Table of ContentsView AllTable of ContentsTypesSymptomsWhen to See a Healthcare ProviderCausesTreatmentPrevention
Table of ContentsView All
View All
Table of Contents
Types
Symptoms
When to See a Healthcare Provider
Causes
Treatment
Prevention
Canker sores, also known asaphthous ulcersor recurringaphthous stomatitis, are small pitted lesions (sores) that occur inside the mouth. There are three types of canker sores that can be uncomfortable and make it difficult to eat or even talk.
This article discusses the symptoms and treatment of three types of canker sores—including their appearance and who may be at risk. It presents possible causes of canker sores and ways to tell them apart from other types of mouth sores.
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Types of Canker Sores
Not all canker sores are alike. Canker sores all occur in the mouth, but they may be classified as minor, major, orherpetiform.
Men and women tend to be equally affected, although women appear to have a slightly greater risk of herpetiform sores.Bacterial changes may play a role in developing the sores. An underlying disease (likedigestive illness) or medication use (as with nonsteroidal anti-inflammatory drugs, orNSAIDs) are among factors that can increase your risk.
Minor or Simple
Minor canker sores are the most common type accounting for around 80% of cases. The size can vary, but they are typically between 1/3 inch and 1/2 inch. They are also sometimes referred to as simple canker sores.
Although painful, minor canker sores are often fully healed within two weeks. They can occur spontaneously, often after a minor mouth injury (from a spicy food, for example) or during times when you are chronically overworked, stressed, and exhausted.
Other causes can include:
Major or Complex
Major canker sores are larger than 1/2 inch and tend to last for up to six weeks. In many cases, these sores begin in adolescence and become a chronic, lifelong condition. These account for 10% of canker sores.
Where minor canker sores are typically round and symmetrical, major canker sores often have irregular, oddly-shaped borders. On rare occasions, this type of canker sore can leave behind a scar.
Major canker sores may also be referred to as complex canker sores. Their causes can include:
1:27Click Play to Learn About the Potential Causes of Canker Sores
1:27
Click Play to Learn About the Potential Causes of Canker Sores
Herpetiform Canker Sores
Herpetiform canker sores are a cluster of several tiny lesions that often converge to form one large sore. Hundreds of pinhead-sized lesions can be involved. Herpetiform canker sores may last from one week to one month.
These canker sores can look like a herpes outbreak, but the herpes virus is not involved. The cause is unknown but they tend to occur later in life.
Herpetiform canker sores represent 5% of aphthous ulcer diagnoses and tend to affect younger adults. These sores are often diagnosed in people with a SARS-CoV-2 (COVID-19) infection, but studies have yet to establish exactly why.
Canker Sore Symptoms
Canker sores appear inside of the mouth as round or oval sores typically with a raised border and a yellow, gray, or white center. They typically develop:
One to two days before the appearance of the lesion, there may be a localized burning or tingling sensation inside the mouth.
Canker sores can become quite painful, especially when eating, drinking, and talking.
You should see a healthcare provider for your mouth sores if they have not healed and last more than two weeks. Other reasons to see a healthcare provider include:
If you have more severe symptoms of fever, skin rash, swollen lymph nodes, or trouble swallowing along with your sores, contact your healthcare provider.
STIs and Different Types of Mouth Sores
Differences Among Cold Sores vs. Canker Sores vs. Chancres
While the ofcauses canker soresare unknown, along with previously discussed factors, underlying health conditions that may increase your risk can include:
Why Do I Keep Getting Canker Sores?
Canker sores do not necessarily need to be treated. If they do, they may respond toat-home remedieslike a saltwater-and-sodium-bicarbonate mouth rinse.
Home Remedies to Try
Mix half water with half hydrogen peroxide, and use a cotton swab to apply it to the sore. Then put a small amount of Milk of Magnesia on it, repeating these steps three to four times a day.
Or, you can mix Milk of Magnesia and Benadryl liquid in equal parts. Swish the mixture in the mouth for about one minute and then spit out.
Medications
Over-the-counter options include topical numbing agents like Anbesol (benzocaine). When severe, prescription drugs may be needed. These include topical steroids like Lidex (fluocinonide), antacids like Carafate (sucralfate), or oral steroids like Decadron (dexamethasone).
If your canker sore is large and painful, your healthcare provider may prescribe an antibacterial mouth rinse or a corticosteroid ointment. Over-the-counter oral pain gels are also available to help ease symptoms.
Canker Sore Prevention
One of the best ways to avoid canker sores is to treat the underlying cause, and your healthcare provider can help you with a diagnosis.
For example, improperly fitting dentures or broken teeth should be repaired. Dietary changes may help if you have celiac disease or IBD or tend to get sores after eating certain foods. They also can help to address any vitamin deficiencies that may be part of the problem.
Stress management techniques may also help as stress can lead to canker sores in some people.
Oral Hygiene Tips
Summary
Canker sores, also known as aphthous ulcers, are painful, pitted sores inside the mouth. There are three different types: minor canker sores (the most common type), major canker sores (often seen in immunosuppressed people), and herpetiform canker sores (which cause clusters of pinhead-sized lesions).
