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Canker sores are small, round sores on the inside the cheek, under the tongue, or in the back of the throat. They usually have a red edge and a gray center. They can be quite painful. They are not the same as cold sores, which are caused by herpes simplex.
Who’s At Risk
Canker sores affect approximately 25% of the general population. They are more common in women, and they usually start to appear in children or teens. People infected with HIV/AIDS are often severely affected with canker sores.
Signs and Symptoms
- Minor aphthae are single or multiple lesions, 1.0 cm or less in diameter.
- Major aphthae are deep ulcers greater than 2.0 cm in diameter.
- Herpetiform aphthae appear as multiple ulcerations.
The most common locations of canker sores are inside the mouth or lips or on the tongue. The genitals may also be affected. The sores can have a white, gray, or yellow base. There is no cure for canker sores because they are caused by a virus. Most will heal in 1–2 weeks, but these options may help relieve the pain:
- Apply protective pastes to form a barrier over the sore.
- Apply local anesthetics (benzocaine, lidocaine) to help numb the area.
- Use antibacterial mouthwashes.
- Avoid products or foods that seem to trigger episodes.
- Maintain a good diet or take vitamins.
- Get enough sleep and reduce stress.
Cleansing agents/ Antiseptics can cleanse the area and decrease the number of bacteria on the ulcer surface. Products that release oxygen can be used as cleansing agents. The foaming of the oxygen exerts a mechanical action that loosens debris and cleanses the wound. Products in this category include Amosan®, Cankaid®, Gly-Oxide®, Orajel®, and Peroxyl®. Hydrogen peroxide when obtained as a 3% solution should be diluted with equal amounts of water before application either directly to the ulcer or as a mouthrinse. Sodium bicarbonate, either as a solution (½ to 1 teaspoon in 4 ounces of water) or as a paste, can also be used to for wound cleansing.
Other oral medications, dapsone and colchicine, may be used in more severe cases, when repeated outbreaks continue for years.
Bolognia, Jean L., ed. Dermatology, pp.419, 1087. New York: Mosby, 2003.
Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6th ed. pp.1115-1116, 1098-1099, 2360, 2467. New York: McGraw-Hill, 2003.