Oral Herpes: A Complete Guide

Oral herpes is an infection of the mouth, lips, and gums caused by herpes simplex virus, specifically, type 1 (HSV-1). Oral herpes presents as fever blisters and cold sores. Some people with oral herpes have no symptoms at all.

Oral herpes is incredibly prevalent, with most people in the United States having HSV-1 by the age of 20.

This article explains what causes oral herpes, its symptoms, when you should seek medical treatment, and more.

Oral Herpes Causes

The herpes simplex virus has two types: HSV-1 and HSV-2. Oral herpes is usually caused by HSV-1, while genital herpes is usually caused by HSV-2. That said, HSV-1 can also cause genital herpes and HSV-2 can also cause oral herpes.

HSV-1 can be spread through mouth-to-mouth contact, such as kissing (saliva), or through touching the skin or sores around the mouth of a person infected with oral herpes, and sharing objects like lip balm, razors, toothbrushes, and even utensils that are infected. It can also be transmitted through oral-genital contact, although this is not typically common.

Stages of Oral Herpes

There are three main stages of oral herpes:

• Primary infection: This stage consists of the initial contraction of the virus.
• Latency: When the infection enters the latency phase, it is dormant and symptoms are absent.
• Recurrence: Following the primary infection and periods of latency, outbreaks can recur.

Oral Herpes Symptoms

Oral herpes is usually asymptomatic. If there are symptoms, these usually appear during the primary infection or recurrence phase.

Incubation Period

The incubation period is the time between the first infection and when symptoms show up. The incubation period for HSV-1 is two to 12 days following exposure.

Symptomatic Period

If someone is symptomatic, herpes symptoms may include:

• Fever
• Fatigue
• Muscle aches
• Irritability
• Oral sores
• Swollen lymph nodes

When to Seek Medical Treatment

While oral herpes symptoms usually go away within one to two weeks without treatment, there may be cases in which an HSV-1 infection is more serious and can cause complications, primarily involving the eyes, fingertips, and skin.

Complications

Potential complications from oral herpes include:

• Eyes: If blisters show up around the eye area, it can cause blindness. Herpes infections are a major cause of blindness across the globe.
• Fingertips: Herpes can spread to the fingers and cause herpetic whitlow, a painful infection.
• Skin: HSV-1 can cause a bacterial skin infection if spread elsewhere on the body.

When to Call a Healthcare Provider

You should contact your healthcare provider if your symptoms persist for more than two weeks, especially if those symptoms are severe. If you are immunocompromised due to certain conditions or medications, it is also a good idea to reach out to a medical professional.

When to Go to the Hospital

Severe complications from HSV-1 are very rare. That said, oral herpes can lead to encephalitis (infection of brain tissue) or eye infections. If you're experiencing symptoms of either of these conditions, visit the emergency room right away. Symptoms may include headache, memory problems, fever, or personality changes.

Medical Treatment for Oral Herpes

Oral herpes symptoms may resolve without treatment within one to two weeks.

If needed, your healthcare provider will prescribe certain antiviral medications to treat your condition. These medications help with any pain you may be experiencing as well as alleviate symptoms more quickly.

Medications that are used to treat HSV-1 include acyclovir, famciclovir, and valacyclovir, which are most effective if taken when initial warning signs of an incoming flare-up appear and before blisters develop.

Follow Up

You should follow up with your healthcare provider if treatments fail to alleviate symptoms so they can rule out other possible conditions.

Tests and Diagnosis

Your healthcare provider can diagnose oral herpes by simply observing your mouth area. If necessary, your healthcare provider may also take a sample from the cold sore to send for laboratory testing. Tests may include a viral culture, a viral DNA test, or a Tzanck test.

Coping With Oral Herpes

There are a number of strategies that may be useful in coping with oral herpes. These include:

• Managing stress
• Using sunscreen before going outside
• Applying cold or warm compresses
• Doing salt water rinses
• Avoiding spicy foods, citrus, and hot drinks
• Keeping blisters clean

Prevention

The best way to prevent oral herpes from spreading to others is to skip sharing items like cups, straws, eating utensils, toothbrushes, and pipes. Kissing can also spread the virus, whether cold sores are present or not, so it's best to use caution there as well.

Outlook

Currently, there is no cure for herpes. However, with proper management, self-care, and prevention strategies, oral herpes should not impact your life in any major way.

Summary

Oral herpes is an infection of the mouth, tongue, and gums caused by the herpes simplex virus, specifically HSV-1. Oral herpes often presents as cold sores, but some people experience no symptoms at all. Oral herpes can be transmitted through kissing or sharing infected objects, such as toothbrushes, lip balm, utensils, and more.

A Word From Verywell

Oral herpes is incredibly common. If you happen to contract HSV-1, know you are not alone and there is treatment available. Practicing proper self-care, taking medications in a timely manner, and communicating with your healthcare provider are all important steps to take in order to manage the condition. Herpes is nothing to be ashamed of but it must be managed accordingly.