What is Herpes?

Herpes is virus with multiple strains; two of these strains, HSV-1 and HSV-2, cause both oral and genital herpes. Herpes viruses infect the skin and/or mucous membranes.

Oral herpes presents itself as cold sores or fever blisters that affect the lips or area near the mouth. Oral herpes is most often caused by the HSV-1 strain, but oral herpes can also be caused by the HSV-2 strain.

Approximately 80 percent of oral herpes cases are caused by HSV-1, while the remaining 20 percent are caused by HSV-2, and 75%-80% of Americans carry at least one Herpes Simplex Virus (Type 1 or 2).

Herpes 1 and 2 can be contracted during vaginal, anal or oral sex. The initial outbreak of either virus strain can result in flu-like symptoms, including fever, swollen lymph nodes and body aches.

What causes oral herpes?

Oral herpes is most commonly transmitted by kissing or sharing drinks or utensils, but can also be contracted from a partner who has genital herpes during oral sex.

HSV-1 and 2 can be contracted from infected bodily fluids, including semen, vaginal fluid, saliva, or herpes lesions, sores or blister fluid.

Upon entering a cell, the infection often does not cause any symptoms. If the virus destroys the host cell during replication, sores or blisters filled with fluid appear.

Scabs form over the sores or blisters once the fluid is absorbed, then the scabs disappear without scarring.

The herpes virus goes through dormant phases where it becomes inactive for indeterminable periods of time and reactivate unpredictably.

Herpes can be transmitted even when signs or symptoms are not present. This process is known as “shedding,” and occurs when cells that have the active virus are dropped or shed from the skin. Approximately one- third to half of all shedding occurrences are asymptomatic.

What are the symptoms of oral herpes?

Oral herpes does not always show symptoms. When it does, oral herpes symptoms include fever blisters and cold sores around the mouth and lips.

People suffering from oral herpes may also experience itching, burning or tingling around the mouth or lips.

Before the first blisters or cold sores appear, individuals infected with the virus may also experience flu-like symptoms including sore throat, fever, swollen glands and/or pain when swallowing.

HSV-1 can recur spontaneously in the eye, causing ocular herpes, which can be serious and lead to blindness.

Very rare instances HSV-1 can spread spontaneously to the brain, causing herpes encephalitis, a dangerous infection that can lead to death.

Furthermore, HSV-1 is also the usual culprit of herpes whitlow, an infection on the finger, as well as “wrestler’s herpes” or herpes gladiatorum– a herpes infection on the chest or face.

How is oral herpes transmitted?

This strain of herpes is spread through contact with a person infected with the virus. This could happen when you come in contact with open cold sores through kissing or other close contact.

Oral herpes can also be transmitted through contact with eating utensils, shaving razors, towels or other personal items used by someone who has herpes.

Sharing food or drinks or coming in contact with the saliva of someone with cold sores could also infect you with oral herpes.

HSV-1 can be contracted from infected bodily fluids, including semen, vaginal fluid, saliva, or herpes lesions, sores or blister fluid. An individual could also contract oral herpes from giving oral sex to someone with genital herpes.

What should I know about the herpes tests?

Herpes type 1 antibodies have a development period of 2 weeks to 6 months after initial infection. This is the time it takes for enough antibodies to develop that can be detected through the ELISA test. This period varies from person to person.

Herpes type 2 antibodies have a development period of 3 weeks to 6 months after initial infection. This is the time it takes for enough antibodies to develop that can be detected through the ELISA test. This period varies from person to person.

Is there a cure for herpes?

No, there is not a cure for oral or genital herpes, but there are treatment options available. Avoiding oral sex or kissing someone with herpes can help prevent the spread of herpes.

The first herpes symptoms after infection may also go away on their own after 10-14 days, although the infection itself remains dormant in your body.

Antiviral medications, such as acyclovir, famciclovir, and valacyclovir, are the most effective medications available for people infected with herpes.

These medications are used to help to reduce the severity and frequency of symptoms, however they cannot cure the infection.

Other conditions linked to oral herpes

Oral herpes is not typically a serious condition. Having herpes may cause personal discomfort, stress and inconvenience such as making it difficult or painful to drink fluids or swallow food.

In rare cases, HSV-1 can recur spontaneously in the eye, a condition known as ocular herpes. Ocular herpes can be serious and can even lead to blindness in some cases.

Herpes simplex virus encephalitis is a rare, but serious condition mainly caused by HSV-1. HSV encephalitis causes inflammation of the brain.

Herpes viruses have also been linked to Recurrent Lymphocytic Meningitis (Mollaret’s meningitis), which is characterized by sudden attacks of meningitis symptoms that last for 2-7 days and are separated by symptom-free (latent) intervals lasting for weeks, months or years.

