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The solution may still be usable, but future reconstitutions should use gentle swirling only

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Other causes may include: Immunodeficiency and general poor health, as in chemotherapy, diabetes or other acquired loss of normal immunity Treatment with certain drugs such as isotretinoin, antiretroviral drugs, antibiotics or systemic corticosteroids these are also associated with oral candidiasis which is another risk factor for angular cheilitis Eczema because of excessively sensitive skin and increased susceptibility to infections Systemic conditions such as inflammatory bowel disease Habitual licking of the lips Dryness and peeling of the lip mucosa Genetic linkage with conditions such as trisomy 21 (Down syndrome) Diagnosis Immunosuppression should be asked for and looked for by testing if no obvious cause is evident