Recurrent aphthous stomatitis: A comprehensive review and recommendations on therapeutic options

Dermatol Ther. 2022 Jun;35(6):e15500. doi: 10.1111/dth.15500. Epub 2022 Apr 18.

Abstract

Recurrent aphthous stomatitis (RAS) is a common chronic disease in the oral mucosa that affects about 20% of the population. It is characterized by solitary or multiple, recurrent, small ulcers with erythematous haloes and yellow/gray floors. RAS can be managed through a wide variety of preventative measures and therapies, intending to reduce ulcer pain, stimulate ulcer healing, and/or prevent ulcer recurrence. First-line treatment options include topical medications in the form of corticosteroids (triamcinolone acetonide), anti-inflammatory drugs (amlexanox), antibiotics (doxycycline), and antiseptics (lidocaine). In more severe cases of RAS where local treatment is insufficient, systemic drugs in the form of corticosteroids (prednisone), immunomodulatory drugs (thalidomide), and antibiotics/antimicrobials (clofazimine) can prove effective. This review will summarize current treatment options for RAS with discussion of prevention, topical measures, natural treatments, systemic therapies, and new potential therapies. Furthermore, this review will provide recommendations on therapeutic options for RAS based on disease severity and patient circumstances.

Keywords: aphthous ulcers; clinical management; disease prevention; recurrent aphthous stomatitis; topical and systemic treatment.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Humans
  • Recurrence
  • Stomatitis, Aphthous* / diagnosis
  • Stomatitis, Aphthous* / drug therapy
  • Ulcer / drug therapy

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents

Supplementary concepts

  • Sutton disease 2