Oral herpes symptoms in men and women

Most common symptoms

  • No symptoms at all

Less common symptoms

  • Mild or severe itching of the mouth or lips
  • Sores or blisters on the lips or inside the mouth
  • Fever
  • Headache
  • Body aches and pains
  • Swollen glands in the neck, armpit or groin

Least common symptoms

  • Sores or blisters on nose or fingers
  • Infections of the eyelid or eyeball

How can I tell if I have oral herpes?

Oral herpes does not always show symptoms. When it does, it shows up as cold sores or fever blisters in the mouth or on or around the lips. The only way to confirm if you have HSV-1 and/or HSV-2 is toget tested.

People infected with the herpes virus may experience itching, burning and tingling around the mouth and lips just before developing cold sores or fever blisters. Other symptoms to watch for include sore throat, fever, swollen glands and pain when swallowing.

When do first outbreaks of oral herpes appear?

The first sign of oral herpes usually appears between 2 to 12 days after initial exposure. This first outbreak may cause mild to severe blisters in or around the mouth, on the tongue or lips and lasts about 7-10 days. Consequent outbreaks may cause painful, but less severe, blisters and sores and can last up to 14 days.

What does an oral herpes outbreak feel or look like?

Oral herpes outbreaks occur when several blisters come together to form a larger blister. Initial blisters are sometimes reddish and filled with clear yellowish fluid.

These blisters may break and leak. When an outbreak occurs you might experience a tingling, burning or itching sensation around the mouth, lips and gums.

Oral herpes blisters are painful sores that heal over time. As the blisters heal, they turn yellowish and crusty before finally turning into pink skin.

What causes or triggers a recurrence of oral herpes?

After the initial oral herpes infection, the herpes virus becomes dormant in the facial nerve tissues. The virus may reactivate at a later date and cause cold sores or fever blisters.

Oral herpes cases suddenly and unexpectedly retrigger the virus causing new outbreaks. There is no cure for oral herpes, but there are antiviral treatments that help reduce outbreaks and the severity of the pain caused by cold sores.

Will I have oral herpes for the rest of my life?

Since there is no cure for HSV-1 or HSV-2, the oral herpes stays with you for life. Oral herpes can be treated with antiviral medications to help shorten outbreaks and lessen their symptoms.

When someone contracts oral herpes, it stays dormant in the facial nerve tissues until it is triggered, causing an outbreak.

Triggers or oral herpes may include fatigue, chemotherapy, steroids, menstruation, physical and/or emotional stress or trauma, and immunosuppression from diseases like HIV.

Is there a difference between canker sores in the mouth and oral herpes?

Yes, there is a difference between herpes’ cold sores and canker sores. Although the names sound similar to one another, a close examination will easily reveal their differences. While oral herpes and canker sores both affect the mouth, they are found in different areas.

Here are a few differences between oral herpes and canker sores:

  • Cold sores (herpes) form as multiple tiny blisters, while canker sores appear as reddened raised areas that ultimately develop into larger sores.
  • Cold sores tend to occur on the roof and gums of the mouth on on the lips, while canker sores appear on the insides of the lip, cheek and/or in back of the throat.
  • Cold sores begin as little bumps that may break apart and leave small sores, while canker sores begin as sores.
  • Cold sores are smaller than canker sores, and tend to heal more quickly.
  • Cold sores may recur in the same location, while canker sores very often occur in different location.
  • Cold sores show up on the lips and mouth, while canker sores show up in various places inside the mouth only.

How is oral herpes spread?

Herpes is virus with multiple strains; two of these strains, HSV-1 and HSV-2, cause both oral and genital herpes. Herpes viruses infect the skin and/or mucous membranes.

Oral herpes presents itself as cold sore or fever blisters that affect the lips or area near the mouth. Oral herpes is most often caused by the HSV-1 strain, but oral herpes can also be caused by the HSV-2 strain.

Approximately 80 percent of oral herpes cases are caused by HSV-1, while the remaining 20 percent are caused by HSV-2, and 75%-80% of Americans carry at least one Herpes Simplex Virus (Type 1 or 2).

Herpes 1 and 2 can be contracted during vaginal, anal or oral sex. The initial outbreak of either virus strain can result in flu-like symptoms, including fever, swollen lymph nodes and body aches.

What causes oral herpes?

Oral herpes is most commonly transmitted by kissing or sharing drinks or utensils, but can also be contracted from a partner who has genital herpes during oral sex. HSV-1 can be contracted from infected bodily fluids, including semen, vaginal fluid, saliva, or herpes lesions, sores or blister fluid.

