Mouth sores can be a symptom of lupus or a warning sign of a lupus flare. They require medical treatment but may or may not be painful.

Lupus is a chronic autoimmune condition that causes inflammation throughout the body. Symptoms of lupus include widespread pain, rashes, and fatigue. For many people, lupus comes and goes in episodes called flares.

Mouth sores are a common lupus symptom and are often the first sign of a lupus flare. When these painful red bumps appear, it’s a good time to contact your doctor.

People with lupus can develop mouth sores during flares and during lupus remission. During lupus remission, mouth sores are typically a side effect of a medication that’s been prescribed to treat lupus.

During lupus flares, mouth sores are part of the system-wide immune inflammation that causes a range of other lupus symptoms such as rashes and joint pain. Mouth sores during a flare are more common at certain times.

This includes during:

Lupus mouth sores vs. canker sores

Canker sore is a broad term that’s used to talk about all mouth sores that aren’t caused by recent injuries or viral infections. Mouth ulcers and mouth sores are types of canker sores. However, canker sores can be treated at home and aren’t a cause for concern — unless you’re immunosuppressed.

If you have lupus and notice any sores inside your mouth at any time, it’s always important to let your doctor know. Mouth sores can be a sign your lupus is flaring and that treatment is needed.

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About 40% of people with lupus get mouth sores when they’re not experiencing flares. This is normally linked to medications. These ulcers are almost always painless.

Mouth ulcers are also very common during flares for people with lupus. Some people experience pain with this ulcer type while others don’t.

The appearance of lupus mouth sores depends on the type. There are two types of lupus mouth sores:

  1. The first type happens outside of flares as a side effect of many lupus medications. These sores are raised white bumps that are surrounded by red lines and are usually painless.
  2. The second type happens during a flare as a symptom of inflammation. These sores are red with a white halo or white lines extending around them and can be painful. They often appear on the roof of the mouth but can develop anywhere.

Picture of lupus-related mouth sores or ulcers

This image will give you an example of lupus mouth sores.

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Hs S. Systemic Lupus Erythematosus in a 12-Year-Old Boy: A Rare Entity in Childhood. Int J Clin Pediatr Dent. 2010 Sep-Dec;3(3):199-202. CC BY 3.0

It’s important to talk with your doctor if you notice mouth sores. Seeing a dentist regularly is a good idea for people with lupus, especially because mouth sores can be painless and located on the roof of your mouth. You may not know that they’ve developed.

However, since they can signal a lupus flare, it’s best to keep an eye out for them. If you or a dentist spots a mouth ulcer, let your doctor know. They order more testing and decide on the best treatment.

Typically, treating your lupus flare will also treat your mouth sores. You might also have treatment to help relieve any pain caused by mouth sores. Common treatments include:

  • adjusting or changing medications
  • topical corticosteroids
  • oral corticosteroids
  • antimalarials
  • medicated mouthwashes and toothpaste
  • pain-relieving and anti-inflammatory oral tooth gels and mouthwashes

Preventing pain from lupus mouth sores

Mouth sores can be painful. Your doctor can prescribe or recommend treatments that might help, such as mouth sprays, medicated mouthwashes, and pain relieving gels.

You can add to those recommendations with products from your local grocery or drug stores, such as soft-bristled toothbrushes, and nonabrasive fluoride toothpaste.

Your diet can also have an effect on mouth sore pain. To help manage mouth sores, it’s a good idea to:

  • avoid spicy food while sores are active
  • avoid acidic foods while sores are active
  • avoid popcorn, crackers, and other hard foods while sores are active
  • eliminate gum from your diet
  • limit your coffee consumption
  • limit foods that could increase the risk of mouth sores, such as peanuts, almonds, strawberries, tomatoes, cheese, wheat flour, and chocolate

How long do lupus mouth sores or ulcers last?

Lupus mouth sores typically clear up after several days of treatment. In some cases, such as if your lupus flare is severe, it might take a week or two.

If sores last for longer than 3 weeks, it’s a good idea to contact your doctor again. This could be a sign that treatment isn’t effective or of infection.

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Mouth sores are a common symptom of lupus. They can develop during flares and during lupus remission. When they happen outside of lupus flares, they’re typically a side effect of lupus medication.

These sores aren’t painful and are easily treated. When sores happen as part of a lupus flare, they can result in pain and are a sign of wider inflammation.

Sores are resolved as part of treatment for the lupus flare. This commonly includes medications such as corticosteroids. You can also manage the pain of mouth ulcers with treatments such as medicated mouthwashes.