Oral Herpes Infection

Medically reviewed by Drugs.com. Last updated on Apr 2, 2024.

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What is an oral herpes infection?

Oral herpes is a sexually transmitted infection (STI) caused by the herpes simplex virus (HSV). HSV has 2 types. An oral HSV infection is usually caused by HSV type 1. HSV type 2 usually affects the genital area but may also affect the mouth.

What increases my risk for an oral HSV infection?

• Close contact with someone who has an HSV infection
• A weak immune system caused by an illness or condition such as a cold, flu, or HIV
• Shared items such as eating utensils, towels, or lip balm
• Fatigue (mentally and physically tired), stress, or injury to your mouth or lips
• Hormone changes during a person's monthly period
• Exposure to extreme temperatures

What are the signs and symptoms of an oral HSV infection?

You may not have any signs or symptoms. Signs and symptoms that do develop may appear suddenly and last 5 days to 2 weeks. Blisters may form on your mouth, lips, or gums. The blisters may burst or join together to form large open sores. Sores on your lips or face will then dry up (crust over). You may also have any of the following:

• Burning, tingling, itching, or pain at the affected area before sores form
• Fever, chills, or a headache
• A sore throat or swollen lymph nodes in your neck
• More tired and irritated than normal for you
• Trouble eating, drinking, or speaking because of your mouth pain
• Red, swollen, and bleeding gums

How is an oral HSV infection diagnosed?

Your healthcare provider will examine your blisters or sores. Your provider may ask if you have other medical conditions. Tell your provider when the blisters or sores started, and about your other symptoms. You may need any of the following:

• Skin or fluid samples may be tested for HSV. Your provider may swab fluid from a blister. Your provider may also scrape skin from a sore in your mouth. Skin scraping needs to be done within 48 hours of the first symptom, when the outbreak is most severe.
• Blood tests may show you have developed antibodies from exposure to HSV. Blood tests may also show which type of HSV you have.

How is an oral HSV infection treated?

An HSV infection cannot be cured. The blisters usually heal on their own within 10 days. Blisters may go away and come back several times. An oral HSV infection that comes back is also known as a cold sore. You may need any of the following:

• Antiviral medicine helps relieve symptoms and shortens the amount of time you have blisters or sores. You may also need to take antiviral medicine daily to prevent outbreaks.
• Pain medicine may be recommended if you have trouble eating or drinking because of the pain. The medicine may be given as a mouth rinse. Use it as directed by your healthcare provider.

How can I manage my symptoms?

• Eat soft, plain foods until your sores heal. Foods such as eggs, yogurt, soup, rice, and pasta may be easier for you to eat. Do not eat crunchy, dry, salty, or spicy foods such as dry toast, popcorn, or chips. Do not have foods or drinks that contain citric acid, such as grapefruit or orange juice.
• Drink cool liquids to help decrease mouth pain. Do not have carbonated liquids, such as soft drinks or sparkling water. A straw may help you drink more easily if you have blisters on your lips or tongue.
• Use ice to help reduce swelling or pain. Use an ice pack, or put crushed ice in a plastic bag. Cover the bag with a towel before you place it on your lip. Apply ice for 15 to 20 minutes every hour, or as directed.

How can I prevent the spread of HSV?

• Avoid close contact with others until your blisters or sores heal. Close contact includes touching, kissing, and oral sex.
• Do not share items with anyone. Examples include eating utensils, towels, and lip balm.
• Do not touch your sores, blisters, or scabs. The virus may spread from your fingers.
• Wash your hands often. Use soap and water. Use germ-killing gel if soap and water are not available.

When should I seek immediate care?

• You see fluid that is not clear coming from the sores.
• You have changes in your vision or sudden eye pain.
• You have eye pain when you look into bright lights.
• You have sores on your eyes.
• You have abdominal pain, a severe headache, or confusion.

When should I call my doctor?

• Your symptoms get worse or have not gone away within 14 days.
• You have trouble eating, drinking, or talking because of your mouth pain.
• You are nauseated, or you vomit.
• Your eyes feel irritated, or you feel like you have something in your eye.
• You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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