Mouth Sores in Melanoma Treatment: What to Expect and How to Manage Them

Mouth sores (oral mucositis) can occur during melanoma treatment, especially with chemotherapy, targeted therapies, radiation to the head and neck, and immunotherapy, though the likelihood varies by regimen and dose. ^[1] Mouth sores may range from mild irritation to painful ulcers that affect eating, speaking, and swallowing, and sometimes they can be severe enough to interrupt treatment. ^[2] Mouth sores typically appear on the inner cheeks, tongue, gums, lips, and palate, and can extend down the esophagus. ^[3]

Why Mouth Sores Happen

• Treatment effects on lining cells: Many cancer therapies temporarily damage fast‑dividing cells that line the mouth and throat, leading to inflammation and ulceration known as oral mucositis. ^[2]
• Which melanoma treatments can cause them: Chemotherapy, targeted therapy (such as BRAF/MEK inhibitors), immunotherapy, and head‑and‑neck radiation are all associated with mouth sores, though risk depends on the specific drug and dose. ^[1]
• Impact on daily life: Sores can make eating and drinking painful, increasing the risk of dehydration and weight loss, and sometimes force pauses or dose changes in treatment. ^{[2] [4]}

Signs and Symptoms to Watch For

• Painful red patches or ulcers on lips, tongue, inner cheeks, or gums. ^[3]
• Burn‑like appearance and sensitivity to hot, spicy, or acidic foods. ^[3]
• Trouble eating, talking, or swallowing, occasionally with symptoms extending down the esophagus. ^[3]

Immediate Self‑Care Steps

• Gentle mouth rinses: Rinse every 4–6 hours with alcohol‑free mouthwash or a homemade salt/baking‑soda solution (1 tsp salt + 1 tsp baking soda in 4 cups water). ^[5]
• Soft, bland foods: Prefer cool, soft foods; avoid spicy, acidic, rough, or very hot items that can irritate sores. ^[6]
• Moisture support: Sip water frequently; consider sugar‑free gum or candies; use lip moisturizers to prevent cracking. ^[7]
• Dental care: Use a soft‑bristle brush, floss gently, and avoid alcohol/peroxide mouthwashes that worsen irritation. ^[5]

Medical Management Options

• Pain control: Your care team may recommend topical anesthetics or systemic pain medicines to help you eat and drink more comfortably. ^[8]
• Protective and lubricating agents: Mucosal coating agents and artificial saliva can reduce friction and dryness and ease discomfort. ^[7]
• Infection prevention: Providers will monitor for bacterial or fungal infection and may treat if needed. ^[9]
• Treatment adjustments: If sores are severe, clinicians may adjust doses or timing to allow healing. ^[2]
• Preventive strategies: Some medicines and protocols are used in select settings (for example, certain targeted therapy regimens) to reduce risk, based on your specific treatment plan. ^[8]

Practical Eating and Comfort Tips

• Choose cool, soft foods like yogurt, smoothies, scrambled eggs, or mashed potatoes. ^[6]
• Avoid spicy, acidic, and rough‑textured foods (chips, crusty bread). ^[6]
• Use a straw for liquids if contact with sores is painful. ^[6]
• Keep the mouth clean and moist with regular gentle rinses and hydration. ^{[5] [7]}

When to Call Your Care Team

• New or worsening sores, significant pain, or inability to eat/drink adequately. ^[8]
• Signs of infection such as fever, pus, or increasing redness and swelling. ^[9]
• Weight loss or dehydration, which may require additional support or IV fluids. ^[2]

Special Notes for Melanoma Therapies

• Immunotherapy (PD‑1/CTLA‑4): Mouth sores can occur; consistent mouth care, alcohol‑free rinses, and early reporting help manage symptoms. ^{[1] [5]}
• Targeted therapy (BRAF/MEK inhibitors): Oral adverse events, including mucositis, are described in melanoma patients; prompt symptom management and supportive care are important to maintain therapy. [PM18]
• Head and neck radiation: This carries a higher risk of mucositis; preventive mouth care and close dental monitoring are typically part of the plan. ^[1]

Summary

• Mouth sores are a known, sometimes common side effect across several melanoma treatments, though the risk depends on the specific therapy and dose. ^[1]
• Effective management includes gentle, alcohol‑free rinses, soft bland diets, moisture support, pain control, and early communication with your care team, which helps prevent complications and keep treatment on track. ^{[5] [8] [7] [2]}

Quick Reference: Self‑Care vs. Medical Care

Situation	What You Can Do	What Your Care Team May Do
Mild soreness or sensitivity	Alcohol‑free rinses 4–6 times daily; soft, cool foods; hydrate; soft‑bristle brushing	Reinforce mouth‑care routine; consider topical analgesics
Painful ulcers affecting eating	Add baking‑soda/salt rinses; avoid irritants; use lubricants/artificial saliva	Prescribe stronger pain meds; protective coating agents; assess for infection
Signs of infection or severe pain	Call promptly; keep up hydration	Swabs/cultures; antifungal/antibacterial treatment; IV fluids if needed
Treatment interference (weight loss/dehydration)	Track intake; ask about nutrition support	Adjust drug dose/timing; nutrition consult; consider additional supportive measures

Mouth sores can be managed well with early, consistent care so you can stay as comfortable as possible during melanoma treatment. ^{[2] [8] [5] [7]}