What are the common symptoms of oral herpes. How is oral herpes transmitted. What triggers outbreaks of oral herpes. How is oral herpes diagnosed and treated. Can oral herpes be prevented.

Understanding Oral Herpes: An Overview of HSV-1 Infection

Oral herpes, also known as herpes labialis or cold sores, is a viral infection affecting the lips, mouth, and gums. It’s primarily caused by the herpes simplex virus type 1 (HSV-1). This common condition manifests as small, painful blisters often referred to as cold sores or fever blisters.

HSV-1 is highly prevalent, with most individuals in the United States contracting the virus by age 20. After the initial infection, the virus becomes dormant in facial nerve tissues, occasionally reactivating to cause outbreaks.

Recognizing the Signs and Symptoms of Oral Herpes

The symptoms of oral herpes can vary from person to person, ranging from mild to severe. They typically appear within 1 to 3 weeks after exposure to the virus and may last up to 3 weeks.

Early Warning Signs

• Itching or burning sensation around the lips or mouth area
• Tingling near the lips or mouth
• Sore throat
• Fever
• Swollen glands
• Difficulty swallowing

Visible Symptoms

As the infection progresses, more noticeable symptoms may develop:

• Red blisters that break open and leak fluid
• Small, clear yellowish fluid-filled blisters
• Clusters of smaller blisters that may merge into larger ones
• Yellow and crusty blisters during the healing phase

Is there a difference in symptom severity between initial and recurrent outbreaks. Initial outbreaks tend to be more severe and longer-lasting compared to recurrent episodes. Subsequent outbreaks are often milder and may be triggered by factors such as hormonal changes, sun exposure, fever, or stress.

Transmission and Risk Factors for Oral Herpes

HSV-1 spreads through close personal contact or exposure to infected items. Understanding the transmission routes is crucial for prevention.

How is oral herpes transmitted.

• Intimate or personal contact with an infected individual
• Touching an open herpes sore
• Using items that have been in contact with the herpes virus (e.g., razors, towels, dishes)
• Parent-to-child transmission during daily activities

Can oral herpes be caused by HSV-2. While HSV-1 is the primary cause of oral herpes, HSV-2 (typically associated with genital herpes) can also cause oral infections, usually through oral sex with an infected partner.

Diagnosis and Medical Evaluation of Oral Herpes

Diagnosing oral herpes often involves a visual examination by a healthcare provider. However, additional tests may be necessary for confirmation or in atypical cases.

Diagnostic Methods

1. Visual inspection of the mouth area
2. Viral culture from a sample of the sore
3. Viral DNA test
4. Tzanck test to check for HSV

Why might a healthcare provider order additional tests for oral herpes. Additional tests may be required to differentiate between HSV-1 and HSV-2, rule out other conditions with similar symptoms, or in cases where the visual diagnosis is unclear.

Treatment Options for Oral Herpes Outbreaks

While oral herpes outbreaks often resolve on their own within 1 to 2 weeks, various treatment options can help manage symptoms and speed up healing.

Antiviral Medications

Prescription antiviral medicines are the primary treatment for oral herpes. These medications work best when taken at the first sign of an outbreak, ideally before blisters appear.

• Acyclovir
• Famciclovir
• Valacyclovir

How do antiviral medications help in managing oral herpes. Antiviral drugs can reduce pain, shorten the duration of outbreaks, and in some cases, suppress future recurrences when taken as a preventive measure.

Over-the-Counter Remedies

While not as effective as prescription antivirals, some over-the-counter treatments can provide symptom relief:

• Docosanol cream
• Benzyl alcohol gel
• Lidocaine or benzocaine for pain relief

Managing Recurrent Outbreaks and Long-Term Care

For individuals experiencing frequent outbreaks, long-term management strategies may be necessary to reduce the frequency and severity of episodes.

Suppressive Therapy

Daily antiviral medication can be prescribed for those with frequent or severe outbreaks. This approach, known as suppressive therapy, aims to reduce the frequency of recurrences and minimize the risk of transmission.

