Some people call it a cold sore, others a fever blister, but this annoying and often painful chronic condition is caused by the same virus: herpes simplex. About 50 percent to 80 percent of US adults have oral herpes. By age 50, approximately 90 percent of adults have been exposed to the virus. Once infected, a person will have the herpes simplex virus for the rest of his/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.
Characterized by blister-like lesions that occur over an eight- to 10-day period most often around the lips, oral mucosa, or tongue, the virus is highly contagious and can spread easily by direct skin-to-skin contact.
The two 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 associated with infections of the oral cavity, with up to 90 percent of people in the US exposed to this virus. HSV-2 is most often associated with genital herpes infections, with up to 30 percent of people in the US exposed to this virus. However, both types of HSV can infect both the mouth and the genitals.
Since HSV is transmitted 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 experiencing an outbreak of the disease. However, genital herpes can be contagious without causing any symptoms of the disease, according to the Centers for Disease Control and Prevention.
Initial infection of the oral herpes simplex virus may cause no symptoms or may cause severe flu-like symptoms with mouth ulcers. In recurring infections, sores tend to erupt in the same area (some patients never have any more symptoms beyond the initial infection). The following are the most common symptoms of an oral herpes simplex virus infection. However, each individual may experience symptoms differently. The progression of symptoms may include:
- Symptoms may begin with redness, swelling, heat, and pain in the area where the infection will erupt.
- Painful, fluid-filled blisters may appear on the lips or under the nose. These blisters are highly contagious.
- The blisters leak fluids and become sores.
- After approximately four days, the sores start to crust over and heal.
The symptoms of an oral herpes simplex virus may resemble other conditions or medical problems. Always consult your physician for a diagnosis.
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, the location of the blisters usually is, to a physician, a positive indication of an infection.
Treatment depends on the severity of symptoms of the HSV virus. Specific treatment for HSV infection will be determined by your physician based on:
- your age, overall health, and medical history
- extent of the disease
- your tolerance for specific medications, procedures, or therapies
- expectations for the course of the disease
- your opinion or preference
Treatment may involve:
- keeping the infected area clean and dry
- antibiotic treatment for any bacterial infections
- topical antiviral creams
- oral antiviral medications