According to the American Academy of Dermatology, the herpes simplex virus causes lesions around the mouth, genitals, nose, buttocks and almost anywhere on the skin. Oral herpes outbreaks usually follow one to three weeks after infection. Signs of herpes on the mouth include: redness and swelling, pharyngitis, gingivostomatitis and perioral lesions.
Redness and Swelling
The term prodrome refers to early symptoms that precede full-blown disease. According to a 2008 article in Archives of Internal Medicine, 60 percent of patients with mouth herpes complain of symptoms such as tingling, burning, itching, soreness or hypersensitivity in the area where lesions later appear. Visible signs of the prodromal period include redness and swelling.
Pharyngitis
The term pharyngitis refers to inflammation of the throat (pharynx) which is a characteristic manifestation of first-time oral herpes infection. Patient may often complain of sore throat, difficulty swallowing and inability to eat. Herpes pharyngitis may be associated with blisters, shallow ulcers or both on the back of the throat and the tonsils, according to Dr. Lawrence Corey in Harrison's Principles of Internal Medicine.
The lesions may be difficult to distinguish from bacterial pharyngitis and other, noninfectious causes of pharyngitis. Pharyngitis is almost always associated with the first outbreak of oral herpes and rarely recurs, except in people with immune system problems.
Gingivostomatitis
The term gingivostomatitis refers to inflammation of the gums (gingiva) and mouth (stoma). In herpes gingivostomatitis, blisters or shallow ulcers may appear on the hard and soft palate, tongue, gums and lining of the cheeks. In one third of patients, according to Dr. Corey, gingivostomatitis appears after pharyngitis. As with pharyngitis, lesions inside the mouth are usually associated with the first outbreak and rarely recur, except in people with immune system problems.
Perioral Lesions
Perioral lesions of herpes are the easiest for most people to recognize. Small (1-2 mm), painful blisters filled with clear or cloudy yellow fluid usually develop over the course of a few hours. According to a 2008 article in the Archives of Internal Medicine, 90 percent occur on the border of the lip, also called the vermillion. About 10 percent occur elsewhere on the face, such as on the chin adjacent to the mouth or around the nose. Within three to four days, the blisters rupture and are replaced by yellow, granular crusts. At this point, the lesions may become extremely itchy. Like other lesions of mouth herpes, perioral lesions usually heal completely within one to two weeks and leave no scars.
References
- American Academy of Dermatology: Herpes Simplex
- 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