Although the cause of canker sores is poorly understood, they are linked to stress, mouth injuries, food sensitivities, vitamin deficiency, menstruation, digestive disorders, and impaired immunity. Canker sores don’t always need to be treated, but some may benefit from a topical numbing agent, antiseptic mouthwash, changes in diets, or oral or topical steroids.
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10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gasmi Benahmed A, Noor S, Menzel A, Gasmi A.Oral Aphthous: Pathophysiology, Clinical Aspects and Medical Treatment.Arch Razi Inst. 2021 Nov 30;76(5):1155-1163. doi:10.22092/ari.2021.356055.1767.Penn Medicine.Cold Sores vs. Canker Sores: What Are They and How Do I Get Rid of ‘Em?Icahn School of Medicine at Mount Sinai.Mouth sores.Manfredini M, Guida S, Giovani M, Lippolis N, Spinas E, Farnetani F,et al.Recurrent Aphthous Stomatitis: Treatment and Management.Dermatol Pract Concept. 2021 Sep 1;11(4):e2021099. doi: 10.5826/dpc.1104a99.Hara Y, Shiratuchi H, Kaneko T, Sakagami H.Search for Drugs Used in Hospitals to Treat Stomatitis.Medicines (Basel). 2019 Jan 29;6(1):19. doi:10.3390/medicines6010019Reis VP, Bezerra AR, Maia ABP, Marques LC, Conde DC.An integrative review of oral manifestations in patients with COVID-19: signs directly related to SARS-CoV-2 infection or secondary findings?Int J Dermatol. 2022 Mar;61(3):278-290. doi: 10.1111/ijd.15881.Workowski KA, Bachmann LH, Chan PA, et al.Sexually transmitted infections treatment guidelines, 2021.MMWR Recomm Rep. 2021;70(4):1-187. doi:10.15585/mmwr.rr7004a1Khemiss M, Hajjaj S, Blouza I, Beji M.Oral manifestations of Behçet’s disease.Tunis Med. 2022 avril;100(4):303-308. English. PMID: 36155901Altenburg A, El-Haj N, Micheli D, Putttkammer M, Adbel-Naser MB, Zouboulis CC.The treatment of chronic recurrent oral aphthous ulcers.Dtsch Arztebl Int.2014 Oct;111(40):665–73. doi:10.3238/arztebl.2014.0665Ziaudeen, S., and R. Ravindran.Assessment of Oxidant-Antioxidant Status and Stress Factor in Recurrent Aphthous Stomatits Patients: Case Control Study.Journal of Clinical and Diagnostic Research. 2017. 11(3):ZC01-ZC04. doi:10.7860/JCDR/2017/22894.9348Additional ReadingEdgar, N., Saleh, D., and R. Miller.Recurrent aphthous stomatitis: a review.J Clin Aesthetic Dermatol. 2017;19(3):26-36.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gasmi Benahmed A, Noor S, Menzel A, Gasmi A.Oral Aphthous: Pathophysiology, Clinical Aspects and Medical Treatment.Arch Razi Inst. 2021 Nov 30;76(5):1155-1163. doi:10.22092/ari.2021.356055.1767.Penn Medicine.Cold Sores vs. Canker Sores: What Are They and How Do I Get Rid of ‘Em?Icahn School of Medicine at Mount Sinai.Mouth sores.Manfredini M, Guida S, Giovani M, Lippolis N, Spinas E, Farnetani F,et al.Recurrent Aphthous Stomatitis: Treatment and Management.Dermatol Pract Concept. 2021 Sep 1;11(4):e2021099. doi: 10.5826/dpc.1104a99.Hara Y, Shiratuchi H, Kaneko T, Sakagami H.Search for Drugs Used in Hospitals to Treat Stomatitis.Medicines (Basel). 2019 Jan 29;6(1):19. doi:10.3390/medicines6010019Reis VP, Bezerra AR, Maia ABP, Marques LC, Conde DC.An integrative review of oral manifestations in patients with COVID-19: signs directly related to SARS-CoV-2 infection or secondary findings?Int J Dermatol. 2022 Mar;61(3):278-290. doi: 10.1111/ijd.15881.Workowski KA, Bachmann LH, Chan PA, et al.Sexually transmitted infections treatment guidelines, 2021.MMWR Recomm Rep. 2021;70(4):1-187. doi:10.15585/mmwr.rr7004a1Khemiss M, Hajjaj S, Blouza I, Beji M.Oral manifestations of Behçet’s disease.Tunis Med. 2022 avril;100(4):303-308. English. PMID: 36155901Altenburg A, El-Haj N, Micheli D, Putttkammer M, Adbel-Naser MB, Zouboulis CC.The treatment of chronic recurrent oral aphthous ulcers.Dtsch Arztebl Int.2014 Oct;111(40):665–73. doi:10.3238/arztebl.2014.0665Ziaudeen, S., and R. Ravindran.Assessment of Oxidant-Antioxidant Status and Stress Factor in Recurrent Aphthous Stomatits Patients: Case Control Study.Journal of Clinical and Diagnostic Research. 