Throat Ulcers & Canker Sores in Throat: 12 Causes & Treatment

A throat ulcer is an open sore that develops in the lining of the throat. It can appear at the back of the throat, near the tonsils, or around the uvula, which is the small piece of tissue that hangs at the back of the mouth.

Throat ulcers can have different causes, including viral infections, injuries, certain medications, and inflammatory diseases. A canker sore, also called an aphthous ulcer, is one specific type of sore. It usually looks like a small, round, white or yellow spot with a red border and is not contagious.

Throat ulcers may cause pain when swallowing, eating, or talking. Some heal on their own within 1 to 2 weeks, while others need medical treatment. You should see a doctor if a sore lasts longer than 2 weeks, keeps coming back, or is accompanied by other symptoms, such as unexplained weight loss.

What causes throat ulcers

Canker sores in the throat can be caused by:

1. Canker sores (aphthous ulcers)

Canker sores, also called aphthous ulcers, are small, painful sores that develop on the soft lining of the mouth. They are not contagious.

They usually appear inside the cheeks, on the lips, or under the tongue. They can also develop on the soft palate near the back of the mouth, although this is less common.

A canker sore usually has a white or yellow center with a red border. It may cause pain when eating, drinking, swallowing, or talking.

The exact cause is unknown, but canker sores may be linked to minor injuries, stress, nutritional deficiencies, or a family history of the condition.

Up to 46% of people with recurrent canker sores have family members who also get them.

Most minor canker sores are less than 1 cm wide and heal within 1 to 2 weeks without leaving scars. Larger canker sores may take several weeks to heal and sometimes leave scars.

How to treat: Canker sores usually heal on their own. A doctor or dentist may recommend a corticosteroid gel or mouthwash to reduce inflammation and help the sore heal. Numbing gels may also help relieve pain.

Also recommended: Stomatitis: Symptoms, Diagnosis, Causes & Treatment tuasaude.com/en/stomatitis

2. Herpes simplex virus

The herpes simplex virus type 1 (HSV-1), which commonly causes cold sores, can also cause painful sores inside the mouth and around the throat.

During the first infection, the virus may cause small blisters that break open and form ulcers. Other symptoms may include fever, swollen lymph nodes, and a severe sore throat.

Unlike canker sores, herpes sores are caused by a contagious virus.

After the first infection, the virus remains in the body and can become active again. Outbreaks may be triggered by stress, illness, or sun exposure, although later outbreaks are usually milder.

How to treat: Herpes sores often heal within 1 to 2 weeks. A doctor may prescribe antiviral medications, such as acyclovir or valacyclovir, to help shorten the infection, especially when treatment starts early.

Also recommended: Herpes Symptoms: Genital Herpes, Cold Sores, Ocular Herpes & Shingles tuasaude.com/en/herpes-symptoms

3. Herpangina and hand, foot, and mouth disease

Herpangina and hand, foot, and mouth disease are contagious viral infections that mainly affect young children, although adults can also get them.

They are commonly caused by enteroviruses, including coxsackieviruses, and can spread through saliva, mucus, fluid from blisters, and stool.

Herpangina usually causes a sudden fever, sore throat, and small, painful blisters or ulcers at the back of the mouth and throat.

Hand, foot, and mouth disease can also cause fever and painful mouth sores. A rash with red spots or blisters may appear on the hands, feet, and sometimes other parts of the body.

These sores are caused by viral infections and are not canker sores.

How to treat: These infections usually clear up on their own within 7 to 10 days. Treatment focuses on relieving symptoms with rest, fluids, and medications such as acetaminophen or ibuprofen when appropriate.

Medical evaluation by a pediatrician is recommended for children who refuse to drink or show signs of dehydration.

4. Acid reflux and esophageal ulcers

Acid reflux can cause inflammation and, in more severe cases, ulcers in the esophagus, which is the tube that connects the throat to the stomach.

These are called esophageal ulcers. They are different from throat ulcers because they develop in the esophagus rather than in the throat.

However, they may cause similar symptoms, especially pain or difficulty swallowing.

Gastroesophageal reflux disease (GERD) is a common cause of esophageal ulcers. It happens when stomach acid repeatedly flows back into the esophagus, irritating and damaging its lining.

Other symptoms may include heartburn, a burning sensation behind the breastbone, nausea, and chest discomfort.

How to treat: A gastroenterologist may recommend acid-reducing medications, such as omeprazole, to help the esophagus heal.

An upper endoscopy may be needed to confirm the diagnosis and identify the cause.

Vomiting blood or having black, tarry stools requires emergency medical care.

Also recommended: GERD Diet: List of Foods to Eat & Avoid (& 3-Day Meal Plan) tuasaude.com/en/gerd-diet

5. Medications

Some medications can irritate or damage the lining of the mouth, throat, or esophagus.