Upon entering a cell, the infection often does not cause any symptoms. If the virus destroys the host cell during replication, sores or blisters filled with fluid appear. Scabs form over the sores or blisters once the fluid is absorbed, then the scabs disappear without scarring.

The herpes virus goes through dormant phases where it becomes inactive for indeterminable periods of time and reactivate unpredictably. Herpes can be transmitted even when signs or symptoms are not present.

This process is known as “shedding,” and occurs when cells that have the active virus are dropped or shed from the skin. Approximately one- third to half of all shedding occurrences are asymptomatic.

How can I prevent getting or spreading oral herpes?

There are many ways to prevent getting or spreading oral herpes, but getting tested first is the only way to know for certain that you are not a carrier of HSV-1 or HSV-2.

You can also help prevent contracting oral herpes by not kissing or having oral sex with anyone with cold sores or genital sores, or sharing creams, medicines, makeup and other fluids that may have come in contact with the virus. Avoid sharing drinks, straws and eating utensils also.

Who is at risk for oral herpes?

Men and women who come in contact with HSV-1 or HSV-2 infections are at risk of contracting oral herpes.

Since oral herpes is transmitted through skin-to-skin contact including kissing and oral sex, anyone engaged in oral-genital or genital-genital sex may also be at risk.

HSV-1 and HSV-2 do not always show symptoms and can lie dormant in your body for many years before being triggered.

Other conditions linked to oral herpes

Oral herpes is not typically a serious condition. Having herpes may cause personal discomfort, stress and inconvenience such as making it difficult or painful to drink fluids or swallow food.

In rare cases, HSV-1 can recur spontaneously in the eye, a condition known as ocular herpes. Ocular herpes can be serious and can even lead to blindness in some cases.

Herpes simplex virus encephalitis is a rare, but serious condition mainly caused by HSV-1. HSV encephalitis causes inflammation of the brain.

Herpes viruses have also been linked to Recurrent Lymphocytic Meningitis (Mollaret’s meningitis), which is characterized by sudden attacks of meningitis symptoms that last for 2-7 days and are separated by symptom-free (latent) intervals lasting for weeks, months or years.

Is there a cure or treatment oral herpes?

No, there is not a cure for oral or genital herpes, but there are treatment options available. Avoiding oral sex or kissing someone with herpes can help prevent the spread of herpes.

The first herpes symptoms after infection may also go away on their own after 10-14 days, although the infection itself remains dormant in your body.

Antiviral medications, such as acyclovir, famciclovir, and valacyclovir, are the most effective medications available for people infected with herpes.

These medications are used to help to reduce the severity and frequency of symptoms, however they cannot cure the infection.

Do oral herpes drugs prevent the HSV-1 or HSV-2 virus from spreading?

No, there are no drugs that can stop the transmission of the virus. Avoiding personal contact with an infected area is the best way to help avoid contracting the HSV-1 and HSV-2 viruses. Antiviral medications can help minimize the effects of cold sores, especially if taken at the onset of the infection.

FDA-approved medications treat fever blisters and cold sores

The best time to treat cold sores and fever blisters is as soon as you notice the symptoms. This means you should begin treatment as soon as you see signs that you may be developing early symptoms.

Though antiviral herpes medications do not completely eliminate oral herpes, they have been shown to shorten and often lessen symptoms of outbreaks.

Herpes Simplex Virus 1

Herpes Simplex Virus 1 (HSV-1) is a strain of the herpes simplex virus. People may believe that HSV-1 is the same thing as “oral herpes,” and that it always causes cold sores to appear on the mouth or facial region, but that’s not always true. HSV-1 can be acquired in the genital region, creating “genital HSV-1.”

Similarly, HSV-2 is popularly known as “genital herpes,” but HSV-2 can be acquired in the facial region creating “oral HSV-2.” Both HSV-1 and HSV-2 are nearly identical; they share 50% of their DNA and produce almost indistinguishable symptoms. This is why it’s important to get tested for both strains of the disease.

Where does HSV-1 live?

HSV-1 and HSV-2 both have specific locations where they prefer to live in the body. HSV-1 likes to live in the back of the neck, causing outbreaks on the face. HSV-2 tends to live at the base of the spine, leading to outbreaks in the genital area.

However, these location preferences are just preferences; each virus will nest at the location closest to where it was acquired and outbreaks will occur based on the nesting location.

How common is Herpes Simplex 1?

HSV-1 is extremely common. In 2012 the World Health Organization estimated that a staggering 67% of the population was infected with the virus, and 140 million of those infected were estimated to have genital HSV-1.

Oral HSV-1 is most commonly contracted during childhood after receiving kisses from family members who carry the virus. Cases of oral HSV-1 and genital HSV-1 are on the rise.

How can you get HSV-1?