Lifestyle Modifications

Identifying and avoiding personal triggers can help reduce the frequency of outbreaks. Common triggers include:

• Stress
• Lack of sleep
• Poor diet
• Excessive sun exposure
• Hormonal changes

Can lifestyle changes alone prevent oral herpes outbreaks. While lifestyle modifications can help reduce the frequency of outbreaks, they may not completely prevent them. A combination of medication and lifestyle changes often yields the best results.

Prevention and Minimizing Transmission Risk

While it’s challenging to completely prevent oral herpes due to its high prevalence and ease of transmission, several measures can reduce the risk of infection and spread.

Preventive Measures

• Avoid kissing or intimate contact during active outbreaks
• Refrain from sharing personal items like utensils, towels, or lip balm
• Practice good hygiene, especially hand washing
• Use sun protection on the lips to prevent sun-triggered outbreaks
• Manage stress through relaxation techniques or exercise

Is it possible to completely prevent transmission of oral herpes. Complete prevention is challenging due to asymptomatic shedding, where the virus can be transmitted even without visible symptoms. However, following preventive measures significantly reduces the risk.

Disclosure and Communication

Open communication with partners about HSV status is crucial for preventing transmission. Discussing the condition, its symptoms, and preventive measures can help reduce stigma and promote understanding.

Living with Oral Herpes: Psychological and Social Aspects

The psychological impact of living with oral herpes can be significant, often due to social stigma and misconceptions about the condition.

Coping Strategies

• Educate yourself and others about the condition
• Join support groups or online communities
• Practice self-care and stress management
• Seek counseling if the condition significantly impacts your mental health

How can individuals with oral herpes maintain a positive self-image. Focusing on overall health, understanding the commonality of the condition, and developing effective management strategies can help maintain a positive self-image and quality of life.

Debunking Myths

Addressing common misconceptions about oral herpes is crucial for reducing stigma:

• Oral herpes is not always sexually transmitted
• Having oral herpes doesn’t mean a person is promiscuous or unclean
• Cold sores are not the same as canker sores, which are not caused by HSV

Oral herpes, while a common and often manageable condition, requires understanding and proper care. By recognizing symptoms, seeking appropriate treatment, and implementing preventive measures, individuals can effectively manage oral herpes and minimize its impact on their lives. As research continues, new treatments and management strategies may emerge, offering hope for even better control of this widespread viral infection.

Herpes – oral Information | Mount Sinai

Cold sore; Fever blister; Oral herpes simplex; Herpes labialis; Herpes simplex

Oral herpes is an infection of the lips, mouth, or gums due to the herpes simplex virus. It causes small, painful blisters commonly called cold sores or fever blisters. Oral herpes is also called herpes labialis.

This close-up view of an early herpes outbreak shows small, grouped blisters and a lot of redness.

Causes

Oral herpes is a common infection of the mouth area. It is caused by the herpes simplex virus type 1 (HSV-1). Most people in the United States are infected with this virus by age 20.

After the first infection, the virus goes to sleep (becomes dormant) in the nerve tissues in the face. Sometimes, the virus later wakes up (reactivates), causing cold sores.

Herpes virus type 2 (HSV-2) most often causes genital herpes. However, sometimes HSV-2 is spread to the mouth during oral sex, causing oral herpes.

Herpes viruses spread most easily from individuals with an active outbreak or sore. You can catch this virus if you:

• Have intimate or personal contact with someone who is infected
• Touch an open herpes sore or something that has been in contact with the herpes virus, such as infected razors, towels, dishes, and other shared items

Parents may spread the virus to their children during regular daily activities.

Symptoms

Some people get mouth ulcers when they first come into contact with HSV-1 virus. Others have no symptoms. Symptoms most often occur in kids between 1 and 5 years old.

Symptoms may be mild or severe. They most often appear within 1 to 3 weeks after you come into contact with the virus. They may last up to 3 weeks.

