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Oral Herpes Overview

What is herpes?

Herpes is a virus with multiple strains; two of these strains, HSV-1 and HSV-2, cause both oral and genital herpes. Herpes viruses infect the skin and/or mucous membranes. Oral herpes presents itself as cold sores or fever blisters that affect the lips or area near the mouth. Oral herpes is most often caused by the HSV-1 strain, but oral herpes can also be caused by the HSV-2 strain. Approximately 80 percent of oral herpes cases are caused by HSV-1, while the remaining 20 percent are caused by HSV-2, and 75%-80% of Americans carry at least one Herpes Simplex Virus (Type 1 or 2).

Herpes 1 and 2 can be contracted during vaginal, anal or oral sex. The initial outbreak of either virus strain can result in flu-like symptoms, including fever, swollen lymph nodes and body aches.

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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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What causes oral herpes?

Oral herpes is most commonly transmitted by kissing or sharing drinks or utensils, but can also be contracted from a partner who has genital herpes during oral sex. HSV-1 and 2 can be contracted from infected bodily fluids, including semen, vaginal fluid, saliva, or herpes lesions, sores or blister fluid. Upon entering a cell, the infection often does not cause any symptoms. If the virus destroys the host cell during replication, sores or blisters filled with fluid appear. Scabs form over the sores or blisters once the fluid is absorbed, then the scabs disappear without scarring.

The herpes virus goes through dormant phases where it becomes inactive for indeterminable periods of time and reactivate unpredictably. Herpes can be transmitted even when signs or symptoms are not present. This process is known as “shedding,” and occurs when cells that have the active virus are dropped or shed from the skin. Approximately one- third to half of all shedding occurrences are asymptomatic.

What are the symptoms of oral herpes?

Oral herpes does not always show symptoms. When it does, oral herpes symptoms include fever blisters and cold sores around the mouth and lips. People suffering from oral herpes may also experience itching, burning or tingling around the mouth or lips. Before the first blisters or cold sores appear, individuals infected with the virus may also experience flu-like symptoms including sore throat, fever, swollen glands and/or pain when swallowing.

HSV-1 can recur spontaneously in the eye, causing ocular herpes, which can be serious and lead to blindness. Very rare instances HSV-1 can spread spontaneously to the brain, causing herpes encephalitis, a dangerous infection that can lead to death. Furthermore, HSV-1 is also the usual culprit of herpes whitlow, an infection on the finger, as well as "wrestler's herpes" or herpes gladiatorum-- a herpes infection on the chest or face.

How is oral herpes transmitted?

This strain of herpes is spread through contact with a person infected with the virus. This could happen when you come in contact with open cold sores through kissing or other close contact.

Oral herpes can also be transmitted through contact with eating utensils, shaving razors, towels or other personal items used by someone who has herpes. Sharing food or drinks or coming in contact with the saliva of someone with cold sores could also infect you with oral herpes. HSV-1 can be contracted from infected bodily fluids, including semen, vaginal fluid, saliva, or herpes lesions, sores or blister fluid. An individual could also contract oral herpes from giving oral sex to someone with genital herpes.

How do I get tested for oral herpes?

We test for Herpes Simplex Virus Type 1 (HSV-1) in the blood using the Chemiluminescence immunoassay (CLIA) test. This type-specific HSV-1 blood test looks for antibodies to the HSV-1 virus in the bloodstream. This test is highly sensitive and will only detect the presence of HSV-1 antibodies. Since 20% of oral herpes cases are caused by the HSV-2 virus, we recommend ordering both the HSV-1 test and HSV-2 test.

To begin, simply order one or both of the herpes tests (HSV-1 test and HSV-2 test), then visit any of our 4,500+ test centers. A small sample of your blood will be collected for testing and you will receive an email with your results in 1-2 days. Your results will read as either positive (HSV-1 and/or HSV-2 was found in your blood) or negative (no HSV-1 and/or HSV-2 virus was found in your blood).

What should I know about the herpes tests?

Herpes type 1 antibodies have a development period of 2 weeks to 6 months after initial infection. This is the time it takes for enough antibodies to develop that can be detected through the CLIA test. This period varies from person to person.

Herpes type 2 antibodies have a development period of 3 weeks to 6 months after initial infection. This is the time it takes for enough antibodies to develop that can be detected through the CLIA test. This period varies from person to person.

Our doctors recommend getting tested for both herpes type 1 and type 2 at least 4-6 weeks after potential exposure.

Is there a cure for herpes?

No, there is not a cure for oral or genital herpes, but there are treatment options available. Avoiding oral sex or kissing someone with herpes can help prevent the spread of herpes. The first herpes symptoms after infection may also go away on their own after 10-14 days, although the infection itself remains dormant in your body.

Antiviral medications, such as acyclovir, famciclovir, and valacyclovir, are the most effective medications available for people infected with herpes. These medications are used to help to reduce the severity and frequency of symptoms, however they cannot cure the infection.

Other conditions linked to oral herpes

Oral herpes is not typically a serious condition. Having herpes may cause personal discomfort, stress and inconvenience such as making it difficult or painful to drink fluids or swallow food.

In rare cases, HSV-1 can recur spontaneously in the eye, a condition known as ocular herpes. Ocular herpes can be serious and can even lead to blindness in some cases.

Herpes simplex virus encephalitis is a rare, but serious condition mainly caused by HSV-1. HSV encephalitis causes inflammation of the brain.

Herpes viruses have also been linked to Recurrent Lymphocytic Meningitis (Mollaret’s meningitis), which is characterized by sudden attacks of meningitis symptoms that last for 2-7 days and are separated by symptom-free (latent) intervals lasting for weeks, months or years.

  1. "Herpes Fast Facts." American Sexual Health Association. http://www.ashasexualhealth.org/stdsstis/herpes/fast-facts-and-faqs/
  2. "Department of Health." Viral Skin Infection: Herpes Gladiatorum ("Mat Herpes"). https://www.health.ny.gov/diseases/communicable/athletic_skin_infections/herpes.htm
  3. Kallio-Laine, Katariina, Mikko Seppänen, Hannu Kautiainen, Marja Liisa Lokki, Maija Lappalainen, Ville Valtonen, Markus Färkkilä, and Eija Kalso. "Recurrent Lymphocytic Meningitis Positive for Herpes Simplex Virus Type 2." Emerging Infectious Diseases. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2744243/
  4. "Herpes Simplex Virus." World Health Organization. https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus

Medically Reviewed by on Jun 18, 2019

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