The efficacy of topical 0.2% hyaluronic acid gel on recurrent oral ulcers: Comparison between recurrent aphthous ulcers and the oral ulcers of Behçet's disease

Background: Hyaluronic acid (HA) is a primary component of the extracellular matrix, and the efficacy of HA on oral ulcers is rarely reported. Objective: To observe the efficacy and safety of the topical application of 0.2% HA gel on recurrent oral ulcers and to compare its effects in patients with recurrent aphthous ulcers (RAU) and the oral ulcers of Behçet's disease (BD): Materials and methods: Thirty-three outpatients with recurrent oral ulcers were included in the study (17 patients: BD, 16 patients: RAU). The patients used topical 0.2% HA gel twice daily for 2.weeks. The subjective parameters of patients [number of ulcers, healing period, visual analogue scale (VAS) for pain]were investigated and objective assessments (number of ulcers, maximal area of ulcer and inflammatory signs) were inspected by a physician. Results: A subjective reduction in the number of ulcers was observed in 72.7% of the patients. A decrease in the ulcer healing period was observed in 72.7% of the patients; 75.8% experienced improvement in VAS for pain. Objective inspection of the ulcers showed a reduction of numbers in 57.6% of the patients, and 78.8% of the ulcers showed a decrease in area. Among the inflammatory signs, swelling and local heat were significantly improved after treatment. No significant differences were found between the BD group and RAU group in subjective and objective parameters, except for inflammatory signs. No side-effects were observed. Conclusions: The topical application of 0.2% HA gel seems to be an effective and safe therapy in patients with recurrent oral ulcers; the study supports the use of HA in BD with oral ulcers.