Updated on February 7, 2024
5 min read

Oral Herpes – Causes, Symptoms & Treatments

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What is Oral Herpes?

Oral herpes is a chronic condition caused by herpes simplex virus type 1 (HSV-1). It is sometimes referred to as cold sores or fever blisters.

Oral herpes is a common infection around the mouth. While some infected people never develop symptoms, others may experience painful and periodic outbreaks.

illustration of infection on a womans lips known as oral herpes

How Common is Oral Herpes?

According to the World Health Organization’s most recent data, 3.7 billion people under 50 had oral herpes in 2016. Most of these cases initially occurred during childhood.

Over 50 to 80 percent of American adults have oral herpes. About 90 percent will be exposed to the virus by age 50.

What Causes Oral Herpes?

Oral herpes spreads among people through physical contact with the virus in active sores, saliva, or surfaces in or around the mouth.

That means you can catch oral herpes by kissing or having oral sex with someone with the virus. The virus also spreads through oral-genital contact, although this is rare and usually causes genital herpes.

People with oral herpes cannot be reinfected, as their body already has the virus. However, they are still at risk of catching genital herpes.

What Does Oral Herpes Look Like?

When people have symptoms, it is usually in the form of mild to severe blisters or sores around the mouth, including the:

  • Lips
  • Tongue
  • Roof of the mouth
  • Gums
  • Area below the nose

These sores are highly contagious and can last up to a week to 10 days. The blisters usually rupture after the first or second day and eventually form scabs.

If you do not experience any breakouts, the virus remains dormant in a group of nerve cells. However, there is always the risk of physical symptoms manifesting.

Symptoms of Oral Herpes

Oral herpes can be asymptomatic. However, some people can experience symptoms. These may look like other medical conditions, so it’s always best to consult your healthcare provider for an accurate diagnosis.

Symptoms of oral herpes are usually the worst during the initial infection. You may experience:

  • Swollen lymph nodes
  • Headaches
  • Fever
  • Body pain
  • Sores around the mouth area

Symptoms are typically more mild during recurring infections. However, sores may still vary from mild to severe. A recurring outbreak will usually begin to show signs around the area where the sores will eventually erupt. 

Symptoms include:

  • Redness
  • Swelling
  • Heat or pain
  • Itching

Recurrence of Oral Herpes

Because oral herpes is a chronic condition, some people may experience frequent outbreaks. They are most common during the first year after the first flare-up.

Medical professionals are still determining specific triggers that cause these outbreaks. However, several of these factors could contribute to a recurrence:

  • Recent fever
  • Stress
  • Menstruation
  • Physical injury
  • Prolonged exposure to sunlight
  • Surgery

These outbreaks can lessen as you develop more antibodies against the virus.

How is Oral Herpes Diagnosed?

It can be challenging to diagnose oral herpes because the condition can be asymptomatic, or the symptoms it manifests can look like other conditions.

If you are showing symptoms, your medical provider may perform the following procedures:

  • Assess the location and appearance of your blisters
  • PCR test
  • Blood test
  • Biopsy

A PCR test involves examining a person’s blood in the laboratory. If the herpes simplex virus is present in the blood sample, a person is positive for oral herpes.

How to Prevent Oral Herpes

The best way to prevent oral herpes is to avoid physical contact with a person with an active herpes infection. Those with the virus should abstain from sexual activity when experiencing symptoms.

Oral herpes is most contagious when active sores are present, but it can still be spread from a person without symptoms.

Here are other things you can do as an extra precaution:

  • Use condoms consistently and correctly
  • Get tested for HIV
  • Inform your healthcare provider if you suspect you have symptoms

What Treatments are Available for Oral Herpes? 

A typical treatment plan for oral herpes involves antiviral medications. These cannot cure the infection, but they help manage the severity and frequency of symptoms.

These antiviral medications include:

  • Acyclovir
  • Famciclovir
  • Valacyclovir

Your treatment plan may also involve:

  • Keeping the area with blisters clean and dry
  • Applying topical antiviral ointments
  • Using over-the-counter anesthetics or anti-inflammatory ointments

Your treatment will also depend on your:

  • Age
  • Overall health and medical history
  • Personal preferences
  • Tolerance for specific medications or therapies
  • Expected treatment outcomes

Potential Complications of Oral Herpes

The most common complication of oral herpes is genital herpes or HIV infection. People infected with genital herpes are also at a higher risk of getting HIV. 

Other complications of oral herpes include:

Neonatal Herpes

If a person catches oral herpes for the first time later in their pregnancy, the risk of the infant developing neonatal herpes increases. 

Neonatal herpes is a rare condition, but when acquired, it is a severe illness that can lead to long-term neurologic disability or death.

Severe Diseases

In rare cases, oral herpes can cause severe diseases, including:

  • Encephalitis (brain infection)
  • Keratitis (eye infection)
  • Aseptic meningitis (inflammation of the linings of the brain)

Some people may also develop lesions on the buttocks, groin, fingers, or eyes during infection, although this is rare.

Mental and Emotional Distress

People who experience frequent outbreaks of blisters and sores may begin to experience negative feelings that impact their quality of life.

These emotions include:

  • Shame
  • Embarrassment
  • Insecurity
  • Stress


Some people may also worry about the condition’s impact on their overall health, including their sex life and relationships.

Summary

Oral herpes is a chronic condition caused by the herpes simplex virus. The disease can be asymptomatic, but some people show signs of the infection.

Symptoms of oral herpes include mild to severe sores or blisters around the mouth area. You may also experience flu-like symptoms like headache and fever during the initial infection.

Oral herpes spreads through physical contact with the virus through active sores, saliva, or surfaces around the mouth. Avoid sexual activity and physical contact if you have active sores.

Treatment involves taking antiviral medications and keeping the infection site clean and dry. Your healthcare provider may also prescribe topical ointments.

Last updated on February 7, 2024
6 Sources Cited
Last updated on February 7, 2024
All NewMouth content is medically reviewed and fact-checked by a licensed dentist or orthodontist to ensure the information is factual, current, and relevant.

We have strict sourcing guidelines and only cite from current scientific research, such as scholarly articles, dentistry textbooks, government agencies, and medical journals. This also includes information provided by the American Dental Association (ADA), the American Association of Orthodontics (AAO), and the American Academy of Pediatrics (AAP).
  1. Oral Herpes.” Johns Hopkins Medicine.
  2. Genital Herpes – CDC Detailed Fact Sheet.” Centers for Disease Control and Prevention, 2021.
  3. Herpes simplex virus.” World Health Organization, 2022.
  4. Genital Herpes.” Centers for Disease Control and Prevention, 2022.
  5. Petti, S., Lodi, G. “The controversial natural history of oral herpes simplex virus type 1 infection.” Oral Diseases, 2019.
  6. Hammad, WAB., Konje, JC. “Herpes simplex virus infection in pregnancy – An update.” European Journal of Obstetrics & Gynecology and Reproductive Biology, 2021.
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