These include certain chemotherapy medications and drugs that may cause mouth sores as a side effect.

Other medications can cause ulcers in the esophagus when pills become stuck or dissolve before reaching the stomach.

Examples include doxycycline, ibuprofen, naproxen, and certain medications used to treat osteoporosis.

These ulcers are caused by medication-related irritation or injury and are not canker sores.

How to treat: Prescribed medications should not be stopped without medical advice.

The doctor may recommend adjusting the dose, changing the medication, or prescribing treatment to help the ulcer heal.

To reduce the risk of pill-related injuries, medications should be taken with a full glass of water, followed by remaining in an upright position for at least 30 minutes, unless otherwise directed by a healthcare professional.

6. Nutritional deficiencies

Low levels of certain vitamins and minerals, especially iron, vitamin B12, and folate, are linked to canker sores that keep coming back.

These deficiencies may affect the health of the lining of the mouth and increase the risk of developing painful sores.

Some people may also have symptoms of anemia, such as tiredness, weakness, or pale skin.

However, not everyone with recurring canker sores has a nutritional deficiency.

How to treat: A doctor may order blood tests to check iron, vitamin B12, and folate levels.

If a deficiency is found, treatment may include supplements and dietary changes.

Foods rich in these nutrients include red meat, beans, lentils, eggs, fish, dairy products, and leafy green vegetables.

Also recommended: Vitamin B12 Deficiency: Symptoms, Causes & Treatment tuasaude.com/en/vitamin-b12-deficiency

7. Injury or irritation

Injuries to the lining of the throat can cause painful sores or ulcers.

These injuries may happen after eating very hot food, drinking hot beverages, swallowing sharp food, or accidentally swallowing a fish bone.

Medical procedures, such as intubation, can also irritate or injure the throat.

Smoking and drinking alcohol may further irritate the lining and make symptoms worse.

Unlike canker sores, these ulcers develop because of direct injury or irritation.

How to treat: Minor sores usually heal once the injury or irritation stops.

Avoiding very hot, spicy, acidic, or crunchy foods may help relieve pain while the throat heals.

If a fish bone or another sharp object becomes stuck in the throat, medical evaluation is recommended rather than attempting to remove it at home.

Also recommended: Fish Bone Stuck in Throat: Safe Removal Tips & Warning Signs tuasaude.com/en/practical-ways-to-take-a-fish-bone-out-of-your-throat

8. Inflammatory bowel disease, celiac disease, and Behçet's disease

Some inflammatory diseases are linked to recurring sores in the mouth.

These include Crohn's disease, ulcerative colitis, and celiac disease, which may be associated with aphthous ulcers.

Behçet's disease is a rare inflammatory condition that can cause repeated mouth ulcers. Some people may also develop genital sores, eye inflammation, or ulcers in other parts of the digestive tract.

The sores may look like canker sores, but their appearance alone is not enough to identify the underlying disease.

How to treat: Treatment focuses on controlling the underlying condition.

A gastroenterologist or rheumatologist may recommend medications to reduce inflammation and prevent new sores from developing.

9. Lupus

Lupus is an autoimmune disease in which the immune system mistakenly attacks healthy tissues.

It can cause ulcers in the mouth, especially on the roof of the mouth or inside the cheeks. These sores are sometimes painless.

Mouth ulcers are one of the clinical features considered when classifying systemic lupus erythematosus.

Other symptoms may include joint pain, tiredness, fever, and a butterfly-shaped rash across the cheeks and nose.

Lupus-related ulcers are not necessarily canker sores, even when they look similar.

Also recommended: What Are The Symptoms of Lupus? (& What Causes Them?) tuasaude.com/en/lupus-symptoms

How to treat: A rheumatologist may recommend blood tests and other exams to help diagnose lupus.

Treatment depends on the organs affected and may include medications such as hydroxychloroquine, corticosteroids, or other medicines that reduce inflammation and immune system activity.

10. HIV

People with HIV, especially those with a weakened immune system, may develop large, deep, and painful ulcers in the mouth or throat.

These sores may take longer than usual to heal and may be linked to recurrent aphthous ulcers or infections.

Unusually large, severe, or recurring aphthous ulcers can sometimes be associated with HIV. However, having a canker sore does not mean that a person has HIV.

How to treat: Treatment depends on the cause of the sores.

If HIV is diagnosed, antiretroviral treatment helps strengthen the immune system and reduce the risk of infections and complications.

HIV testing is recommended when there is a possibility of exposure to the virus.

11. Radiation therapy

Radiation therapy to the head or neck can damage the lining of the mouth and throat.

This can cause inflammation and painful sores, a condition known as oral mucositis.

Radiation therapy to the chest may also cause inflammation or ulcers in the esophagus, leading to pain when swallowing.

