Ulcer, aphthous

A small, painful ulcer that occurs, alone or in a group, on the inside of the cheek or lip or underneath the tongue. Aphthous ulcers are most common between the ages of 10 and 40 and affect more women than men. The most severely affected people have continuously recurring ulcers; others have just 1 or 2 ulcers each year. Each ulcer is usually small and oval, with a grey centre and a surrounding red, inflamed halo. The ulcer, which usually lasts for 1–2 weeks, may be a hypersensitive reaction to haemolytic streptococcus bacteria. Other factors commonly associated with the occurrence of these ulcers are minor injuries (such as at an injection site or from a toothbrush), acute stress, or allergies (such as allergic rhinitis). In women, aphthous ulcers are most common during the premenstrual period. They may also be more likely if other family members suffer from recurrent ulceration. Analgesic mouth gels or mouthwashes may ease the pain of an aphthous ulcer. Some ointments form a waterproof covering that protects the ulcer while it is healing. Ulcers heal by themselves, but a doctor may prescribe a paste containing a corticosteroid drug or a mouthwash containing an antibiotic drug to speed up the healing process.