New Effective Treatment for Intractable Sore Mouth Mucositis

0.05% Methylene Blue oral rinse therapy was cheap and effective treatment for mucositis from chemotherapy or radiotherapy. Amazing result could be big help.

Pain Pract. 2017 Feb 22. doi: 10.1111/papr.12566. [Epub ahead of print]
Methylene Blue for the Treatment of Intractable Pain Associated with Oral Mucositis.
Roldan CJ et al
https://www.ncbi.nlm.nih.gov/pubmed/28226414

• With chemo sore mouth 3-5 days into, with actual sores 2 days later
• With radiotherapy, after 20 Gy  reddening starting to  ulceration occurs
• agents used are not great
• Procedure:
  “a mix of methylene blue diluted to 0.05% in normal saline (100 mL total) was prepared. Patients were instructed to take a mouthful of the mix, hold it at the painful sites for 5 minutes, and then gargle and spit. These steps were to be repeated every 6 hours as needed for pain for 3 to 6 uses.”
• 3/5 got relief with first use while 2/5 took second dose to achieve relief
• oddly methylene blue is a monoamine oxidase inhibitor (MAOI)

Comment:

Methylene blue has been found helpful in other situations:

•  procaine and methylene blue (annoyingly, strength not available even from initial source)”injected into the pelvic fracture site greatly reduced pain. 33 This analgesic effect lasted about 3 weeks with a single injection.”
  33 Sheng ZY. Medical support in the Tangshan earthquake: a review of the management of mass casualties and certain major injuries. J Trauma. 1987;27:1130-1135.
• “In a small double-blind, prospective, randomized controlled study of intravenous methylene  blue in patients with chronic, therapy-resistant neuropathic pain, Miclescu et al. saw a significant  decrease in pain in those treated with methylene blue compared with the control group (P = 0.04), and 3  of the 6 patients with dynamic mechanical allodynia showed an improvement of tactile allodynia after methylene blue treatment.38”
  38. Miclescu AA, Svahn M, Gordh TE. Evaluation of the protein biomarkers and the analgesic response to systemic methylene blue in patients with refractory neuropathic pain: a double- blind, controlled study. J Pain Res. 2015;8:387-397
• Injected intracutaneous perianal skin  2 patients who experienced prolonged relief (1 and 7 years) following the intradermal methylene blue injection to treat pruritus ani. .34
  34 Eusebio EB, Graham J, Mody N. Treatment of intractable pruritus ani. Dis Colon Rectum. 1990;33:770-772. – 0.5 percent is injected intracutaneously on the anodermal and perianal skin

Suspect methylene blue was dissolved in a little alcohol and then diluted in a lot of saline – though soluble up to 3 gm/100 mls water =3%