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Behçet’s Disease

A rare, long-term inflammation of the blood vessels that causes painful mouth and genital sores, skin bumps and eye inflammation, and sometimes affects the veins, brain or gut. It comes and goes in flares; there is no cure, but treatment controls it for most people.

What is Behçet’s disease?

Behçet’s disease is a rare, long-term inflammatory condition caused by vasculitis — inflammation of the blood vessels — which can affect and damage both arteries and veins (Cleveland Clinic). It most often affects the small blood vessels of the mouth, genitals, skin and eyes (MedlinePlus Genetics), and unusually among the forms of vasculitis it can involve blood vessels of almost every size and type (Johns Hopkins Vasculitis Center). It is named after the Turkish dermatologist Hulusi Behçet, who described it in the 1930s (Johns Hopkins). It is not contagious (National Eye Institute).

Who gets it

Symptoms

Get help fast for these.

How it’s diagnosed

There is no single test (Cleveland Clinic). Doctors usually look for mouth sores that keep returning (typically at least three times a year) plus at least two of: genital sores, eye inflammation, skin lesions, or a positive pathergy test (Cleveland Clinic, NORD). In a pathergy test the forearm is pricked with a small sterile needle; a red bump or pustule a day or two later is a positive result. It supports the diagnosis, but only a minority of patients react, and the reaction is far less common in the United States (American Behcet’s Disease Association, Johns Hopkins). Blood tests help rule out look-alikes such as lupus, Crohn’s disease and other vasculitis (Cleveland Clinic). Because symptoms come and go, it can take months or years to reach a diagnosis (MedlinePlus) — writing down your symptoms and when they happen helps your doctors (National Eye Institute).

What to expect over time

Behçet’s is chronic, with flares and periods of remission when symptoms go away (National Eye Institute). Most people live with symptoms on and off but are able to live a full life (Cleveland Clinic), most can control symptoms with treatment (MedlinePlus), and for most people the problems ease with age (MedlinePlus Genetics).

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Care led by a rheumatologist, with an eye specialist and others as needed. Steroid creams and rinses and colchicine for sores; apremilast (FDA-approved for mouth ulcers); steroids plus immunosuppressants such as azathioprine or TNF inhibitors for eye, vessel, brain or gut disease. Apremilast (Otezla) listed at about $4,700 for a 30-day supply (2024); Medicare’s negotiated price is $1,650 from 2027. Co-pay help exists. Specialist visits: cost estimate being researched. No cure, but treatment can prevent serious problems and ease pain. Flares and remissions are typical; eye, nerve and blood-vessel disease need prompt, aggressive treatment.
Chiropractic Being researched — coming soon.
Acupuncture Being researched — coming soon.
Herbal medicine No herb or supplement is proven to treat Behçet’s. Not applicable — not a recommended treatment. Some herbs interact with immunosuppressants, apremilast or blood thinners, or may stir up the immune system. Check with your doctor or pharmacist first.
Massage therapy Gentle massage for comfort and relaxation only, avoiding sores, skin nodules and any swollen or painful limb. About $60–$120 for 45–60 minutes with a private therapist, or $50–$90 at clinics, gyms and spas. No Behçet’s-specific research. Massage is generally low-risk, but rare blood clots have been reported, so ask your doctor first.
MBHA Wellness Coach Mouth care and gentle eating during ulcer flares, tracking flares, balancing rest and activity, medicine routines, emotional support, quitting smoking and finding support groups. Cost estimate being researched. Quitlines (1-800-QUIT-NOW) are free. Supports — never replaces — your rheumatologist and eye doctor. Good records help your team spot patterns and adjust treatment.

Approach 1 of 6

Conventional medicine (AMA)

There is no cure, but treatment can lower pain and prevent serious problems (National Eye Institute). Treatment is tailored to the parts of the body involved and how severe the disease is (NORD). We don’t list doses; your doctors will tailor any medicine to you.

Your care team

Rheumatologists know the disease best and should lead care, ideally with a primary care doctor coordinating the specialists (American Behcet’s Disease Association). Depending on your symptoms, the team may include an ophthalmologist, dermatologist, neurologist, vascular specialist or kidney specialist (GARD). Eye inflammation needs close teamwork with an ophthalmologist (NORD).

What the European guideline says

The European Alliance of Associations for Rheumatology (EULAR) updated its Behçet’s recommendations in 2026, building on the earlier 2018 version (EULAR). Its summary stresses that the disease relapses and remits, that treatment should match disease activity and risk, and that care should be multidisciplinary, with patient education and shared decision-making (EULAR 2025 update, Ann Rheum Dis, 2026).

