Oral Herpes

Alternate Names
herpes simplex
HSV-1



Definition of Oral Herpes

Oral herpes is a common condition that shows up as blisters in the mouth or the area around it. They usually develop on the gums, roof of the mouth, outside of the lips, or the nostrils. Oral herpes is caused by the herpes simplex virus, usually type 1 (HSV-1), although type 2 (HSV-2), the kind usually responsible for genital herpes, can sometimes cause oral herpes as well.

What is going on in the body?

Oral herpes occurs in two stages: primary infection and recurrence of infection. At some time during childhood, many people come down with the primary infection. The individual may or may not have symptoms. This primary infection takes about two weeks to clear up. After that, the virus remains in the body but is inactive.

After this primary infection, a recurrence can happen at any time. Many outbreaks occur without any obvious reason. However, the following factors may trigger a recurrence:

• being tired or rundown
• dental work
• emotional stress
• exposure to sunlight
• an upper respiratory infection, such as a cold or flu

What are the signs and symptoms of the disease?

Someone with an active oral herpes infection may have the following symptoms:

• difficulty eating
• fatigue
• fever
• malaise, or a vague feeling of illness
• sore throat
• swelling and redness, usually both before and during an outbreak
• tiny blisters that grow into larger sores in the mouth, on the tongue, or on the lips

What are the causes and risks of the disease?

Oral herpes is caused by the herpes simplex virus. People in the following categories may be more at risk for oral herpes:

• people undergoing radiation therapy or chemotherapy
• people with cancer or other debilitating diseases
• people with HIV or other immunodeficiency disorders or organ transplants

What can be done to prevent the disease?

Oral herpes can be passed from person to person. Someone with oral herpes should not share lipstick, utensils, or drinks with others. Touching and kissing can also spread the virus.

How is the disease diagnosed?

Oral herpes is generally diagnosed with a history and physical exam. There are laboratory tests for this virus, but they are seldom needed.

What are the long-term effects of the disease?

Oral herpes causes no serious long-term effects. The virus will stay in the person's body indefinitely.

What are the risks to others?

Oral herpes can be spread from person to person much like a cold or flu. Sores also can be spread to other parts of the body such as fingers or eyes. Sometimes sores can also spread to the genitals, particularly through oral sex. Women who are pregnant need to take care to not spread the virus to their genital areas or birth canal. In addition, care should be taken when lesions are active to avoid spreading to them to people whose immune systems are compromised.

What are the treatments for the disease?

In most cases, sores caused by oral herpes are self-limiting. They will usually crust over and go away in about two weeks. If they last longer, the healthcare professional should be consulted.

Treatment for oral herpes includes the following:

• diluted, or 1 1/2%, hydrogen peroxide mouth rinse
• lip balm to soothe sores on the lips
• penciclovir (i.e., Denavir) cream, which is applied every two hours
• prescription oral antiviral medicines, such as acyclovir, valacyclovir (i.e., Valtrex), and famciclovir (i.e., Famvir).
• salt-water rinse, with 1/2 teaspoon salt in 8 ounces of warm water
• sunblock cream for lip protection

What are the side effects of the treatments?

Antiviral medications may cause nausea, vomiting, diarrhea, and allergic reactions.

What happens after treatment for the disease?

The sores usually clear up and go away in about two weeks. If they last longer than this or if they come back often, the healthcare professional should be consulted.

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare professional.