Warning symptoms include:

• Itching of the lips or skin around the mouth
• Burning near the lips or mouth area
• Tingling near the lips or mouth area

Before blisters appear, you may have:

• Sore throat
• Fever
• Swollen glands
• Painful swallowing

Blisters or a rash may form on your:

• Gums
• Lips
• Mouth
• Throat

Many blisters are called an outbreak. You may have:

• Red blisters that break open and leak
• Small blisters filled with clear yellowish fluid
• Several smaller blisters that may grow together into a large blister
• Yellow and crusty blister as it heals, which eventually turns into pink skin

Symptoms may be triggered by:

• Menstruation or hormone changes
• Being out in the sun
• Fever
• Stress

If the symptoms return later, they are usually more mild in most cases.

Exams and Tests

Your health care provider can diagnose oral herpes by looking at your mouth area. Sometimes, a sample of the sore is taken and sent to a laboratory for closer examination. Tests may include:

• Viral culture
• Viral DNA test
• Tzanck test to check for HSV

Treatment

Symptoms may go away on their own without treatment in 1 to 2 weeks.

Your provider can prescribe medicines to fight the virus. This is called antiviral medicine. It can help reduce pain and make your symptoms go away sooner. Medicines used to treat mouth sores include:

• Acyclovir
• Famciclovir
• Valacyclovir

These medicines work best if you take them when you have warning signs of a mouth sore, before any blisters develop. If you get mouth sores frequently, you may need to take these medicines all the time.

• Antiviral skin creams may also be used. However, they are expensive and often only shorten the outbreak by a few hours to a day.

The following steps can also help make you feel better:

• Apply ice or a warm washcloth to the sores to help ease pain.
• Wash the blisters gently with germ-fighting (antiseptic) soap and water. This helps prevent spreading the virus to other body areas.
• Avoid hot beverages, spicy and salty foods, and citrus.
• Gargle with cool water or eat fruit-flavored ice pops.
• Rinse with salt water.
• Take a pain reliever such as acetaminophen (Tylenol).

Outlook (Prognosis)

Oral herpes most often goes away by itself in 1 to 2 weeks. However, it may come back.

Herpes infection may be severe and dangerous if:

• It occurs in or near the eye.
• You have a weakened immune system due to certain diseases and medicines.

Possible Complications

Herpes infection of the eye is a leading cause of blindness in the United States. It causes scarring of the cornea.

Other complications of oral herpes may include:

• Return of mouth sores and blisters
• Spread of the virus to other skin areas
• Bacterial skin infection
• Widespread body infection, which may be life threatening in people who have a weakened immune system due to atopic dermatitis, cancer, or HIV infection

When to Contact a Medical Professional

Contact your provider if you have:

• Symptoms that are severe or that don’t go away after 2 weeks
• Sores or blisters near your eyes
• Herpes symptoms and a weakened immune system due to certain diseases or medicines

Prevention

Here are some tips to prevent mouth sores:

• Apply sunblock or lip balm containing zinc oxide to your lips before you go outside.
• Apply a moisturizing balm to prevent the lips from becoming too dry.
• Avoid direct contact with herpes sores.
• Wash items such as towels and linens in boiling hot water after each use.
• Do not share utensils, straws, glasses, or other items if someone has oral herpes.

Do not have oral sex if you have oral herpes, especially if you have blisters. You can spread the virus to the genitals. Both oral and genital herpes viruses can sometimes be spread, even when you do not have mouth sores or blisters.

DinulosJGH. Warts, herpes simplex, and other viral infections. In: Dinulos JGH, ed. Habif’sClinical Dermatology: A Color Guide in Diagnosis and Therapy. 7th ed.Philadelphia, PA: Elsevier; 2021:chap 12.

Schiffer JT,Corey L. Herpes simplex virus. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases.9th ed. Philadelphia, PA: Elsevier; 2020:chap 135.

Whitley RJ,Gnann JW. Herpes simplex virus infections. In: Goldman L, Schafer AI, eds. Goldman-CecilMedicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 350.

Last reviewed on: 7/19/2021

Reviewed by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Herpes simplex – symptoms and diagnosis, prices for the treatment of herpes simplex in Moscow at the Hadassah clinic

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Herpes simplex (herpes virus type 1,2) is an infectious disease that manifests itself mainly in the appearance of blisters on the skin or mucous membranes. Symptoms occur mainly in the lips, eyelids or genitals. Herpes affects more women than men. Herpes simplex type 1 is the main cause of

blisters characteristic of this disease in the area of ​​the lips. Herpes simplex type 2 blisters appear mainly in the genital area. The disease of herpes simplex most often does not lead to death. It can be life-threatening for infants (if the virus enters the brain and causes encephalitis) and for patients with weakened immune systems.

