Tobacco use is associated with an increase in keratinization of the oral mucosa. In extreme forms, this may manifest as leukoplakia or stomatitis nicotina (smokers keratosis). This increased keratinization may mechanically reinforce the mucosa and reduce the tendency of ulcers to form after minor trauma, or present a more substantial barrier to microbes and antigens, but this is unclear. Nicotine is also known to stimulate production of adrenal steroids and reduce production of TNF-α, interleukin-1 and interleukin-6. Smokeless tobacco products also seem to protect against aphthous stomatitis. Cessation of smoking is known to sometimes precede the onset of aphthous stomatitis in people previously unaffected, or exacerbate the condition in those who were already experiencing aphthous ulceration. Despite this correlation, starting smoking again does not usually lessen the condition. Antigenic sensitivity
Various antigenic triggers have been implicated as a trigger, including L forms of streptococci, herpes simplex virus, varicella-zoster virus, adenovirus, and cytomegalovirus. Some people with aphthous stomatitis may show herpes virus within the epithelium of the mucosa, but without any productive infection. In some persons, attacks of ulceration occur at the same time as asymptomatic viral shedding and elevated viral titres.In some instances, recurrent mouth ulcers may be a manifestation of an allergic reaction. Possible allergens include certain foods (e.g., chocolate, coffee, strawberries, eggs, nuts, tomatoes, cheese, citrus fruits, benzoates, cinnamaldehyde, and highly acidic foods), toothpastes, and mouthwashes.
Prevention
Collagen and elastin are proteins in the skin that contribute to the skins strength, resilience, flexibility, and help skin that has been stretched to recover its original state. Boosting the production of collagen and elastin helps prevent stretch marks from occurring. Stretch marks can also derive from nutritional deficiencies. Consuming foods that contribute to the skins health, such as zinc-rich foods, foods high in vitamin A, C, D, and protein rich foods, can help suppress stretch marks. A systematic review has not found evidence that creams and oils are useful for preventing or reducing stretch marks in pregnancy. The safety in pregnancy of one ingredient, Centella asiatica, has been questioned. Evidence on treatments for reducing the appearance of the scars after pregnancy is limited. Treatment
There are no clearly useful treatments for stretch marks, although there are many different suggestions on how to remove them or lessen their appearance.Various efforts that have been tried including laser treatments, glycolic acid, and microdermabrasion. Tretinoin (0.1% w/w), which is a retinoid, has found to be effective on early stretch marks in several studies. Hyaluronic acid also improves the appearance of stretch marks. Topical tretinoin is categorized by the FDA as a known teratogen (causing malformations in fetuses) in animals, without adequate human studies on safety in pregnancy.Carboxytherapy is a known procedure; however, there is a lack of evidence to support how effective it is. History
Since ancient times, pregnant women have sought remedies to prevent stretch marks during pregnancy.