Review of over-the-counter treatments for aphthous ulceration and results from use of a dissolving oral patch containing glycyrrhiza complex herbal extract

The aim of this article is to present a review of over-the-counter (OTC) treatment strategies used for aphthous ulcerations and to provide results from the use of an herbal extract containing glycyrrhiza. Aphthous ulceration, a disease of the intra-oral mucosa, is a common condition of unknown etiology that is often self-managed by OTC (no prescription required) medication. Preparations currently on the market can be divided into several categories: local anesthetic agents, oxygenating agents, mouth rinses, and barriers - further subdivided into paste coverings such as gels or dissolvable or non-dissolvable adhesive patches containing plant extract or synthetic drugs. Other strategies include herbs, hematinic replacement, or off-label OTC drug applications. While many OTC treatments are available and accepted for use with aphthous ulceration, a review of the literature via a number of published research search engines suggests that to date there are no randomized controlled studies to demonstrate OTC preparations do more than manage symptoms. Exceptions include OTC cyanoacrylate products and CankerMelts GX patches which include glycyrrhiza (licorice) extract. The use of CankerMelts has been shown to alter the course of the condition by reducing lesion duration, size, and pain. The results of the studies reviewed here suggest CankerMelts GX discs may be as effective as amlexanox (which must be prescribed) in reducing pain and speeding healing. In addition it can be applied by the patient without the adverse events associated with cyanoacrylate formulations.