Which topical medications are used in the treatment of aphthous stomatitis (canker sore)?

Updated: Sep 25, 2020
  • Author: Ginat W Mirowski, MD, DMD; Chief Editor: William D James, MD  more...
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Please refer to medications section for specific information regarding recommended dosage and mechanism of action.

Topical regimens may include the following:

  • Topical corticosteroids, including dexamethasone, [86] triamcinolone, fluocinonide, and clobetasol [66]

  • Immunomodulatory agents, including retinoids, cyclosporine, and amlexanox [87, 88] : Cyclosporine has been tested as a systemic agent and a topical paste with mixed reports of efficacy, but it is now most often used effectively as an oral rinse. [89, 90, 91] Isotretinoin (0.1% gel), tretinoin in an adhesive base (0.1%), and retinoic acid in an oral base (0.05%) have been used in the treatment of oral lichen planus with reported efficacy, and they may also be useful in the treatment of recurrent aphthous ulcers. [92, 93] Researchers have also found systemic isotretinoin to be an effective therapy for recurrent aphthous ulcers. [94]

  • Antimicrobials, including tetracycline, [95] chlorhexidine gluconate, [96] and dilute hydrogen peroxide

  • Anesthetics such as topical lidocaine or benzocaine [97]

  • Occlusive and bioadherents agents such as oral bioadherent (Gelclair), [98] sucralfate, bismuth subsalicylate, and 2-octyl cyanoacrylate [99] : Some studies have reported improvement in symptomology and duration of ulcers, [100] while other studies have found that sucralfate is not effective in the treatment of recurrent aphthous ulcers. [101]  Some clinicians advise patients to include bismuth subsalicylate in mouthwash recipes along with other ingredients, such as liquid diphenhydramine. [102, 103]

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