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What are Canker Sores?

Canker sores, also called apthous ulcers, are small, painful ulcers inside the mouth.

They typically have a red border, are not contagious, and may occur on your tongue, inside your cheeks or lips, and on floor of your mouth.

Although canker sores are common, in many cases the cause is unknown. They generally take one to two weeks to heal.

Cold sores, in contrast, are found on the lips, gums, or the hard part of the roof of your mouth (hard palate) and are extremely contagious.

• Photo of a canker sore
  
• Close-up photo of a canker sore

Canker Sore Remedies

These are some natural remedies that are being explored for the treatment of canker sores. It's important to see a doctor, especially if canker sores recur, because they can be a symptom of another condition, such as celiac disease, Behcet's syndrome, inflammatory bowel disease, and squamous cell carcinoma.

German Chamomile

Chamomile is a herb that has been used traditionally for thousands of years. It has been used to treat a variety of conditions such as sore throats, gingivitis, eczema, psoriasis, irritable bowel syndrome, colds, abscesses, and ulcerative colitis.

Chamomile is also used to relieve pain in people with canker sores. In one preliminary study, 82% of people taking a German chamomile extract reported "excellent" pain relief. The study didn't include a placebo group, however, so it's impossible to know the true effectiveness of German chamomile in this study.

People with allergies to ragweed, chrysanthemum, aster, or feverfew should avoid chamomile because it is in the same plant family. Allergic reactions, which require urgent medical attention, may include swollen eyes and lips, itching, hives, throat tightness, shortness of breath.

Chamomile may interact with sedative medications, alcohol, and anti-clotting and anti-platelet ("blood-thinning") medications such as warfarin (coumadin).

• Chamomile Fact Sheet
  
• Chamomile - Drug Interactions
  
• Chamomile and Warfarin (Coumadin) Don't Mix

Lady's Mantle

The herb lady's mantle (Alchemilla vulgaris) has been used as a folk remedy for mouth and throat infections, menopausal ailments, painful menstrual periods, and skin rashes.

One preliminary study examined the effectiveness of a gel containing lady's mantle (3% extract of lady's mantle) in glycerine in 48 people.with canker sores. People applied the gel three times daily. After three days, the lady's mantle gel relieved discomfort and healed canker sores in 75% of people, compared with 40 percent who used commonly available treatments and 33.3% who used no treatment.

Vitamin B12

People with recurrent canker sores have been found to be low in vitamin B12. Vitamin B12, also called cobalamin, is a water-soluble B vitamin that is important for maintaining nerve cells, producing DNA and RNA (our genetic material), forming red blood cells, helping iron function better in the body, improving immune function, and helping the body withstand stress.

Symptoms of vitamin B12 deficiency include fatigue, shortness of breath, nervousness, diarrhea, and numbness or tingling in the fingers and toes. People who are at risk for vitamin B12 deficiency are those who have had stomach surgery, follow a strict vegetarian or vegan diet, have certain intestinal infections such as tapeworm or Helicobacter pylori, or have an eating disorder.

Vitamin B12 supplements should not be taken with the antibiotic tetracycline, because it may reduce the effectiveness of the antibiotic.

Deglycyrrhizinated licorice (DGL)

A form of the herb licorice, called deglycyrrhizinated licorice or DGL, has been explored for canker sores in a small study. By the third day of the study, 75 percent or 15 people had complete healing of canker sores. The study lacked a placebo group, however, which makes it impossible to conclude from this study that DGL was effective.

The study used a mouthwash made of powdered DGL mixed with water. DGL is different from crude licorice because it has had the glycyrrhizic acid removed, the portion that can increase blood pressure. Alternatively, DGL tablets can be allowed to dissolve in the mouth.


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Koybasi S, Parlak AH, Serin E, Yilmaz F, Serin D. Recurrent aphthous stomatitis: investigation of possible etiologic factors. Am J Otolaryngol. 27.4 (2006): 229-232.

Lahteenoja H, Toivanen A, Viander M, Maki M, Irjala K, Raiha I, Syrjanen S. Oral mucosal changes in coeliac patients on a gluten-free diet. Eur J Oral Sci. 106.5 (1998): 899-906.

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Piskin S, Sayan C, Durukan N, Senol M. Serum iron, ferritin, folic acid, and vitamin B12 levels in recurrent aphthous stomatitis. J Eur Acad Dermatol Venereol. 16.1 (2002): 66-67.

Ramos-e-Silva M, Ferreira AF, Bibas R, Carneiro S. Clinical evaluation of fluid extract of Chamomilla recutita for oral aphthae. J Drugs Dermatol. 5.7 (2006): 612-617.

Volkov I, Rudoy I, Abu-Rabia U, Masalha T, Masalha R. Case report: Recurrent aphthous stomatitis responds to vitamin B12 treatment. Can Fam Physician. 51 (2005): 844-845.</sub>