Written by Greg Arnold, DC, CSCS. Applications of aloe or myrrh for 5 days in participating subjects resulted in a 38% decrease in ulcer size from application of aloe and a 21% decrease in pain intensity from application of myrrh when compared to a placebo.
Recurrent aphthous stomatitis, characterized by the presence of an ulcer on the lips or tongue, is the most common disease of the mouth. The characteristic feature that precedes the appearance of the ulcer is a burning sensation that lasts from 2 to 48 hours. The exact cause of recurrent aphthous stomatitis is unknown, but it occurs in otherwise healthy individuals. Contributing factors are known to include trauma in those genetically susceptible to the condition, bacteria/viral infection, stress, allergies, and even B-vitamin deficiency (1).
The current treatment for recurrent aphthous stomatitis includes prescription topical agents (2, 3). Now a new study (4) suggests that a more natural topical treatment with either aloe vera or myrrh may be a benefit.
The study involved 90 subjects (38 men, 52 women) aged 23 to 38 with recurrent aphthous stomatitis. They applied either a topical treatment containing aloe (0.5% = 30 subjects), myrrh (0.5% = 30 subjects), or placebo (30 subjects) 4 times per day for 5 days. Each subject was evaluated before treatment started and at day 6 to evaluate for changes in ulcer size, pain intensity, redness (“erythema”), and ulcer discharge (called “exudation”) while also interviewing each subjects regarding side effects.
By day 6, the researchers noted the following benefits of the 3 treatments:
| Aloe | Myrrh | Placebo | p-value | |
|---|---|---|---|---|
| Ulcer Size (cm2) | 69.5% decrease (6.17 to 2.5) | 41.5% decrease (5.98 to 3.5) | 31.5% decrease (6.13 to 4.2) | < 0.05 |
| Pain Intensity | 31.5% decrease (6.13 to 4.2) | 84.4% decrease (4.61 to 0.72) | 63.3% decrease (4.62 to 1.7) | < 0.05 |
No significant differences were seen with redness or exudation (p > 0.05).
When suggesting mechanisms for how aloe and myrrh elicit these healthful benefits, the researchers pointed to studies showing 2 components of aloe, glucomannan and gibberellin, to stimulate wound healing and increase blood supply (6, 7). Myrrh has been shown to promote healing and repair of damaged tissue (8) by affecting the activity of white blood cells (9). Unfortunately, no comment was made as to why the placebo group had a 31.5% decrease in ulcer size and a 63.3% decrease in pain.
For the researchers, “The new formulated aloe- and myrrh-based gels proved to be effective in topical management of recurrent aphthmous stomatitis” and “The fact that no side effects were encountered with the use of any of the three mucoadhesive gels supports the safety of this drug formulation.”
Source: Mansour, Ghada, et al. “Clinical efficacy of new aloe vera‐and myrrh‐based oral mucoadhesive gels in the management of minor recurrent aphthous stomatitis: a randomized, double‐blind, vehicle‐controlled study.” Journal of Oral Pathology & Medicine 43.6 (2014): 405-409.
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Posted December 23, 2015.
Greg Arnold is a Chiropractic Physician practicing in Hauppauge, NY. You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com.
References:
- Akintoye SO. Recurrent aphthous stomatitis. Dent Clin North Am 2014 Apr;58(2):281-97. doi: 10.1016/j.cden.2013.12.002. Epub 2014 Jan 21
- Saxen MA, Ambrosius WT, Rehemtula al KF, Russell AL, Eckert GJ. Sustained relief of oral aphthous ulcer pain from topical diclofenac in hyaluronan: a randomized, double-blind clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997 Oct;84(4):356–361
- Khandwala A, Van Inwegen RG, Alfano MC. 5% amlexanox oral paste, a new treatment for recurrent minor aphthous ulcers: I. Clinical demonstration of acceleration of healing and resolution of pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997 Feb;83(2):222–230
- Mansour G. Clinical efficacy of new aloe vera- and myrrh-based oral mucoadhesive gels in the management of minor recurrent aphthous stomatitis: a randomized, double-blind, vehicle-controlled study. J Oral Pathol Med 2014 Jul;43(6):405-9. doi: 10.1111/jop.12130. Epub 2013 Oct 25
- Chithra R, Sajithlal GB, Chandrakasan G. Influence of aloe vera on the glycosaminoglycan in the matrix of healing dermal wound in rat. J Ethnopharmacol 1998; 59: 179–86.
- Josias H. Hamman composition and applications of aloe vera leaf gel. Molecules 2008; 13: 1599–616.
- Al-Mobeeriek A. Effects of myrrh on intra-oral mucosal wounds compared with tetracycline- and chlorhexidine-based mouthwashes. Clin Cos Investig Dent 2011; 3: 53–8
- Haffor AS. Effect of myrrh (Commiphora molmol) on
- leukocyte levels before and during healing from gastric ulcer or skin injury. J Immunotoxicol 2010; 7: 68–75.
