An open mouth saying ah.

Lupus Mouth & Nose Ulcers

Most people with lupus develop some type of skin problems during the course of their disease, and painful ulcers or sores that appear in the mouth are one of the most common. These ulcers may also develop in the nose, vagina, eyes, and anus.

Mouth (oral) and nose (nasal) ulcers are one of the symptoms doctors look for when diagnosing lupus because they appear in 25 percent to 45 percent of people with lupus.1,3 You may also see these sores called mucosal ulcers because they appear on the mucosa, the skin (membrane) that lines cavities in the body.

What do lupus mouth sores look like?

There are 2 types of lupus mouth sores. The first type is usually painless and looks like a raised white bump surrounded by a reddish line. The second type is sometimes painful and appears red with a white halo or white lines around the sore.

Some people say these ulcers feel like a canker sore, the type of sore you get from accidentally biting the inside of your cheek, or like burning the roof of your mouth on hot food. Lupus mouth sores tend to develop on the roof of the mouth but can appear anywhere. Nose ulcers most often appear on the septum (the wall dividing the left and right nostrils).1-3

Mouth and nose ulcers causes

These sores may appear during lupus flares, along with joint pain, rashes on other parts of the body, and hair loss. In some people, stress or being overly tired may make mouth ulcers worse. In others, mouth ulcers are a signal that a flare is coming.

These sores may be triggered during a severe flare, the hormonal changes of pregnancy, when you are low on vitamin B12 or iron, or when you take NSAIDs or beta-blockers. The good news is that mouth ulcers tend to go away when the flare subsides.1-3

Ulcer treatments

These sores can be quite uncomfortable or painful but are not usually dangerous to your health. Treatments for mouth and nose ulcers include:1-3

  • Antimalarials and steroids to control all of your lupus symptoms, including mouth and nose ulcers
  • A special mouthwash or toothpaste to help mouth ulcers heal more quickly
  • A painkilling spray, mouthwash, or gel such as Orajel, Orabase, or Anbesol, for especially painful ulcers
  • Steroid nasal sprays for sores in the nose

Tips for managing mouth ulcers

There are several things you can try to either help prevent mouth ulcers or help them heal once they appear, including:1-3

  • Use a soft-bristle toothbrush to avoid irritating the gums
  • Eat soft foods and avoid rough, crunchy foods like popcorn
  • Get regular dental check-ups
  • Avoid very hot or acidic drinks such as too-hot coffee or orange juice
  • Avoid very spicy, salty, or acidic foods
  • Do not chew gum

Foods to avoid

Certain foods are known to increase the risk of developing mouth ulcers in some people. These goods include:1-3

  • Chocolate
  • Coffee
  • Peanuts
  • Almonds
  • Strawberries
  • Cheese
  • Tomatoes
  • Wheat flour

It may help to keep a food diary to identify which foods make your mouth more sensitive or seem to be connected to sores cropping up after eating.

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Written by: Jessica Johns Pool | Last reviewed: January 2020