Pearls of Wisdom: Aphthous Ulcers Part II
Answer: Beta blockers (eg, propranolol)
Eliminating sodium lauryl sulfate (SLS)-containing toothpaste can sometimes make a major difference in canker sore recurrence. But if that doesn’t do the job, what else can you do? An interesting study published over a decade ago suggests that a low dose of beta blockers may be a good next step. And, since the dose is very low, expense is low, and tolerability is good, it may be a worthwhile effort.
The Research
In a reasonable-sized study with 179 individuals with recurrent aphthous ulcers, researchers tested an incidental observation that canker sores improved in a patient who was receiving beta blockers for another indication.
Recurrent Alphous Ulcers1
All study subjects had frequent ulcers at baseline, and were started on propranolol or placebo. Propranolol was dosed at 30 mg/d for 1 week and tapered to 20 mg/d for 1 week, followed by 10 mg/d for 2 months.
The Results
Complete ulcer resolution was seen in 68% of the beta blocker group versus only 7.7% of placebo, and some patients remained ulcer-free for as long as 3 years. There were no serious adverse events, and the dose of beta blocker employed was insufficient to have a meaningful impact upon blood pressure, hence no reports of hypotension.
Recurrent Alphous Ulcers: Results1
What’s the “Take Home?”
Because of its low toxicity profile and expense, beta blockers may be worthwhile in patients with recurrent canker sores.
Reference:
1. Goldman EK. Beta-blocker effective in clearing recurrent aphthous ulcers. Family Practice News. 2002;11:24.