All strains of the herpes virus are extremely contagious and can be spread through saliva, sores, and skin-to-skin contact where the outbreaks occur.

The herpes virus sheds, releasing traces of the virus periodically, even without visible symptoms. This means that it’s able to be contracted even when sores are not present. However, the virus is most contagious when sores are present.

What is an initial herpes outbreak?

The symptoms of the initial outbreak of the HSV-1 virus are a lot more severe than the symptoms in the recurring outbreaks.

When the virus is first contracted, typical symptoms may include fever, nausea, headaches, muscle aches, and a general feeling of unwell, accompanied by fluid-filled lesions or “cold sores.” An Initial outbreak may occur days, weeks, or even years after first being exposed to the virus.

What are the recurring symptoms?

HSV-1 is a latent and lifelong virus. This means it lies dormant in the system, only to appear sporadically throughout the course of its host’s lifetime.

Recurring outbreaks of HSV-1 are much less severe than the initial outbreak and only include the fluid-filled blisters or “cold sores.”

After the blisters form, they eventually break and the fluid oozes out. A yellow scab crusts over the broken blister. Once the scab falls off, there’s new skin underneath.

These lesions tend to appear in clusters either on the face or in the genital region, and they can last anywhere from 7 days to 3 weeks.

Recurring symptoms appear months or even years after the initial outbreak and can continue to occur randomly throughout the infected person’s life.

Symptoms can surface every month, every year, and sometimes they may never appear at all (especially in the case of genital HSV-1).

Unfortunately, there is no way to identify exactly when the HSV-1 symptoms will emerge. Outbreaks tend to decrease in frequency and severity as time goes on because the body builds up more antibodies to fight off the virus.

Simplex 1 Treatment

There is currently no cure for either strand of the herpes simplex virus. However, both can be managed with prescribed antivirals.

Medication

Acyclovir, famciclovir, and valacyclovir are three of the most common antivirals used to help manage HSV-1 and HSV-2. Of the three, acyclovir is most prescribed for HSV-1.

All three help by shortening the life cycle of the virus to accelerate the healing time for the cold sore symptoms.

Acyclovir can be taken orally or applied topically, but the oral route is much more effective. Acyclovir must be prescribed by a doctor.

What are Cold Sores & What Causes Them?

Cold sores are small, painful, fluid-filled blisters that usually occur in clusters on or around the lips. Sometimes called fever blisters, cold sores are caused by the herpes simplex virus.

There are two strains of herpes simplex virus that cause cold sores: HSV-1 and HSV-2. HSV-1 is more commonly linked with cold sores (oral herpes), while HSV-2 is more often the cause of genital herpes.

It is important to note that you can contract HSV-1 and HSV-2 in either location (oral or genital). Approximately 80 percent of cold sore cases are caused by HSV-1, while the remaining 20 percent are caused by HSV-2.

What do They Look Like & Where do They Appear?

These uncomfortable sores often appear in small clusters. They can best be identified by their irritated, reddish or pinkish color, Cold sores have been referred to as “weepy” because once the blisters break, they will leak fluids and then eventually scab over.

Cold sores most commonly appear on or around the lips, however, sometimes HSV-1 and HSV-2 can spread to the fingertips (called herpes whitlow), the eyes (called ocular herpes), or widespread areas of the skin (people with eczema are more susceptible to this).

How do You Get Cold Sores?

Sores caused by HSV are contracted through skin-to-skin contact with someone whose blisters are present. Additionally, you can still receive a cold sore from someone whose blisters are not present by sharing bodily fluids.

This means that though there is no outbreak, you may not be entirely in the clear. This can occur in a number of ways, including kissing and oral sex, or sharing toothbrushes, food utensils, razors, and towels.

Are They Contagious?

Cold sores are extremely contagious, so much so, that about two-thirds of the world’s population has HSV-1. Additionally, 1 in every 6 people has HSV-2.

If you have cold sores, it is important to be aware and avoid skin-to-skin contact with small children and those with a weak immune system.

Cold Sore Symptoms

The first outbreak of cold sores will typically be the worst, and may include:

  • Fever
  • Painful eroded gums
  • Sore throat
  • Muscle aches
  • Swollen lymph nodes

After the first outbreak symptoms will often be reduced, but may still include:

  • Pre-cold sore tingling and itching
  • Blisters
  • Oozing and Crusting

Are Cold Sores Treatable? What Medicine can be Taken?

Cold sores can best be treated with suppressive therapy, using an oral antiviral medicine such as acyclovir, famciclovir, or valaciclovir. These medications must be prescribed by a doctor.

They are used to help to reduce the severity and frequency of symptoms. However, they cannot cure the infection. Cold sores are a symptom of herpes (or the herpes simplex virus), and there is currently no cure.