Oral herpes is a common infection caused when the herpes simplex virus (mostly HSV-1 but sometimes HSV-2) affects areas around the mouth, lips, gums, tongue, or face. The virus causes small, painful sores, commonly known as cold sores or fever blisters.1 Oral herpes can also cause other symptoms like fever, swollen lymph nodes, and muscle aches. But not everyone shows signs—some people never develop symptoms of the virus.
Once you have herpes, you carry it for life. When the virus is dormant, it stays silently in the nerve tissues. The virus may occasionally reactivate, causing periodic outbreaks. Although there’s no cure, antiviral medication can help prevent or shorten outbreaks.
Oral herpes can be transmitted by kissing, sharing eating utensils or drinks, or during sex. Since oral herpes can be contracted from both Type 1 and Type 2 strains of the Herpes Simplex Virus, our doctors recommend getting tested for both of these HSV strains at the same time.
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It’s important to know that oral herpes doesn’t always show symptoms. When it does, it usually appears as a cold sore, a group of small blisters around the lip or mouth often surrounded by red, swollen, and painful skin. You may experience tingling or burning on your lips or face before a cold sore appears. Other symptoms include sore throat, fever, swollen glands, and pain when swallowing.
The herpes virus goes through episodes of active outbreaks followed by periods without symptoms. If sores are present, that’s when the virus is most contagious. However, oral herpes can still be spread when sores aren’t visible.
You can have the herpes simplex virus for years or even decades without experiencing noticeable symptoms. However, the average incubation period (the time it takes to experience first symptoms after infection) is about 3-6 days.
When an outbreak does occur, there are five stages you can expect. Knowing how far along you are in the process can reassure you that it will be over soon.1
Primary infection or initial outbreak commonly refers to the first time you experience symptoms. Symptoms of the first outbreak are generally more severe than following outbreaks.
Oral herpes primary infection (initial outbreak) symptoms may include:2
Some people only experience one outbreak of oral herpes symptoms ever. For others, symptoms may reappear occasionally in recurrent infections.
A recurrent herpes infection is when a person experiences following episodes of herpes outbreaks after an initial outbreak. Though symptoms go away, they can reappear intermittently. Not everyone experiences recurrent outbreaks. For those who do, they usually become milder and occur less often the longer you have the virus.
Recurrent oral herpes symptoms can include symptoms around the mouth area, including:
According to the American Academy of Dermatology, cold sores or an oral herpes outbreak can last anywhere from a few days up to 2 weeks. If a cold sore lasts longer than a couple of weeks, you should seek treatment.3
Oral herpes is not typically a serious condition, and most people who are affected have only minor or no symptoms. However, herpes outbreaks may cause personal discomfort, stress, and inconvenience such as making it difficult or painful to drink fluids or swallow food. If you are symptomatic, oral herpes is very manageable with medication that shortens the duration of symptoms and lessens their pain and severity.
Aside from the flu-like symptoms that you may experience with an initial outbreak, the rest of your body will not be affected by oral herpes.
However, it is possible to spread the HSV-1 virus to other parts of the body, which is why it’s important to avoid your saliva coming into contact with open cuts around your genitals or eyes (especially during an outbreak). If HSV-1 is spread to the genitals, it can cause genital herpes. If it’s spread to the eye, it can cause ocular herpes. Ocular herpes can cause sores in the eye and inflammation of the cornea. This can lead to irritation, pain, and vision problems.
Absolutely not! In generally healthy adults, oral herpes doesn’t usually cause serious problems. Your life will continue as normal. Oral herpes is so common that up to 80% of the adult U.S. population has it.4 Many acquire herpes during childhood from close contact or kissing, and have the virus without ever knowing.
In rare cases, the herpes simplex virus can cause meningitis (inflammation of the membranes around the brain and spinal cord) or encephalitis (inflammation of the brain itself), which can be serious. HSV-1, which is the cause of most cold sores, is the main cause of HSV encephalitis, while meningitis is more often caused by HSV-2.
A herpes outbreak will normally go away on its own, though the virus remains for life and outbreaks may reappear later. If symptoms are prolonged or overly painful, seek medical attention and you may have treatment prescribed. Over time, outbreaks typically become less severe and frequent.
If you think you might have herpes, STDcheck.com believes that you always have the right to know your status, regardless of whether symptoms are present. Most doctors will only test you for herpes if symptoms are painful and present.
If you know you have herpes, it’s typically only necessary to see a doctor if symptoms prove difficult to predict or manage, or if they’re overly painful. Medication can be prescribed to help reduce and manage symptoms if needed. If you have not experienced symptoms or they are manageable, seeing a doctor might not be necessary.
Having oral herpes should not affect your pregnancy. There is more cause for concern with genital herpes, which a doctor may treat to prevent outbreaks during delivery.5 It’s worth noting that receiving oral sex from a partner with oral herpes can give you genital herpes. If you have oral herpes and have reason to believe this may affect your pregnancy, speak with your primary health care provider.
Medically Reviewed by Gill Sellick, MBChB on February 28, 2022Written by Taysha on January 25, 2020