefore, it requires different treatments.
The first step in eliminating sores at the edges of the mouth is to determine what’s causing them. Read on to learn how to differentiate oral herpes from angular cheilitis and how each is treated.
Both oral herpes and angular cheilitis can cause discoloration, rawness, and inflammation around the corners of the mouth. However, the sores look slightly different.
Cold sores are fluid-filled blisters that are discolored and bubbly. They tend to clump together in patches on the face, especially in or near the mouth and lips.
Cold sores also look wet or weepy before scabbing and healing. On lighter skin tones, the blisters may appear red or pink. On darker skin tones, they may appear more brown or purple.
Angular cheilitis typically only affects the skin at the corners of the mouth but may sometimes extend onto the face or lips. It also usually results in cracked, dry, and irritated skin instead of fluid-filled blisters.
While they may resemble each other, cold sores and angular cheilitis sores have different causes.
Oral herpes
Cold sores are most commonly caused by the herpes simplex virus type 1 (HSV-1). In some cases, they may be caused by HSV-2, although this virus is more likely to cause genital herpes.
Oral herpes is a transmissible disease, which means you can contract the virus if you come into direct contact with someone who has the virus. This may include kissing, having oral sex, or touching open blisters and wounds.
Once a person has contracted the virus, they’ll carry it for life. It’s common for those who have the herpes virus to develop cold sores on the face, especially near the mouth.
However, not everyone with the herpes simplex virus develops cold sores. Those who do may experience herpes outbreaks, which are when cold sores form in response to triggers like stress, illness, and dietary habits.
Angular cheilitis
Unlike cold sores, angular cheilitis isn’t caused by a virus, and it isn’t carried for life. It can usually be resolved with treatment.
Angular cheilitis is
Some other causes of angular cheilitis may include:
- contact dermatitis from excess saliva
- dry, chapped lips
- bacterial infections
- nutritional deficiencies, such as zinc, iron, vitamin B, and protein
- underlying health conditions, such as Sjögren disease and inflammatory bowel disease (IBD)
In some instances, a cause can’t be determined. When this is the case, it’s called idiopathic angular cheilitis.
For cold sores, symptoms appear in stages, beginning with discoloration, inflammation, and discomfort. Within 48 hours, these develop into blisters. Angular cheilitis has less defined stages with more overlap of various symptoms.
Angular cheilitis most often occurs in the corners of the mouth, while herpes may affect parts of the face beyond this area, including on the lips, in and around the mouth, and inside the nose.
| Cold sores | Angular cheilitis |
|---|---|
| initial discoloration, swelling, discomfort, or itching on skin, lips, or in the mouth before cold sores emerge | painful blisters or cracks in the skin |
| uncomfortable, fluid-filled blisters (the fluid inside is highly contagious) | dryness and crusting of the skin |
| leaking blisters that turn into wet sores | discoloration |
| scabbing and healing sores | bleeding |
Angular cheilitis is a temporary problem, but if left untreated, it can lead to complications like impetigo and candidiasis of the skin, which require further treatment.
Cold sores and angular cheilitis require different treatment approaches. Treating cold sores is about managing the symptoms, whereas treating angular cheilitis can help the infection go away entirely.
Treating cold sores
In many cases, cold sores will heal on their own in around 10 days, but some treatments can reduce the severity and length of an outbreak. This may include over-the-counter and home remedies, such as:
- taking OTC pain relievers, such as ibuprofen, to manage discomfort
- applying OTC anti-inflammatory creams to reduce the swelling and appearance of cold sores
- wearing sunscreen with an SPF of at least 15 to protect your skin when cold sores are healing
- regularly cleaning cold sores and keeping the area dry
If you experience serious cold sore outbreaks, a doctor could prescribe antiviral ointment or oral medications to help alleviate symptoms.
Treating angular cheilitis
Treatment for angular cheilitis depends on the underlying cause.
In mild cases of angular cheilitis, maintaining proper oral hygiene and
In more severe cases, however, treatment may require:
- using topical antiseptics to clean the affected area
- applying topical antifungals or taking oral antifungals for a yeast infection
- applying topical antibiotics or taking oral antibiotics for a bacterial infection
- applying a topical prescription steroid cream to reduce inflammation
A healthcare professional can help develop the best treatment plan for you.
If you notice sores on the side of your mouth that worsen or don’t go away over time, consider connecting with a primary care physician.
They can assess your symptoms to provide a proper diagnosis and develop an appropriate treatment plan.
It’s possible that you have neither herpes nor angular cheilitis but a completely different condition. A doctor can perform other tests, such as a skin scrape, to help determine what’s causing your symptoms.
Oral herpes usually causes fluid-filled blisters to develop anywhere on the lips or inside the mouth, while angular cheilitis primarily affects the corners of the mouth with dry, cracked skin.
Some people can sometimes mistake angular cheilitis for herpes, but both conditions have specific symptoms and causes that differentiate them.
You may be able to kiss with angular cheilitis because it’s not transmissible. However, in severe cases, kissing may be painful.
Cold sores and angular cheilitis are two different conditions that often affect the corners of the mouth.
While they share some symptoms, such as discoloration, inflammation, and blistering, cold sores are caused by a virus, while angular cheilitis is often caused by a fungus.
Each condition tends to resolve on its own, but treatment can help speed healing and reduce discomfort.
If you have sores on the side of the mouth that don’t go away with time and treatment, consider speaking with a healthcare professional. They can help determine the underlying cause and develop an appropriate treatment plan.