What is the herpes simplex virus?
Some people call it a cold sore, others a fever blister, but this annoying and often
painful chronic condition is caused by a virus: herpes simplex. About 50% to 80% of
U.S. adults have oral herpes. According to the National Institutes of Health (NIH),
by age 50, about 90% of adults have been exposed to the virus. Once infected, a person
will have the herpes simplex virus for the rest of his or her life. When inactive,
the virus lies dormant in a group of nerve cells. Some people never have any symptoms
from the virus. Others have periodic outbreaks of infections.
How long do the herpes lesions last?
The herpes lesions typically last a week to 10 days. It most often occurs around the
lips, oral mucosa, or tongue. The lesions occur first as fluid-filled blisters that
rupture after a day or two. The sores will weep fluid that contains the virus. After
a few days, the sores will form crusts or scabs. The virus is highly contagious and
can be spread by skin-to-skin contact such as kissing.
The 2 most common forms of the virus are herpes simplex virus type 1 (HSV-1) and herpes
simplex virus type 2 (HSV-2). HSV-1 is most often linked with infections of the oral
cavity, with up to 90% of people in the U.S. exposed to this virus. HSV-2 is most
often associated with genital herpes infections, with up to 30% of people in the U.S.
exposed to this virus. However, both types of HSV can infect both the mouth and the
How can HSV infections be prevented?
Since HSV is spread through direct, physical contact, such as kissing and sexual contact,
the best method of prevention is to avoid physical contact with the HSV sores when
someone is having an outbreak. However, genital herpes can be contagious without causing
any symptoms of the disease, according to the CDC.
What are the signs and symptoms of an oral herpes simplex virus infection?
The initial (primary) infection of the oral herpes simplex virus is usually the worst.
It may cause severe, flu-like symptoms, swollen lymph nodes, and headache. However,
some people have no symptoms at all. In the initial infection, sores can occur on
and around the lips and throughout the mouth.
Recurring infections tend to be much milder, and the sores usually erupt in the edges
of the lips. Some people never have any more outbreaks beyond the initial infection.
These are the most common signs and symptoms of a recurring oral herpes simplex virus
Initial redness, swelling, heat, and pain, or itching in the area where the infection
Painful, fluid-filled blisters may appear on the lips or under the nose. These blisters,
and the fluid they contain, are highly contagious.
The blisters leak fluids and become sores.
After about 4 to 6 days, the sores start to crust over and heal.
The signs and symptoms of an oral herpes simplex virus outbreak may look like other
conditions or medical problems. Always see your healthcare provider for a diagnosis.
What causes the virus to recur?
It is not clear what triggers the virus to recur, but several factors are thought
to play a role. Prolonged or intense exposure to sunlight, a recent fever, emotional
stress, menstruation, surgery, or physical injury might contribute to a recurrence
of the virus. Recurrent outbreaks are more common in the first year after the initial
episode, then lessen as the body builds antibodies to the virus.
How is an oral HSV infection diagnosed?
Herpes simplex virus is difficult to diagnose. Often confused with many other infections,
such as allergic reactions, the herpes simplex virus can only be confirmed with a
virus culture, blood test, or biopsy. However, a healthcare provider can often diagnose
it based on the location and appearance of the blisters.
What are treatments for oral HSV infections?
Your healthcare provider will figure out the best treatment based on:
How old you are
Your overall health and medical history
How well you can handle specific medicines, procedures, or therapies
How long the condition is expected to last
Your opinion or preference
Treatment may involve: