What are the symptoms of oral herpes. How is oral herpes caused. What treatments are available for oral herpes. How can oral herpes be diagnosed. Who is most at risk for oral herpes infection. How can oral herpes outbreaks be prevented. What are the long-term effects of oral herpes.

Understanding Oral Herpes: A Comprehensive Overview

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

The prevalence of oral herpes is significant, with most people in the United States becoming infected with HSV-1 by the age of 20. Understanding the nature of this infection, its symptoms, and available treatments is crucial for managing outbreaks and preventing transmission.

The Herpes Simplex Virus: Types and Transmission

Two types of herpes simplex viruses exist: HSV-1 and HSV-2. While HSV-1 typically causes oral herpes, HSV-2 is more commonly associated with genital herpes. However, it’s important to note that HSV-2 can also cause oral herpes through oral-genital contact.

How is oral herpes transmitted? The virus spreads through direct contact with infected individuals, especially during active outbreaks. Transmission can occur through:

• Intimate or personal contact with an infected person
• Touching an open herpes sore
• Using items that have been in contact with the virus (e.g., razors, towels, dishes)

Parents can unknowingly transmit the virus to their children during routine daily activities. This highlights the importance of practicing good hygiene and taking precautions during active outbreaks.

Recognizing Oral Herpes Symptoms: From Early Warning Signs to Full-Blown Outbreaks

The symptoms of oral herpes can vary from person to person. Some individuals may experience no symptoms at all, while others may have severe outbreaks. Typically, symptoms appear within 1 to 3 weeks after initial contact with the virus and can last up to 3 weeks.

What are the early warning signs of an oral herpes outbreak? Before blisters appear, you may notice:

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

As the outbreak progresses, blisters or a rash may form on the gums, lips, mouth, or throat. These blisters can vary in appearance and may include:

• Red blisters that break open and leak
• Small blisters filled with clear yellowish fluid
• Clusters of smaller blisters that may merge into larger ones
• Yellow and crusty blisters as they heal, eventually turning into pink skin

Triggers and Risk Factors for Oral Herpes Outbreaks

While the initial infection with HSV-1 leads to the first outbreak, subsequent recurrences can be triggered by various factors. Understanding these triggers can help individuals manage and potentially prevent future outbreaks.

What are the common triggers for oral herpes outbreaks?

• Hormonal changes, including menstruation
• Excessive sun exposure
• Fever or illness
• Stress
• Weakened immune system
• Trauma to the affected area

It’s worth noting that recurrent outbreaks are often milder than the initial infection. However, the frequency and severity of outbreaks can vary greatly among individuals.

Diagnosing Oral Herpes: Clinical Examination and Laboratory Tests

Accurate diagnosis of oral herpes is crucial for appropriate treatment and management. Healthcare providers can often diagnose the condition through a visual examination of the affected area. However, in some cases, additional tests may be necessary for confirmation.

How is oral herpes diagnosed? The diagnostic process may include:

1. Clinical examination: A healthcare provider will inspect the mouth area for characteristic signs of oral herpes.
2. Viral culture: A sample from the sore is collected and sent to a laboratory to grow and identify the virus.
3. Viral DNA test: This test detects the genetic material of the herpes virus in a sample from the sore.
4. Tzanck test: This involves scraping cells from the base of the lesion and examining them under a microscope for changes characteristic of herpes infection.

These diagnostic methods help differentiate oral herpes from other conditions that may cause similar symptoms, ensuring appropriate treatment strategies are employed.

Treatment Options for Oral Herpes: From Over-the-Counter Remedies to Prescription Antivirals

While oral herpes outbreaks often resolve on their own within 1 to 2 weeks, various treatment options can help manage symptoms, reduce pain, and potentially shorten the duration of an outbreak.

What treatments are available for oral herpes?

• Antiviral medications: Prescription drugs such as acyclovir, famciclovir, and valacyclovir can fight the virus and alleviate symptoms.
• Over-the-counter pain relievers: Acetaminophen or ibuprofen can help manage pain and discomfort.
• Topical treatments: Creams or ointments containing docosanol or benzyl alcohol can provide relief and promote healing.
• Cold or warm compresses: These can help soothe the affected area and reduce inflammation.
• Lysine supplements: Some studies suggest that lysine may help prevent or reduce the severity of outbreaks, although more research is needed.

For individuals experiencing frequent outbreaks, healthcare providers may recommend daily suppressive therapy with antiviral medications. This approach can significantly reduce the frequency and severity of recurrences.

Living with Oral Herpes: Managing Outbreaks and Preventing Transmission

While there is no cure for oral herpes, individuals can take steps to manage the condition and reduce the risk of transmitting the virus to others.

How can you manage oral herpes outbreaks and prevent transmission?

• Avoid touching or picking at sores to prevent bacterial infection and spreading the virus.
• Wash hands frequently, especially after touching the affected area.
• Avoid sharing personal items like towels, lip balms, or utensils during outbreaks.
• Abstain from kissing or engaging in oral sex during active outbreaks.
• Use sunscreen on the lips to prevent sun-induced outbreaks.
• Manage stress through relaxation techniques, exercise, or counseling.
• Maintain a healthy lifestyle to support your immune system.

By adopting these practices, individuals with oral herpes can minimize the impact of the condition on their daily lives and reduce the risk of transmitting the virus to others.

The Psychological Impact of Oral Herpes: Coping Strategies and Support

Living with oral herpes can have significant psychological effects on individuals. The visible nature of outbreaks, coupled with the stigma often associated with herpes infections, can lead to feelings of embarrassment, anxiety, and social isolation.

How can individuals cope with the psychological impact of oral herpes?

• Educate yourself about the condition to dispel myths and misconceptions.
• Join support groups or online communities to connect with others who understand your experiences.
• Practice self-care and stress-reduction techniques to manage triggers and improve overall well-being.
• Communicate openly with partners about the condition to build trust and understanding.
• Seek professional counseling if the psychological impact becomes overwhelming.

Remember that oral herpes is a common condition affecting millions of people worldwide. With proper management and support, individuals can lead fulfilling lives despite recurring outbreaks.

Oral Herpes in Special Populations: Children, Pregnant Women, and Immunocompromised Individuals

Certain populations may require special considerations when it comes to oral herpes management and treatment.

How does oral herpes affect different populations?

• Children: Primary HSV-1 infections often occur in childhood. Parents should be cautious about kissing children during active outbreaks and teach proper hygiene practices.
• Pregnant women: Herpes infections during pregnancy can pose risks to the fetus. Pregnant women with oral herpes should consult their healthcare provider for appropriate management.
• Immunocompromised individuals: People with weakened immune systems may experience more severe and frequent outbreaks, requiring closer medical supervision and potentially more aggressive treatment.

Healthcare providers can offer tailored advice and treatment plans for these special populations to ensure optimal management of oral herpes.

The Future of Oral Herpes Treatment: Research and Emerging Therapies

Scientific research continues to explore new avenues for treating and potentially preventing oral herpes infections. Several promising areas of study include:

• Vaccine development: Researchers are working on preventive and therapeutic vaccines for HSV-1 and HSV-2.
• Gene editing techniques: CRISPR technology is being investigated as a potential tool to eliminate the virus from infected cells.
• Novel antiviral drugs: New medications with improved efficacy and fewer side effects are in various stages of development.
• Immunotherapy: Approaches to boost the immune system’s ability to control herpes infections are being explored.

While these potential treatments are still in the research phase, they offer hope for improved management and possible prevention of oral herpes in the future.

Oral Herpes and Dental Care: Special Considerations

Individuals with oral herpes may have concerns about dental care, especially during active outbreaks. How can oral herpes affect dental care?

• Postpone non-emergency dental procedures during active outbreaks to prevent spread and discomfort.
• Inform your dentist about your oral herpes history to ensure appropriate precautions are taken.
• Maintain good oral hygiene to prevent complications and promote overall oral health.
• Consider using an antiviral medication before dental procedures if you’re prone to stress-induced outbreaks.

Open communication with your dental care provider is key to managing oral herpes effectively in the context of dental health.

Nutritional Considerations for Oral Herpes Management

While diet alone cannot cure oral herpes, certain nutritional strategies may support the immune system and potentially help manage outbreaks. What dietary approaches might be beneficial for individuals with oral herpes?

• Consume foods rich in lysine, such as fish, chicken, and legumes, which may help inhibit viral replication.
• Limit foods high in arginine, like nuts and chocolate, as arginine may promote viral growth.
• Increase intake of foods high in vitamin C and zinc to support immune function.
• Stay well-hydrated to promote overall health and potentially speed healing of sores.
• Consider probiotic-rich foods to support gut health and immune function.

While more research is needed to definitively establish the impact of diet on oral herpes, a balanced, nutrient-rich diet can contribute to overall health and potentially support the body’s ability to manage the virus.

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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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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