These sores develop as a side effect of cancer treatment and are not canker sores.

How to treat: The oncology team may recommend special mouthwashes, pain relievers, and foods that are soft and easy to swallow.

Treatment depends on how severe the inflammation is and whether the person can eat and drink normally.

12. Throat or oral cancer

A sore in the mouth or throat that does not heal may be a warning sign of oral or throat cancer.

Other warning signs include a persistent sore throat, a lump in the neck, difficulty swallowing, hoarseness, ear pain, or unexplained weight loss.

Some people may also notice white or red patches inside the mouth or on the tonsils.

Smoking, heavy alcohol use, and human papillomavirus (HPV) infection are risk factors for certain types of head and neck cancer.

Cancer-related sores are not canker sores, although some may initially look like ordinary mouth ulcers.

How to treat: Any sore that does not heal within 2 weeks should be evaluated by a doctor or dentist.

If cancer is suspected, a biopsy may be needed to confirm the diagnosis.

Treatment depends on the type and stage of cancer and may include surgery, radiation therapy, chemotherapy, or other cancer treatments. Learn more about head and neck cancer.

Canker sores on the uvula or tonsils

Canker sores usually develop on the soft lining inside the mouth, but they can sometimes appear farther back, such as on the soft palate.

A sore near the uvula or tonsils may look like a small, round, white or yellow spot with a red border. It may cause pain when swallowing, sometimes on only one side of the throat.

However, not every sore or white spot on the uvula or tonsils is a canker sore.

Other possible causes include viral infections, tonsillitis, strep throat, tonsil stones, and oral thrush.

For example, tonsil stones often look like small white or yellow lumps, while strep throat may cause fever, swollen tonsils, and white patches.

Also recommended: White Spots on Tonsils: Causes, Symptoms & Treatment tuasaude.com/en/white-spots-on-tonsils

Oral thrush can cause creamy white patches that may be wiped away, sometimes leaving a red or irritated area underneath.

Because these conditions may look similar, a doctor may need to examine the throat to identify the cause.

How to treat: If the sore is confirmed to be a canker sore, treatment usually focuses on relieving pain while it heals.

A doctor or dentist may recommend a suitable medicated mouthwash or other topical treatment.

Numbing gels should not be applied deep in the throat without medical advice, as some products can affect swallowing.

How to treat throat ulcers

Treatment for throat ulcers depends on the cause. Minor canker sores usually heal on their own within 1 to 2 weeks, while ulcers caused by infections, injuries, or other health conditions may require specific treatment.

A doctor or dentist may recommend medications to relieve pain, reduce inflammation, or treat the underlying cause. These may include pain relievers, medicated mouthwashes, or other treatments, depending on the diagnosis.

Identifying the cause is important before starting treatment, as medications used for canker sores may not be suitable for other types of throat ulcers.

Home remedies for throat ulcers

Some simple home remedies may help relieve pain and discomfort while throat ulcers heal. These include:

• Gargling with salt water: A saltwater solution can be prepared by mixing ½ teaspoon of salt with 1 cup (8 oz) of warm water. Gentle gargling may help soothe irritation. The solution should be spit out after use. Learn more about saltwater gargles.
• Avoiding irritating foods: Acidic, spicy, salty, or crunchy foods, such as citrus fruits, tomatoes, chips, and toast, should be avoided if they increase pain or irritation.
• Eating soft, cool foods: Soft foods, such as yogurt, smoothies, oatmeal, and mashed potatoes, may be easier to swallow.
• Drinking plenty of water: Staying hydrated helps prevent dryness and is especially important when swallowing is painful.
• Using a soft toothbrush: A soft-bristled toothbrush can help prevent further irritation. Toothpaste without sodium lauryl sulfate (SLS) may also benefit some people with recurring canker sores.
• Avoiding smoking and alcohol: Cigarettes, alcoholic drinks, and alcohol-based mouthwashes may irritate the sore and make symptoms worse.

These measures may help relieve symptoms, but they do not replace medical treatment when an ulcer is caused by an infection or another health condition.

Also recommended: 11 Natural Ways to Cure Mouth Ulcers Fast tuasaude.com/en/mouth-ulcers

When to worry about a throat ulcer

Medical evaluation is recommended if a throat ulcer lasts longer than 2 weeks, is larger than 1 cm, keeps coming back, or does not improve. Other warning signs include a lump in the neck, persistent hoarseness, unexplained weight loss, high fever, or severe pain when swallowing.

Emergency medical care is necessary if a person has trouble breathing, cannot swallow saliva, vomits or coughs up blood, or has black, tarry stools. People who smoke, drink heavily, or have a weakened immune system should also have persistent throat sores checked by a doctor.

To identify the cause, a doctor may examine the throat and recommend blood tests, infection tests, an upper endoscopy, or a biopsy if needed.