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Symptoms of herpes infection

HSV-1 appears as clear and fluid-filled blisters. Herpes simplex virus type 1 rarely causes pimples on the genitals – mostly on the face. When initially infected with the virus, acne appears only in about 10% of patients 2-20 days after contact with an infectious person. There may be several wounds or one. Before the appearance of acne, there are such precursors as itching and burning of the skin.

A pimple may burst when struck or scratched and release fluid. After the wound heals, a crust remains on it, which dries up and leaves. The duration until recovery is about 10 days. At the end of the recovery, the skin usually recovers completely.

Even after the initial wound has healed, the virus remains in the body. It penetrates the nerve cells and remains in them in an inactive state until the right conditions arise. Any “awakening” can cause bubbles to appear in or near the same spot.

Primary infection with herpes simplex virus type 2 usually presents with blisters on the surface of the genitals, buttocks, or cervix 2 to 20 days after exposure to a carrier of the virus. Herpes simplex virus type 2 can cause symptoms to appear elsewhere, but it usually attacks below the waist. A second outbreak of the virus can cause the symptoms of a herpes infection, such as itching, painful pimples, fever, muscle pain, and burning when urinating.

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Causes of herpes simplex

The herpes virus is transmitted by direct contact of infected skin with the skin of a healthy person, in the mouth or genital area. The penetration of the virus is possible only through a skin defect (wound or scratch), mainly in the area of ​​the penis and vulva, rectum and cervix.

In most cases, herpes simplex type 1 infection occurs in childhood through close contact with peers or family members who are carriers of the virus. The infection can be transmitted with a kiss, through ordinary cutlery or lipstick.

Herpes type 2 infection usually occurs through sexual contact with a carrier of the virus. The virus is present in 20% of sexually active people. As far as we know, this form of infectious disease (genital herpes type 2) cannot be contracted through contact with objects such as a toilet seat, toilet paper or towel. This is because the herpes virus is very sensitive to environmental conditions and does not survive outside the body.

Among the predisposing factors activating the “dormant” virus in the body, it should be noted:

• colds;
• fever;
• prolonged sun exposure;
• menstrual cycle;
• severe emotional stress;
• injury to the skin or mucosa.

With both types of herpes simplex, the recurrence rate can vary. Pimples can spread to different parts of the body due to constant scratching.

Methods for diagnosing herpes virus 1.

2 type

Herpes is relatively easy to diagnose. Usually, the diagnosis of herpes type 1.2 is necessary for patients suffering from impaired immune function, those undergoing chemotherapy and patients with AIDS. The following diagnostic measures are recommended:

Laboratory tests

include microscopic and other tests of blood or fluid from the pimple to detect antibodies against the virus; some tests are valid only in the initial stages of the disease

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Treatments for herpes simplex

Existing technologies do not allow to clear the hereditary material of the virus from the DNA of nerve cells, and the displacement of the ganglia will cause much more acute side effects (for example, paralysis of the lips). That is why today the disease is incurable.

Treatment for herpes simplex is directed at controlling the symptoms and preventing complications. Antiviral drugs used to treat rashes are prescribed (Acyclovir, Gerpevir, etc.)

After stopping the acute process, a herpes vaccine is recommended, which allows achieving a stable remission. Among the physiotherapeutic methods of treatment, infrared and UV radiation, OCU therapy and laser therapy should be distinguished.

Treatment of herpes simplex in the Hadassah clinic

For the treatment of herpes types 1 and 2, please contact the Hadassah clinic in Moscow. We have doctors with extensive practical experience, we have modern equipment that simplifies the diagnosis.

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Shilov
Dmitry Yurievich

Allergist-immunologist, Ph.D.

Work experience: 17 years

Published: 07/06/2023

The information provided on the site is for reference only and cannot serve as a basis for making a diagnosis or prescribing treatment. Internal consultation of the expert is necessary.

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