Topical Steroid Use in Inflammatory Oral Conditions

Indications and Formulations

The British Association of Dermatologists recommends topical corticosteroids for conditions with oral inflammation such as Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), eosinophilic esophagitis, and lichen planus, with application methods and potency tailored to the specific condition 1, 2
Topical corticosteroids are effective in reducing oral inflammation in various blistering and inflammatory conditions affecting the mouth, according to the British Journal of Dermatology 1, 2
For SJS/TEN, consider using betamethasone sodium phosphate 0.5 mg in 10 mL water as a 3-minute rinse-and-spit preparation four times daily, as recommended by the British Journal of Dermatology 1, 2
For eosinophilic esophagitis, fluticasone propionate at doses of 440-880 μg per day for children and 880-1760 μg per day for adolescents/adults is recommended by Gastroenterology 5, 6, 7

Apply white soft paraffin ointment to the lips every 2 hours during acute illness, and protect ulcerated mucosal surfaces with a mucoprotectant mouthwash three times daily, as recommended by the British Journal of Dermatology 1, 2, 4
Clean the mouth daily with warm saline mouthwashes or an oral sponge, and use antiseptic oral rinses twice daily to reduce bacterial colonization, according to the British Journal of Dermatology 1, 2
Monitor for oral candidiasis (fungal infection), the most common side effect of topical steroid use in the mouth, and treat with nystatin oral suspension or miconazole oral gel if necessary, as recommended by Gastroenterology and the British Journal of Dermatology 1, 2, 5, 6