Herpes of the Mouth and Skin

Herpes simplex virus is divided into two types: type 1 (HSV-1) and type 2 (HSV-2).

The herpes simplex virus 1 causes tiny, painful blisters to appear on the skin of the lips, mouth, gums or lip area. Cold sores or fever blisters are frequent names for these blisters.

HSV2 is more often linked with genital herpes. However, it can also infect non-genital sites.

Oral Herpes: What Causes It?

Oral herpes is a very common condition caused by a herpes simplex virus infection in the mouth, most commonly type 1. By the age of 20, the majority of Americans have been infected with the type 1 virus.

The initial infection may go unnoticed or result in mouth ulcers. The virus is still present in the facial nerve tissue. The virus reactivates in some persons, resulting in repeated cold sores that are usually in the same place but are not dangerous.

Herpes is contagious. A person can get herpes from directly touching an infected area. Contact with infected razors, towels, plates and other shared items can also spread the virus.

Oral herpes can sometimes spread to the genitals through oral-to-genital contact (and vice versa). People with active herpes sores on or around their mouths or on their genitals should avoid oral intercourse.

Symptoms of Oral Herpes

Itching, burning, heightened sensitivity or tingling sensations may appear two days before lesions emerge as warning symptoms. Other signs and symptoms include:

• Lesions or rashes around the lips, mouth and gums
• Small blisters with a bright yellowish fluid inside
• Blisters on a painful, elevated, red part of the skin
• Breaking and oozing blisters
• Flu-like symptoms include a mild fever, sore throat and other flu-like symptoms.

The first symptoms typically emerge 1-2 weeks following contact with an infected person but can take up to three weeks. Oral herpes lesions usually last 7-10 days before starting to fade. The virus could become dormant and reside in nerve cells, causing recurrence at or near the original site.

Lesions that recur are usually milder. Menstruation, sun exposure, fever, stress and other unknown factors may cause them.

Do I Need Oral Herpes Treatment?

The symptoms of oral herpes will usually go away in 1 to 2 weeks if left untreated. Antiviral drugs taken by mouth may help to reduce pain and minimize the duration of symptoms. Herpes-related sores frequently reappear. Antiviral medicine works best if you take it when you first notice the recurrence of symptoms. If the virus returns frequently, your doctor may recommend that you take medication all the time.

Wash blisters gently with soap and water to minimize the spread of the virus to other areas of the skin. An antiseptic soap may be helpful. Applying ice or warmth to the site also may reduce pain.

Call your health care provider in the following cases:

• Your symptoms persist for more than 1 or 2 weeks.
• Your symptoms seem severe.
• You have an immunosuppressive disorder and develop herpes symptoms.

How Can I Prevent Getting or Spreading Oral Herpes?

Take precautions to avoid infecting others: 

• Avoid direct contact with cold sores or other herpes lesions. Minimize the risk of indirect spread by thoroughly washing items in hot (preferably boiling) water before re-use.
• Do not share personal items (such as towels or drinking glasses) with an infected person, especially when herpes lesions are active. Avoid precipitating causes (especially sun exposure) if you are prone to oral herpes.
• Avoid performing oral sex when you have active herpes lesions on or near your mouth and avoid receiving oral sex from someone who has active oral or genital herpes lesions. Condoms reduce but do not eliminate the risk of transmission via oral or genital sex.

Unfortunately, both oral and genital herpes viruses can sometimes be transmitted even when the person does not have active lesions.