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Oral Herpes (HSV 1)

Oral herpes is an infection of the lips, mouth, or gums due to the herpes simplex virus. It causes small, painful blisters commonly called cold sores or fever blisters.

Oral herpes is also called herpes labialis (Herpes occurs on lips). Oral herpes is a common infection of the mouth area.

It is caused by the herpes simplex virus type 1 (HSV-1). Most people in the United States are infected with this virus by age 20.


Outside the body the herpes virus cannot survive for more than a few seconds. It makes highly unlikely that HSV will be passed on to other people by the sharing of towels or toilet seats

How common

More than 50 percent of the adult population in the United States has oral herpes, typically caused by herpes simplex virus type 1 (HSV-1), 57-58% for Canada and the Netherlands and there are many more countries with national rates of 65-85%, including Belgium (67%), the Czech Republic (81%), and Bulgaria (84%). Infection rates in the sub-Saharan Africa vary from country to country with some having a prevalence rate of upto 80%. Northern Africa has a comparatively lower burden with around a HPV prevalence of 26% among the middle aged women.

Chances of being infected

As the transmission of oral Herpes is by direct exposure to saliva or droplets formed in the breath of infected individuals, the chance of being infected by kissing with someone who has contracted the disease is quite high. By adulthood, nearly all people in general (60 – 90%) have been infected with HSV-1.

How to detect if someone has it

Oral herpes is commonly referred to as “cold sores” and “fever blisters.” While symptoms of oral herpes most commonly appear on or around the lips, oral herpes is not always limited to this area. For some, symptoms may appear between the upper lip, on or inside the nose, or on the chin or cheek. In these instances, herpes is referred to as oral-facial herpes.

Herpes labialis can at times be confused with apthous stomatitis. As such it is important to highlight the distinguishing characteristics at this point.

  • Aphthous stomatis produces canker sores while herpes labialis produces cold sores.
  • Cold sores are contagious while canker sores are not contagious.
  • Apthous ulcers (canker sores) occur in the non-keratinized tissues. Examples of such are mucobuccal fold, buccal mucosa, soft palate, under or at the sides of the tongue and floor of the mouth. On the other hand, cold sores occur in the keratinized tissues like the hard palate, lips, gingiva and alveolar ridge.
  • Canker sores are usually few at one given instance with an ulcerated center covered by a yellowish pseudomembrane with a reddish ring of inflammation surrounding the sore. Cold sores usually start as numerous small vesicles that eventually coalesce and crust especially on the lips.

Oral Herpes - Detect


Unfortunately, currently there’s no vaccine or preventive medications available to prevent us from contracting oral Herpes.


Symptoms may go away on their own without treatment in 1 to 2 weeks. Your health care provider can prescribe medicines to fight the virus. This is called antiviral medicine. It can help reduce pain and make your symptoms go away sooner. Medicine used to treat mouth sores include:



  • Painkiller


Take a non-prescription painkiller, such as Paracetamol or ibuprofen, to ease any pain or discomfort. 

  • Antiviral

There are two topical antiviral medications prescribed for the treatment of oral HSV symptoms: acyclovir ointment (brand name Zovirax®) and penciclovir cream (brand name Denavir®). Both work to speed up the healing process and reduce the viral activity. These topical drugs are put directly on the lesions themselves, but can also be used at the onset of prodrome (early symptoms).

  • Cream

There are other over-the-counter topical treatments for oral herpes, but please note that some of them may actually delay the healing time symptoms’ and irritate the area instead. There’s only one over the counter FDA approved cream called Abreva. This cream can speed the healing process.

  • Avoiding the factors that trigger the flare-up of the HSV 1 symptoms is very helpful. Measures such as avoidance of strong sunlight and drugs that suppress the immune system comes in handy.

Best sources for more information

The risk chart is the heart of this guide, and it can be found here

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