WHAT ARE THE Common TREATMENTS Options FOR AN APTHOUS ULCER?

* Be aware that the recommended treatments of illnesses are always being improved. This website was last update on 11/1/2024. The best treatment option MIGHT have changed since that time.

1. Topical Anesthetics:
A. Benzocaine (Orajel, may help relieve pain).
B. Lidocaine Suspension (Rinse and Spit)

2. Antibiotics (prevent secondary infections)
A. chlorhexidine oropharygngel mouthwash. 10-15 ml 2 x/d

3. Oral Corticosteroids Paste:
A. Triamcinolone paste “Kenolog In Orabase” 0.025% 0.1% 0.5% tid as needed (PRN)
B. Dexamethasone 0.5 mg/5 mL 3 times a day (PRN)
C. Clobetasol ointment 0.05% (PRN)
D. Fluocinonide ointment 0.05% in Carboxymethylcellulose mucosal protective paste (1:1) applied 3 times a day (PRN)

4. For Severe Cases:
A. Oral Prednisone 40 mg q day x ~ 5 Days

5. Vitamins
A. Iron
B. B12

Caution:

1. All medication, including vitamine, oral antibiotics, oral anestheic medications,  and all medications that come in lotions, ointment, and creams have a risk of side effects.

2. Possible Mild side effects are nausea, vomiting, diarrhea, itching, and light to moderate skin rash.

3. Possible Severe side effects are a severe skin rash, an anaphylactic allergic reaction (leading to the inability to breathe and subsequent death if not treated rapidly), and Clostridioides difficile infection (C. Diff.) of the colon.

4. Medications such as creams, lotions, and gels should be tested in small dosages in areas of the body that are not easily seen.

WHAT ARE THE SYMPTOMS OF AN APTHOUS ULCER (OR CANKER SORE)?

The symptoms of an Apthous Ulcer are one or a few painful sores on the lips or inside the mouth. They appear as white or gray small erosions about 3-6 mm. Pain is usually increased when eating or drinking certain foods, especially those containing salt.

Typical Apthous Ulcers do NOT cause a tingling discomfort or itching in the area. They also do NOT change very much is appearance from beginning to end. However, Lesions that cause a tingling sensation are more likely caused by Herpes Simplex Virus I or 2 (Cold Sore).

 

WHAT CAUSES AN APTHOUS ULCERS OR CANKER SORE?

Apthous Ulcers are NOT caused by a virus. This is different than Cold Sores which are caused by Herpes Simplex Virus 1 or 2. Instead of a virus there is disruption in the person’s immune system, most notably Cytokines, such as IL-2, IL-10, and TN-alpha. This disruption in the immune system can be brought on by stress, trauma, and a variety of food. The foods include: chocolate, coffee, peanuts, eggs, cereals, almonds, strawberries, cheese, and tomatoes.

 

HOW ARE APTHOUS ULCERS DIAGNOSED?

Apthous ulcers can be diagnosis based on a careful history and a brief visual exam.