# Aphthous Stomatitis (Recurrent mouth ulcers) - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: British Association of Oral Surgeons Guidelines 2019 · Corsodyl 0.2% Mouthwash SmPC sections 4.2 and 4.4 (eMC product 529) · Egyptian National Drug Formulary, endocrine 2024, triamcinolone monograph, oral paste (printed p. 177) - Verified date: 2026-08 ## Verified against - Egyptian National Drug Formulary, endocrine 2024, triamcinolone monograph, oral paste (printed p. 177) - Corsodyl 0.2% Mouthwash SmPC sections 4.2 and 4.4 (eMC product 529) ## Treatment metadata - Triamcinolone — oromucosal.paste - Chlorhexidine — topical ## Complete treatment card ```text APHTHOUS STOMATITIS (RECURRENT MOUTH ULCERS) Sources: British Association of Oral Surgeons Guidelines 2019 · Corsodyl 0.2% Mouthwash SmPC sections 4.2 and 4.4 (eMC product 529) · Egyptian National Drug Formulary, endocrine 2024, triamcinolone monograph, oral paste (printed p. 177) Review status: REVIEWED against 2 sources listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (2) - The hallmark is recurring, painful mouth ulcers that can last from a few days up to several months [mouth ulcers] - Oral discomfort can precede the ulcer appearing, in the minor form SIGNS - what you find (8) - Minor ulcers are small, usually under 5 mm, oval or round, 1 to 6 at a time, ringed by erythema, and covered by a gray-white pseudomembrane [mouth ulcers · redness] - Minor ulcers mainly occur on non-keratinized mucosa - buccal, labial, floor of mouth - and heal within two weeks without scarring - Major ulcers are bigger, over 10 mm, and persist 5 to 10 weeks, usually healing with a scar [mouth ulcers · scarring] - Major ulcers can appear anywhere in the mouth, including the oropharynx - Major ulcers do not usually follow a cyclical pattern [mouth ulcers] - Herpetiform ulcers are painful, small, and numerous, up to 100 at once, each 2 to 3 mm and lasting one to two weeks [mouth ulcers] - Herpetiform ulcers favor the floor of the mouth and the tip and edges of the tongue - Herpetiform ulcers can merge into one large, irregular ulcer that heals with scarring [mouth ulcers · scarring] TESTS (2) - Diagnosis is clinical, but Behcet disease, nutritional deficiency, or inflammatory bowel disease should be excluded, especially with sudden adult onset - Work-up for anemia or deficiency often checks CBC, red cell folate, ferritin, and vitamin B12, which can also flag GI disease IF NOT THIS - what else fits (4) - Behcet disease brings recurrent genital ulcers, skin lesions, posterior uveitis, and neuro/GI/renal/hematologic/joint involvement - MAGIC/Sweet syndrome brings sudden fever, leukocytosis, and plum-colored papules or plaques, with malignancy in about half of patients - PFAPA syndrome brings periodic fever, pharyngitis, aphthae, and cervical adenitis in young children; most improve with tonsillectomy - Cyclic neutropenia brings fever, skin abscesses, lymphadenopathy, and respiratory infections, plus severe gingivitis and aggressive periodontitis Source StatPearls "Recurrent Aphthous Stomatitis" - disease-level clinical article Status traced to the source above 1. TRIAMCINOLONE [1st line] Adult Coat the ulcer with a thin film of 0.1% oral paste - just enough to cover it, not rubbed in - two or three times a day, preferably after meals Peds Children: same oral paste dose as adults; the monograph carries no age restriction for the oral paste. Source Egyptian National Drug Formulary, endocrine 2024, triamcinolone monograph, oral paste (printed p. 177) Why Topical corticosteroid paste that damps local mucosal inflammation, easing pain and speeding healing of aphthous ulcers; withheld from ulcers that are actually fungal or viral, since suppressing local immunity there would let those infections worsen. Caution Press a small dab onto ulcer without rubbing until thin film forms. Do not apply inside fungal or viral oral infections (e.g. herpes, thrush). Investigate for iron, folate, B12 deficiency or IBD if ulcers are recurrent/intractable. Egypt TOPICORT 0.1% CREAM 20 GM PHARCO 6.00 EGP -> ? different route - not oromucosal.paste PHARCOCINOLONE 40MG/ML I.M AMP. CHEMIPHARM > ... 8.00 EGP -> ? different route - not oromucosal.paste AMCINOL 40MG/ML I.M AMP. SIGMA TEC 11.00 EGP -> ? different route - not oromucosal.paste EPIRELEFAN 40MG/ML I.M AMP. EIPICO 38.00 EGP -> ? different route - not oromucosal.paste SYNTHECORTIN 40MG/ML I.M AMP. MUP 54.00 EGP -> ? different route - not oromucosal.paste 2. CHLORHEXIDINE [add-on - not a substitute] Adult Rinse with 10 mL of 0.2% mouthwash for 1 minute twice daily - Continue for 48 hours after clinical resolution Peds Children under 12 years of age should not use the product unless recommended by a healthcare professional. Source Corsodyl 0.2% Mouthwash SmPC sections 4.2 and 4.4 (eMC product 529) Why Antiseptic mouthwash added alongside the topical steroid to reduce the bacterial load over the ulcer and guard against secondary infection; supports the anti-inflammatory treatment rather than replacing it. Caution Accelerates healing and prevents secondary bacterial infection of ulcers. May cause reversible brown staining of teeth and tongue with prolonged use. Do not rinse with water or use toothpaste immediately after rinsing. Do not use straight after toothpaste - it inactivates chlorhexidine. Separate the two, rinsing the mouth in between, or use them at different times of day. A course of about one month is what the label describes; staining of the teeth is temporary. Egypt ELUGEL ORAL GEL 20 GM GLOBAL NAPI P... 6.50 EGP RECARE ORAL GEL 30 GM UNIPHARMA CO.... 14.95 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)