How does the visit work?
The doctor reads your answers and looks at your photos. We do not test your skin or your blood. The doctor sends a plan. The plan has these steps. Pat the corners dry after you eat or drink. Put petroleum jelly on them many times a day and at bedtime. Try not to lick or pick the corners. Stop any new lip balm, lipstick, toothpaste, or mouthwash that you started before the cracks. If you wear dentures, take them out every night. Clean them every day. If they are loose, ask your dentist to check them. Use a new toothbrush when you start. Wash your hands before and after you use a cream. Some people also get one prescription cream. It may be an antifungal cream, like clotrimazole. You put it on twice a day for 14 days. Use it for all 14 days, even if the corners look better. If the corners have yellow crusts, it may be mupirocin, an antibiotic ointment. You put it on 3 times a day for up to 10 days. You use only one of them at a time. Put it on the skin at the corners. Do not put it inside your mouth or near your eyes. While you use mupirocin, do not put petroleum jelly or other creams on those spots. Do not use a steroid cream on the corners unless the doctor says so. Most corners start to feel better in a few days. Most are healed in about 2 weeks.
Is it contagious?
No. It does not spread to other people. Spit and moisture build up in the corners. Then yeast or germs can grow there.
Do you test for yeast?
No. We do not test your skin or your blood. The doctor reads your answers and looks at your photos. Then the doctor sends a plan.
Do I need vitamins?
This visit does not give vitamins, and we do not test your blood. If you know you have low iron, anemia, or low vitamin B12, folate, or zinc, please see your own doctor.
How do I use the cream safely?
You use only one cream at a time. Put it on the skin at the corners. Do not put it inside your mouth or near your eyes. While you use mupirocin, do not put petroleum jelly or other creams on those spots. Wash your hands before and after you use a cream. Do not use a steroid cream on the corners unless the doctor says so. Tell us if you ever had a reaction to a cream, if you are pregnant or breastfeeding, or if you have kidney disease. Stop the cream and call 911 if you get hives, swelling of your lips, tongue, or face, or trouble breathing. If the corners burn, sting, or get more red or sore, stop it and message us. If you get diarrhea while you use mupirocin or after you finish it, stop using it and see a doctor in person today.
What if it does not heal?
Most corners start to feel better in a few days. Most are healed in about 2 weeks. If you use mupirocin and see no change after 5 days, message us. If the corners are not healed after 14 days, see your own doctor. If you have had this 3 or more times in the past 12 months, see your own doctor.
When do I need care right away?
Call 911 or go to the ER now if you have any of these. You have trouble breathing, or your lips, tongue, or throat swell, or you have trouble swallowing. The corner of your mouth bleeds and the bleeding does not stop after 10 minutes of firm pressure. You have a rash spreading across your body, or round patches that are darker in the middle, after a new medicine or an infection. You have a rash with blisters or peeling skin. You have mouth sores and red, sore eyes. Your vision changes. Go to the ER or urgent care today if you have any of these. You have a fever or chills, or you feel very ill. The skin at the corner is getting worse fast, or the pain is much worse than the cracks look. You have redness, swelling, or pain around an eye. Your mouth hurts so much that you cannot drink enough, or you cannot swallow. See a doctor in person today if redness, warmth, swelling, or pus spreads from the corner of your mouth onto your cheek, chin, or lip.
When do I need an exam in person?
See a doctor in person within 14 days if you have any of these. The crack or sore has lasted 3 weeks or longer. You have a lump, or a hard or thick area, at the corner, on a lip, or in your mouth. The crack bleeds a lot, or bleeds again and again. You have a white or red patch in your mouth that does not wipe off.
When should I see my own doctor instead?
See your own doctor if any of these are true. You have a weak immune system. It can come from HIV, a transplant, chemotherapy, steroid pills, or other medicine that weakens it. You have diabetes that is not well controlled, or you are much thirstier than usual and pass much more urine. You know you have low iron, anemia, or low vitamin B12, folate, or zinc. You have celiac disease, Crohn's disease, or ulcerative colitis, or you had weight loss surgery. You are losing weight without trying, or you are eating very little. You have a red, sore area under a denture or on the roof of your mouth. You have had this 3 or more times in the past 12 months. You used an antifungal, antibiotic, or steroid cream for 2 weeks or more, and the corners are not fully healed. If you are under 18, please see your own doctor. If you are under 18 and have any sign in the 911 list above, call 911 or go to the ER now.
Could another visit fit better?
If you have small blisters on your lips or around your mouth now or had them before it began, or you had tingling or burning before it began, or you get cold sores, use our cold sores visit. If you have white patches inside your mouth that wipe off, use our oral thrush visit. If you have honey-colored crusts or sores on your cheek, chin, or around your nose, use our impetigo visit. If you have a rash of small red bumps around your mouth, nose, or chin, use our perioral dermatitis visit.