Oral Herpes: Cold Sore Symptoms, Causes and Treatment

Oral herpes (Herpes Labialis) is a condition often characterized by small blisters on the lips or around the mouth. Although these blisters may heal on their own within a short time, the virus remains in the body and can recur at any time. Oral herpes not only causes discomfort but is also a condition for which there is currently no treatment that can permanently eliminate the virus from the body. Therefore, prevention and symptom control play a very important role in maintaining the quality of life for those infected.

Causes of oral herpes

Oral herpes is caused by infection with the Herpes Simplex virus (HSV). This virus is divided into two main types: HSV-1 and HSV-2:

• HSV-1: The main cause of oral herpes. This virus is usually transmitted through direct contact with an infected area, such as kissing or sharing personal items with an infected person
• HSV-2: The cause of genital herpes, usually transmitted through unsafe sexual contact

When the virus enters the body for the first time, it moves along the nerves and hides in the nerve ganglia, allowing the virus to remain in the body for life. When there are triggering factors such as stress, illness, or hormonal changes, the virus can be reactivated and cause recurrence.

Symptoms and characteristics of oral herpes

Oral herpes typically progresses through clear stages:

• Prodromal stage: The patient may feel itching, burning, or mild pain at the site where the lesion is about to appear (lasting approximately 24–48 hours)
• Appearance of blisters: Small red or pink bumps quickly develop into fluid-filled blisters
• Bursting and ulceration: The blisters burst and merge into ulcers
• Crusting: The ulcers begin to crust, which can cause tightness and pain
• Healing: The crust falls off, and new skin forms

Typically, the entire process lasts about 7–14 days, but it may be longer during the first infection or when the immune system is weakened.

Possible systemic symptoms:

• Headache
• Fever
• Swollen lymph nodes in the neck

Transmission routes

Oral herpes spreads easily through direct contact:

• Kissing or close contact with someone who has oral herpes
• Sharing personal items such as cups, spoons, lip balm, or towels
• Contact with the saliva of an infected person, even without visible sores
• Oral sex (oral sex) with an infected person

After the first infection, the body produces antibodies, but it can still transmit the virus to others.

Diagnosis of oral herpes

Diagnosis is mainly based on clinical examination. In some cases, testing may be required:

• Taking a sample from the ulcer to detect the virus
• PCR testing to detect the virus's DNA
• Blood tests to detect HSV antibodies

These tests are usually applied when confirmation is needed or in individuals with a weakened immune system.

Prevention of oral herpes

• Avoid direct contact with areas that have blisters
• Do not share personal items
• Wash hands frequently
• Reduce stress
• Get enough sleep
• Eat a healthy diet
• Avoid prolonged exposure to strong sunlight
• Consult a doctor if there are suspected symptoms

Effective prevention requires good personal hygiene and overall health care.

Treatment of oral herpes

1. Antiviral medication treatment

The goal is to reduce symptoms, shorten the duration of the illness, and limit the spread. Commonly used medications:

• Acyclovir
• Valacyclovir
• Famciclovir

These medications are available in oral and topical forms. The earlier they are used, the more effective they are, helping to shorten the duration of the illness by approximately 1–2 days.

2. Symptomatic treatment

• Use pain relievers and fever reducers such as paracetamol or ibuprofen
• Apply cold compresses for 15–20 minutes at a time, multiple times a day

3. Notes during treatment

• Do not touch or squeeze the ulcers
• Wash hands frequently
• Avoid products containing alcohol or fragrances
• Use lip sunscreen

It is advisable to consult a doctor in severe cases or during the first infection.

Differentiating oral herpes from canker sores

• Oral herpes: Caused by HSV virus, appears as blisters on the lips, then bursts and crusts, and is contagious
• Canker sores: Caused by irritation or weak immunity, are ulcers inside the mouth, not contagious, and not caused by a virus

Correct differentiation helps in more effective treatment.

Can oral herpes recur?

Oral herpes can recur because the virus remains in the body for life. The frequency may be:

• 1–2 times per year
• Or more frequently, depending on the immune system

Factors that trigger recurrence

• Stress
• Lack of sleep
• Other infections
• UV rays from sunlight
• Fever
• Menstrual cycle

Ways to reduce the risk of transmission to others

• Avoid kissing
• Do not share personal items
• Avoid direct contact with the sores
• Wear a mask when symptoms are present
• Maintain personal hygiene

Frequently asked questions about oral herpes

Oral herpes is a common viral infection. Although it cannot be completely cured, it can be effectively controlled with appropriate treatment and proper care. Understanding the disease helps reduce symptoms, prevent recurrence, and effectively prevent its spread.

References (Sources)

• World Health Organization (WHO). (2023). Herpes simplex virus.
  → https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus
• Centers for Disease Control and Prevention (CDC). (2023). Herpes – STI Treatment Guidelines. → https://www.cdc.gov/std/treatment-guidelines/herpes.htm
• Looker, K.J. and others. (2015). Global and regional estimates of the prevalence and number of new infections of herpes simplex virus type 1 in 2012. PLoS ONE, 10(10). → https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0140765