Mouth, genital and skin sores, and joints

Eyes, blood vessels, brain and gut

What it costs

  • Apremilast (Otezla): its 2024 list price was about $4,722 for a 30-day supply; Medicare’s negotiated price is $1,650 starting January 1, 2027 (CMS fact sheet). What you pay depends on your coverage.
  • Help paying: with commercial insurance, the maker’s co-pay program may lower the cost to as little as $0 a month (eligibility rules and limits apply); it is not for Medicare, Medicaid or underinsured patients, who can call Amgen SupportPlus at 1-844-468-3952 for other options (Otezla.com). Amgen also lists independent charities, such as the PAN Foundation and HealthWell Foundation, that set their own rules (Amgen SupportPlus). With Medicare drug coverage, out-of-pocket costs for covered drugs are capped at $2,100 in 2026 and $2,400 in 2027, and Extra Help is available for people with limited income (Medicare.gov).
  • Rheumatology and eye-specialist visits, biologics and other medicines: cost estimate being researched.

Find a medical doctor in our directory

Approach 4 of 6

Herbal medicine

We found no herb or supplement proven to treat Behçet’s, and none of the medical sources we reviewed recommends one. The bigger issue is safety, because many people with Behçet’s take immune-suppressing medicines or blood thinners.

  • St. John’s wort has a high overall risk of drug interactions, including with the immunosuppressant cyclosporine and the blood thinner warfarin (NCCIH), and it may interact with apremilast (MedlinePlus).
  • Cat’s claw may interact with immunosuppressants and blood thinners, and might make the immune system more active (NCCIH).
  • Asian ginseng may worsen autoimmune disorders and interfere with blood clotting (NCCIH).
  • “Natural” doesn’t always mean safe, and the FDA has found hidden prescription drugs, including blood thinners, in some products sold as supplements (NCCIH).

Before you take any supplement, show it to your rheumatologist or pharmacist — especially if you take an immunosuppressant, a biologic, apremilast or a blood thinner, or are pregnant (NCCIH). Never stop or change a prescribed medicine on your own. We don’t list doses here.

Approach 5 of 6

Massage therapy

There is no research on massage for Behçet’s. Gentle massage may help some people relax and ease sore muscles, but it does not treat the inflammation.

The risk of harm from massage appears low, but rare serious problems, including blood clots, have been reported, sometimes with vigorous or deep-tissue work (NCCIH). Behçet’s itself can cause clots in the leg veins (Johns Hopkins), and the skin can overreact to minor injury — the basis of the pathergy test (ABDA). As a precaution, MBHA suggests:

  • Ask your doctor first, especially if you have had a blood clot or take a blood thinner.
  • Choose light pressure, and skip any area with open sores, tender skin nodules or broken skin.
  • Never have a swollen, red, warm or painful leg or arm massaged — get it checked for a clot instead (MedlinePlus).
  • Don’t use massage to put off seeing a doctor about a new problem (NCCIH).

What it costs

About $60–$120 for 45–60 minutes with a private therapist, or $50–$90 at clinics, gyms and spas (CostHelper).

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

An MBHA Wellness Coach can help you turn your care team’s advice into daily habits — alongside, never instead of, your medical care.

Mouth care during ulcer flares

General advice for mouth sores includes avoiding hot or spicy foods, which can cause pain; rinsing with salt water or a mild mouthwash without alcohol; brushing twice a day and flossing daily; and getting routine dental check-ups (MedlinePlus). Your doctor may prescribe numbing or steroid rinses (NORD). MBHA suggests softer, cooler foods on bad days and a soft toothbrush, and a coach can help you plan meals that still meet your nutrition needs.

Tracking flares

Writing down your symptoms and when they happen helps your doctors (National Eye Institute). A coach can help you keep a simple log of sores, eye symptoms, joint pain, possible triggers and medicines, and bring it to appointments. Stress is one known trigger of ordinary canker sores (MedlinePlus), so stress-management habits may be worth tracking too.

Rest, activity and energy

Rest during flares and moderate exercise such as walking when you feel well are part of managing Behçet’s (National Eye Institute); a regular exercise routine can ease joint pain (Cleveland Clinic). A coach can help you pace your days and build a routine that bends around flares.

Medicines and mood

Many people take several medicines, so keep an up-to-date list for every doctor (ABDA). Apremilast can affect mood (MedlinePlus), and living with a rare, unpredictable illness is hard; tell your doctor if you feel low. Mental health professionals can be part of the care team (ABDA).

Smoking

Smoking raises the risk of blood clots (MedlinePlus) and of uveitis (National Eye Institute). Free, confidential coaching is available at 1-800-QUIT-NOW, and counseling plus medicine gives the best chance of quitting for good (CDC).

Support groups

Finding others with this rare disease can be hard, but shared experience helps (Cleveland Clinic). The American Behcet’s Disease Association runs a patient hotline at (800) 723-4238, free literature, webinars and Community Connection events (ABDA), and points people to the American College of Rheumatology to find a rheumatologist (ABDA). GARD also lists the ABDA and the Vasculitis Foundation among patient organizations (GARD).

Still being researched: Chiropractic, Acupuncture. We add each approach once its costs and results are sourced. Are you a practitioner with experience treating Behçet’s Disease? Tell us.

Member stories

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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