From the Guidelines
Steroid-induced mouth ulcers should be managed with topical measures, such as local corticosteroids, lidocaine gel, and chlorhexidine, as first-line treatment to reduce inflammation and prevent secondary infection 1. When considering treatment options, it's essential to prioritize the patient's quality of life and the severity of the mucocutaneous involvement.
- Topical corticosteroids can be applied directly to the ulcers to reduce inflammation and promote healing.
- Lidocaine gel can be used to manage pain and discomfort associated with the ulcers.
- Chlorhexidine mouthwash can help prevent secondary infection and promote oral hygiene. It's also crucial to maintain good oral hygiene, avoid spicy or acidic foods, and stay hydrated to support the healing process.
- Regular dental check-ups and professional cleanings can help prevent complications and promote overall oral health. If ulcers persist beyond two weeks despite these measures, it's essential to consult a healthcare provider to discuss potential dose adjustments of the steroid medication or alternative treatment options.
- In some cases, systemic measures, such as azathioprine or TNF-alpha antagonists, may be necessary for resistant or severe cases of steroid-induced mouth ulcers 1.
From the Research
Steroid Induced Mouth Ulcers
- Steroid induced mouth ulcers can be treated with intralesional steroid therapy (IST) as shown in a study published in 2019 2
- The study found that IST may be an effective treatment for inflammatory and immune-mediated oral ulcers, with complete resolution achieved in 81.7% of patients
- Topical steroid therapy can also be used to treat oral ulcers, with triamcinolone acetonide being a commonly used steroid 3
- The analgesic mechanism of steroid ointments against oral ulcerative mucositis has been studied, and it was found that triamcinolone acetonide suppresses oral ulcerative mucositis-induced pain by general anti-inflammatory actions and inhibits mechanical sensitivity in peripheral nerves 3
Diagnosis and Management
- The diagnosis and management of oral ulcers can be challenging due to the varied and complex aetiology and pathogenesis of oral ulceration 4
- It is important to differentiate recurrent aphthous stomatitis (RAS) in otherwise healthy individuals from recurrent oral ulceration (ROU) secondary to known or unknown systemic disease 4
- A definitive diagnosis is crucial in managing patients with oral mucosal disease, and treatment requires an understanding of the immunopathologic nature of the lesion 5
Treatment Options
- Intralesional steroid therapy (IST) can be an effective treatment for oral ulcerative conditions, with a median of 2 injections and a median dose of 12 mg per injection 2
- Topical steroid therapy can also be used to treat oral ulcers, with triamcinolone acetonide being a commonly used steroid 3, 6
- The use of long-lasting ointments such as TRAFUL® can help to induce the therapeutic effects of steroid ointments 3