Treatment of Aphthous Ulcers

First-Line Topical Treatments

The American College of Physicians recommends applying topical steroids as primary therapy for accessible lesions, with options including betamethasone sodium phosphate, dexamethasone mouth rinse, and clobetasol 0.05% ointment, for patients with aphthous ulcers 1, 2
Topical anesthetic preparations, such as viscous lidocaine 2% and benzydamine hydrochloride rinse or spray, are effective for pain relief in patients with aphthous ulcers 1, 2
Mucoprotectant mouthwashes, such as Gelclair, and antiseptic oral rinses, such as 0.2% chlorhexidine digluconate, can be used to promote healing and prevent infection in patients with aphthous ulcers 1, 2

The American Academy of Dermatology recommends considering intralesional steroid injections, such as triamcinolone, and systemic corticosteroids, such as prednisone or prednisolone, for ulcers that do not respond to topical therapy 1, 2
Systemic therapies, such as colchicine, azathioprine, interferon-alpha, and TNF-alpha inhibitors, may be considered for recurrent aphthous stomatitis or resistant cases 1, 2

The National Institutes of Health recommends considering protein or amino acid supplementation to promote healing in patients with aphthous ulcers 3, 4
Patients with oral ulcers lasting more than 2 weeks or not responding to 1-2 weeks of treatment should be referred to a specialist, and biopsy is indicated to rule out malignancy 1
Proper diagnosis is essential before initiating treatment, and chemical agents or plasters should be avoided to remove callus or corns 2, 5