Corticosteroid creams and gels are the most commonly used treatments for aphthous ulcers. These topical treatments calm the activity of the immune system, which is believed to be responsible for the ulcers, at the site where the aphthous ulcer has developed. The most effective topical corticosteroids are betamethasone (Alphatrex®, Diprolene®, Maxivate®), fluocinonide (Lidex®), fluocinolone (Synalar®, Fluonid®), clobetasol (Temovate®), hydrocortisone (Cortaid®, Westcort®), and triamcinolone (Aristocort®, Flutex™, Kenalog®). These topical treatments should be used carefully, as many of them (except hydrocortisone and triamcinolone) can cause the adrenal glands (located on top of the kidneys) to slow production of adrenalin, an important hormone. Prolonged use of these treatments can also increase the risk of certain oral infections, like candidiasis.
Large aphthous ulcers, or ulcers that do not respond to topical corticosteroids, are often treated using more powerful corticosteroids taken in pill form, such as prednisone.
Thalidomide (Thalomid®) has been shown to be a very effective treatment for aphthous ulcers. However, it is only approved in the United States for the treatment of leprosy. While it is possible to fill a prescription for thalidomide to treat aphthous ulcers, the drug must not be used by women who are pregnant. Thalidomide can cause severe birth defects.
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