Oral herpes, according to the American Social Health Association, is a mild and usually recurrent infection of the mouth and surrounding skin caused by the herpes simplex virus. The infection is, in fact, so mild that many of the estimated 50 to 80 percent of Americans with the disease are unaware that they have it. Since the first outbreak is typically the worst, it's important to be familiar with the first symptoms of oral herpes.
Prodrome
According to a 2008 article in the "Archives of Internal Medicine," outbreaks of oral herpes are preceded by a prodrome, or early phase of premonitory symptoms, in 60 percent of herpes cases. Prodromal symptoms may include tingling, itching, burning, stinging, hypersensitivity or some combination of these in or around the places where lesions later develop. Careful observation may reveal mild swelling or redness. Prodromal symptoms may last between two hours to two days, and end with the appearance of lesions.
Flu-Like Illness
For many people, an outbreak of oral herpes is also accompanied by a flu-like illness. According to "Harrison's Principles of Internal Medicine," systemic symptoms of herpes commonly include fever, malaise, muscle and joint pain, inability to eat, irritability and swollen lymph nodes. Notably absent, however, are the characteristic respiratory symptoms of flu such as cough and runny nose. The onset of systemic symptoms usually coincides with, or slightly precedes, the appearance of lesions, and the symptoms last three to 14 days.
Lesions
The most recognizable symptom of oral herpes is the lesion itself, which is also known as a cold sore or fever blister. The lesion begins as a bump or swelling on a base of red skin which matures over the course of a few hours into a blister filled with clear or cloudy yellow fluid, according to the article in the "Archives of Internal Medicine." The blisters are tiny (1 to 2 mm), painful and may occur in clusters or as isolated lesions on the hard and soft palate, gingiva, tongue, lip and/or facial area. Sometimes, according to MedlinePlus, several blisters will coalesce into a single, large blister. After a few days, the lesions will crust and start to heal, a process which can take up to three weeks during the first outbreak.
References
- American Social Health Association: Learn About Herpes - Oral Herpes
- "Archives of Internal Medicine"; The Treatment of Herpes Simplex: An Evidence-Based Review; C. Cernik, K. Gallina and R.T. Brodell; June 2008
- "Harrison's Principles of Internal Medicine"; A.S. Fauci, et al. (Eds.); 2008
