This image displays white-to-yellow lesions typical of aphthous ulcers.
This image displays white-to-yellow lesions typical of aphthous ulcers.
This image displays several small erosions and aphthous ulcers on the lower lip.
This image displays several small erosions and aphthous ulcers on the lower lip.
This image displays the grayish-white color of an aphthous ulcer.
This image displays the grayish-white color of an aphthous ulcer.
This canker sore (aphthous ulcer) has a typical red border and white center.
This canker sore (aphthous ulcer) has a typical red border and white center.
As displayed in this image, aphthous ulcers can be large, deep, and painful.
As displayed in this image, aphthous ulcers can be large, deep, and painful.
As displayed in this image, aphthous ulcers typically have a white or yellow color.
As displayed in this image, aphthous ulcers typically have a white or yellow color.
This image displays a tongue with 3 small ulcers from aphthae.
This image displays a tongue with 3 small ulcers from aphthae.
This image displays an unusually large amount of canker sores of the lower inner lip.
This image displays an unusually large amount of canker sores of the lower inner lip.
This image displays a large healing canker sore on the lower lip.
This image displays a large healing canker sore on the lower lip.

Images of Canker Sore (Aphthous Ulcer) (9)

This image displays white-to-yellow lesions typical of aphthous ulcers.
This image displays several small erosions and aphthous ulcers on the lower lip.
This image displays the grayish-white color of an aphthous ulcer.
This canker sore (aphthous ulcer) has a typical red border and white center.
As displayed in this image, aphthous ulcers can be large, deep, and painful.
As displayed in this image, aphthous ulcers typically have a white or yellow color.
This image displays a tongue with 3 small ulcers from aphthae.
This image displays an unusually large amount of canker sores of the lower inner lip.
This image displays a large healing canker sore on the lower lip.

Canker Sore (Aphthous Ulcer)

Aphthous ulcers, commonly known as canker sores and also known as aphthae, are the most common cause of recurring ulcers inside the mouth or on the genital area. Their cause is unknown, but stress, lack of sleep, trauma, and some vitamin deficiencies, toothpastes, and foods may make the condition worse. People with anemia and other medical conditions that weaken their immune system may be more likely to develop canker sores.

There are 3 types of canker sores:

  • Minor aphthae (approximately 80% of cases) – mildly painful, shallow ulcers that last about 1-2 weeks and generally heal without scarring
  • Major aphthae (Sutton disease, approximately 10% of cases) – extremely painful, deep ulcers that last from 2-4 weeks and generally cause scars after they heal
  • Herpetiform aphthae (approximately 10% of cases) – usually multiple ulcers, but they last about 1-4 weeks and generally heal without scarring

Who's At Risk?

Canker sores are more common in women, and they usually start to appear in children or teens. Most people who get a canker sore have recurrences.

People with certain underlying diseases, such as HIV/AIDS and inflammatory bowel disease, are often severely affected with canker sores.

Signs & Symptoms

The most common locations of canker sores are inside the lips or on the tongue. The genitals may also be affected. The ulcers can have a round or oval shape and have a white, gray, or yellow base surrounded by a red ring.

  • 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.

Self-Care Guidelines

There is no cure for canker sores. Most heal in 1-2 weeks, but the following measures may help relieve the pain:

  • Apply protective pastes to form a barrier over the sore, such as Orabase.
  • Apply local anesthetics (benzocaine, lidocaine) to help numb the area.
  • Avoid acidic foods and beverages when you have a canker sore, as they can increase ulcer pain.

To help prevent canker sores:

  • Maintain a good diet or take vitamin supplements.
  • Try to reduce stress and get enough sleep.
  • Toothpaste free of sodium lauryl sulfate may help decrease the frequency of recurrences.
  • Antibacterial mouthwashes containing chlorhexidine may also help decrease recurrences.

Treatments

Treatments include:

  • Mouth rinses that contain chlorhexidine, lidocaine, and/or sucralfate.
  • Topical steroid paste or ointment such as triamcinolone or clobetasol.
  • Tetracycline dissolved in water to swish around the mouth.
  • Prednisone in severe cases.

Other oral medications, dapsone and colchicine, may be used in more severe cases, when repeated outbreaks continue for years.

Visit Urgency

See your medical professional if you have canker sores that do not heal, occur frequently, or if you have extreme discomfort or pain.

References

Bolognia J, Schaffer JV, Cerroni L. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018.

James WD, Elston D, Treat JR, Rosenbach MA. Andrew’s Diseases of the Skin. 13th ed. Philadelphia, PA: Elsevier; 2019.

Kang S, Amagai M, Bruckner AL, et al. Fitzpatrick’s Dermatology. 9th ed. New York, NY: McGraw-Hill Education; 2019.

Last modified on October 25th, 2023 at 12:33 pm

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