Worry in Mouth Ulcers

There are many forms of mouth ulcers. Most of them are not very serious and are NOT a cancer. The two most common are the ones you have mentioned: cold sore or herpes simplex ulcers and aphtous ulcers.

Cold sores are ulcers caused by a virus called herpes simplex. They often appear on lips or the face and sometimes may affect the eye. They are very painful and the pain is burning in nature. The virus attacks the roots of the nerves and once in your body will always be there.
It does not mean, however, that you will always be sick. The ulcer, which starts as a painful blister, will eventually heal and may not return for months, even years. It often gets reactivated when our self-defense or immune system is down and weakened like during an illness or during stressful situations.

Some treat herpes ulcers with antiviral medications, but honestly, their help is minimal. Topical antiviral creams are even less effective.

One has to be careful when having an active ulcer because the ulcers can spread from person to person by touching and kissing. When a painful ulcer is present near the eye, it is very important to see an eye doctor immediately because the herpetic ulcers can scar the eye when healing.
The exact cause of many aphthous ulcers is unknown. Factors that provoke them include citrus (orange juice, lemons, acidic items, etc.), stress, fatigue, illness, injury from accidental biting, hormonal changes, menstruation, sudden weight loss, food allergies, the foaming agent in toothpaste (sodium lauryl sulfate or SLS), and deficiencies in vitamin B12, iron, and folic acid.
Some drugs, such as nicorandil, also have been linked to mouth ulcers.
In some cases they are thought to be caused by an overreaction by the body's own immune system.


Trauma to the mouth is the most common trigger of aphthous ulcers. Physical trauma, such as that caused by toothbrush abrasions, laceration with sharp or abrasive foods (toast) or objects, accidental biting (particularly common with sharp canine teeth), or dental braces can cause mouth ulcers by breaking the mucous membrane.

Other factors, such as chemical irritants or thermal injury, may also lead to the development of ulcers. The large majority of toothpastes sold in the U.S. contain SLS, which is known to cause aphthous ulcers in certain individuals. Using toothpaste without SLS will reduce the frequency of aphthous ulcers in persons who experience aphthous ulcers caused by SLS. A possible cause of aphthous ulcers in a susceptible population is gluten intolerance (Celiac disease), whereby consumption of wheat, rye, barley and sometimes oats, results in chronic mouth ulcers.

One study concluded that one-third of its test group found relief from canker sores after eliminating gluten from the diet. This means observing a strict diet, eliminating breads, pastas, cakes, pies, scones, biscuits, beers and so on from the diet and substituting gluten-free varieties where available. The opportunity to go into such a drastic measure is to be balanced with its potential benefits.

Although the exact cause is not known, aphthous ulcers are thought to form when the body becomes aware of and attacks molecules which it does not recognize. The presence of the unrecognized molecules starts a reaction by the T-cells, which trigger a reaction that causes the damage of a mouth ulcer. People who get these ulcers have lower numbers of regulatory T-cells.
Playing wind musical instruments such as the clarinet may also aggravate the ulcers. Repeat episodes of aphthous ulcers can be indicative of the low levels of immunoglobulin in the mucous membrane of the mouth. Immunoglobulins are proteins which play a very important role in our defense system. Certain types of chemotherapy cause mouth ulcers as a side effect. Mouth ulcers may also be symptoms or complications of several diseases. The list is long and includes, but is not limited to Behçet's disease, bullous pemphigoid, celiac disease (gluten sensitivity), Crohn's disease, gingivostomatitis, leukoplakia, oral lichen planus, lupus erythematosus, neutropenia (low white cell count), oral thrush (fungal infection) and ulcerative colitis. The treatment depends on the believed cause. Since it is impossible to clearly identify if your problem may be due to any of these diseases seeing a skin doctor is the next step for you. Your doctor was right. Most of the patients experiencing mouth ulcers will benefit from symptomatic treatment like local anesthetics.

Honey is believed to be a very helpful remedy according to the ancient Indian science of Ayurveda. I hope that you find the an effective relief soon.