Herpes of the mouth is an incurable viral disease known by several different names, including herpes labialis, cold sores and fever blisters. The American Social Health Association advises that somewhere between 50 and 80 percent of adults in the United States are infected with the virus, with most acquiring the disease during childhood. Although herpes of the mouth can be spread by people who exhibit no symptoms at all, people who are actively experiencing symptoms should refrain from activities such as kissing and oral sex until symptoms resolve.
Prodrome
According to a 2008 report in the Archives of Internal Medicine, in approximately 60 percent of people, an outbreak of herpes of the mouth is preceded by prodromal or premonitory symptoms such as tingling, itching, burning, soreness and/or hypersensitivity in the areas where lesions subsequently appear. Physical examination may reveal blanching, redness or subtle swelling. The prodrome phase of herpes of the mouth lasts between two hours and two days.
Illness
Herpes of the mouth is frequently accompanied by a flu-like illness, particularly during the first episode. Common complaints include fever, malaise, headache, muscle pain, lack of appetite, irritability and swollen lymph nodes in the neck. According to Dr. Lawrence Corey in "Harrison's Principles of Internal Medicine," fever usually lasts three to seven days. Other symptoms take longer---up to two weeks---to resolve.
Outside Lesions
Herpes of the mouth produces two kinds of lesions. The first is a flaccid, 1-to-2-mm blister that features a central depression or dimple. The second is a larger, shallow erosion with well-defined borders that is commonly described as an ulcer. Both types of lesions are extremely painful at first. Then, after a three to four days, according to the report in the Archives of Internal Medicine, they typically crust or scab and become itchy. Although mouth herpes lesions can appear almost anywhere on the face, the most common site is at the border of the lip.
Inside Lesions
Lesions inside the mouth are most common during the first episode of mouth herpes, and patients frequently fail to recognize them as such. According to "Harrison's Principles of Internal Medicine," common sites include the back of the throat, tonsils, the soft and hard palates, lining of the cheeks, gums and tongue. Lesions inside the mouth complicate activities of daily living, such as eating, drinking and tooth brushing.
References
- American Social Health Association: Learn About Herpes - Oral Herpes
- Herpes Simplex Viruses (Chapter); L. Corey; In: "Harrison's Principles of Internal Medicine, 17th edition"; A.S. Fauci, E. Braunwald, D.L. Kasper, S.L. Hauser, D.L. Longer, J.L. Jameson, and J. Loscalzo (Eds); 2008
- Archives of Internal Medicine; The Treatment of Herpes Simples: An Evidence-Based Review; C. Cernik, K. Gallina, and R.T. Brodell; June 2008