2017. 11(3):ZC01-ZC04. doi:10.7860/JCDR/2017/22894.9348Additional ReadingEdgar, N., Saleh, D., and R. Miller.Recurrent aphthous stomatitis: a review.J Clin Aesthetic Dermatol. 2017;19(3):26-36.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Gasmi Benahmed A, Noor S, Menzel A, Gasmi A.Oral Aphthous: Pathophysiology, Clinical Aspects and Medical Treatment.Arch Razi Inst. 2021 Nov 30;76(5):1155-1163. doi:10.22092/ari.2021.356055.1767.Penn Medicine.Cold Sores vs. Canker Sores: What Are They and How Do I Get Rid of ‘Em?Icahn School of Medicine at Mount Sinai.Mouth sores.Manfredini M, Guida S, Giovani M, Lippolis N, Spinas E, Farnetani F,et al.Recurrent Aphthous Stomatitis: Treatment and Management.Dermatol Pract Concept. 2021 Sep 1;11(4):e2021099. doi: 10.5826/dpc.1104a99.Hara Y, Shiratuchi H, Kaneko T, Sakagami H.Search for Drugs Used in Hospitals to Treat Stomatitis.Medicines (Basel). 2019 Jan 29;6(1):19. doi:10.3390/medicines6010019Reis VP, Bezerra AR, Maia ABP, Marques LC, Conde DC.An integrative review of oral manifestations in patients with COVID-19: signs directly related to SARS-CoV-2 infection or secondary findings?Int J Dermatol. 2022 Mar;61(3):278-290. doi: 10.1111/ijd.15881.Workowski KA, Bachmann LH, Chan PA, et al.Sexually transmitted infections treatment guidelines, 2021.MMWR Recomm Rep. 2021;70(4):1-187. doi:10.15585/mmwr.rr7004a1Khemiss M, Hajjaj S, Blouza I, Beji M.Oral manifestations of Behçet’s disease.Tunis Med. 2022 avril;100(4):303-308. English. PMID: 36155901Altenburg A, El-Haj N, Micheli D, Putttkammer M, Adbel-Naser MB, Zouboulis CC.The treatment of chronic recurrent oral aphthous ulcers.Dtsch Arztebl Int.2014 Oct;111(40):665–73. doi:10.3238/arztebl.2014.0665Ziaudeen, S., and R. Ravindran.Assessment of Oxidant-Antioxidant Status and Stress Factor in Recurrent Aphthous Stomatits Patients: Case Control Study.Journal of Clinical and Diagnostic Research. 2017. 11(3):ZC01-ZC04. doi:10.7860/JCDR/2017/22894.9348
Gasmi Benahmed A, Noor S, Menzel A, Gasmi A.Oral Aphthous: Pathophysiology, Clinical Aspects and Medical Treatment.Arch Razi Inst. 2021 Nov 30;76(5):1155-1163. doi:10.22092/ari.2021.356055.1767.
Penn Medicine.Cold Sores vs. Canker Sores: What Are They and How Do I Get Rid of ‘Em?
Icahn School of Medicine at Mount Sinai.Mouth sores.
Manfredini M, Guida S, Giovani M, Lippolis N, Spinas E, Farnetani F,et al.Recurrent Aphthous Stomatitis: Treatment and Management.Dermatol Pract Concept. 2021 Sep 1;11(4):e2021099. doi: 10.5826/dpc.1104a99.
Hara Y, Shiratuchi H, Kaneko T, Sakagami H.Search for Drugs Used in Hospitals to Treat Stomatitis.Medicines (Basel). 2019 Jan 29;6(1):19. doi:10.3390/medicines6010019
Reis VP, Bezerra AR, Maia ABP, Marques LC, Conde DC.An integrative review of oral manifestations in patients with COVID-19: signs directly related to SARS-CoV-2 infection or secondary findings?Int J Dermatol. 2022 Mar;61(3):278-290. doi: 10.1111/ijd.15881.
Workowski KA, Bachmann LH, Chan PA, et al.Sexually transmitted infections treatment guidelines, 2021.MMWR Recomm Rep. 2021;70(4):1-187. doi:10.15585/mmwr.rr7004a1
Khemiss M, Hajjaj S, Blouza I, Beji M.Oral manifestations of Behçet’s disease.Tunis Med. 2022 avril;100(4):303-308. English. PMID: 36155901
Altenburg A, El-Haj N, Micheli D, Putttkammer M, Adbel-Naser MB, Zouboulis CC.The treatment of chronic recurrent oral aphthous ulcers.Dtsch Arztebl Int.2014 Oct;111(40):665–73. doi:10.3238/arztebl.2014.0665
Ziaudeen, S., and R. Ravindran.Assessment of Oxidant-Antioxidant Status and Stress Factor in Recurrent Aphthous Stomatits Patients: Case Control Study.Journal of Clinical and Diagnostic Research. 2017. 11(3):ZC01-ZC04. doi:10.7860/JCDR/2017/22894.9348
Edgar, N., Saleh, D., and R. Miller.Recurrent aphthous stomatitis: a review.J Clin Aesthetic Dermatol. 2017;19(3):26-36.
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