What is herpes?Herpes simplex is a viral disease from the herpesviridae family caused by both Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). Infection with the herpes virus is categorized into one of several distinct disorders based on the site of infection.
- Oral herpes, the visible symptoms of which are colloquially called cold sores or fever blisters, is an infection of the face or mouth. Oral herpes is the most common form of infection.
- Genital herpes, known simply as herpes, is the second most common form of herpes.
- Other disorders such as herpetic whitlow, herpes gladiatorum, ocular herpes, cerebral herpes infection encephalitis, Mollaret's meningitis, neonatal herpes, and possibly Bell's palsy are all caused by herpes simplex viruses.
Oral herpesOral herpes, also known as herpes labialis, is the most common type of herpes which occurs on the lip. An outbreak typically causes small blisters or sores on or around the mouth commonly known as cold sores or fever blisters. They tend to occur in the same location, be unilateral and recur two or three times a year on average.
Signs and symptomsThe initial viral tissue invasion occurs typically in childhood or adolescence. This primary infection is often asymptomatic and may not be noticed by the patient or parents. When perioral symptoms do occur with the primary infection, they usually manifest 6-24 hours before the appearance of a lesion and include tingling, pain and/or itching in the perioral area. Cold sores are usually seen on the lips and extend to the skin around the mouth. Other areas on the face, chin, or nose are sometimes involved. Lesions begin as erythematous areas that swell into papules. These become vesicles, which then collapse into ulcers. This takes 1-3 days. The ulcers crust over and the skin returns to normal within about two weeks. Oral mucosal lesions are rare and not generally associated with fever. They are usually restricted to small clusters of micro vesicles that rupture to leave punctate ulcers, typically on the palatal gingiva. Immunocompromised people may develop chronic ulcers, often on the tongue.
Causes of herpes labialisHerpes labialis infection occurs when the herpes simplex virus comes into contact with oral mucosal tissue or abraded skin of the mouth. The majority of the viruses enter after an uninfected person has direct contact with someone carrying the virus (either with or without noticeable lesions). Simply touching an infected person is often the way children get exposed. Adolescents and adults frequently get exposed by skin contact also but may get their first exposure by kissing or sexual contact, especially for HSV-2.
TriggersCold sore outbreaks may be influenced by stress, menstruation, sunlight, sunburn, fever, dehydration, or local skin trauma. Surgical procedures such as dental or neural surgery, lip tattooing, or dermabrasion are also common triggers. HSV-1 can in rare cases be transmitted to newborn babies by family members or hospital staff who have cold sores; this can cause a severe disease called Neonatal herpes simplex.
Herpes treatmentSince this is a viral infection antibiotics will be of no use in treatment. Symptoms may go away on their own without treatment in 1 to 2 weeks. Currently, there is no treatment able to eliminate the infection permanently. Only a few products help accelerate healing and reduce the duration of the symptoms. Your health care provider may prescribe you one of these antiviral medicines:
- Apply ice or a warm washcloth to the sores to help ease pain.
- Wash the blister gently with germ-fighting (antiseptic) soap and water. This helps prevent spreading the virus to other body areas.
- Avoid hot beverages, spicy and salty foods, and citrus.
- Gargle with cool water or eat popsicles.
- Rinse with salt water.
- Take a pain reliever such as acetaminophen (Tylenol).
Possible complicationsHerpes infection may be severe and dangerous if:
- It occurs in or near the eye
- You have a weakened immune system due to certain diseases and medications.
- Return of mouth sores and blisters,
- Spread of the virus to other skin areas,
- Bacterial skin infection.