Patients often experience difficulties in applying topical steroids in
orabase to the oral mucosa, particularly when large areas need to be
covered. An aqueous hydrocortisone mouthwash solution has been develop
ed, one that was anticipated to be more acceptable to patients. The so
lution contains hydrocortisone (0.3% w/v) in a 4.5% (w/v) 2-hydroxypro
pyl-beta-cyclodestrin solution. Hydroxypropylmethylcellulose (0.5% w/v
) was used to increase the viscosity of the solution and to promote th
e hydrocortisone-cyclodextrin complex. One hundred and two patients wi
th aphthous ulceration, lichen planus, and other mucosal conditions us
ed the mouthwash in an open clinical efficacy study. Most patients rep
orted some or considerable improvement following a 2-week course of tr
eatment with the mouthwash: 26 of 33 (78.8%) patients with aphthous ul
ceration were 'much better', as were 26 of 54 (48.1%) patients with li
chen planus and 5 of 16 (31.3% patients with other mucosal lesions. No
serious side effects were reported. Aqucous mouthwash solutions offer
a potential vehicle for topical steroid therapy of oral mucosal lesio
ns.