According to the American Social Health Association, between 50 and 80 percent of American adults are infected with oral or mouth herpes. Signs of mouth herpes first appear one to three weeks after exposure to the virus and intermittently thereafter. In addition to the characteristic skin lesions, there are other signs of mouth herpes.
Prodrome
Prodrome refers to premonitory symptoms that precede the full syndrome. According to a 2008 study 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 develop. Visible signs of the prodromal phase include redness and mild swelling.
Pharyngitis
Pharyngitis, or inflammation of the throat, is a common sign of mouth herpes during the initial outbreak, according to Dr. Lawrence Corey in "Harrison's Principles of Internal Medicine." The affected person may report sore throat, problems with swallowing and/or inability to eat. Herpes pharyngitis is classified as "exudative" or "ulcerative." Exudative pharyngitis is characterized by blisters similar to those seen on the skin while ulcerative pharyngitis is characterized by shallow, well-defined "punched out" lesions. In both cases, lesions affect the back of the throat and the tonsils.
Gingivostomatitis
Gingivostomatitis means inflammation of the gums (gingiva) and mouth (stoma). In herpes gingivostomatitis, blisters or "punched out" lesions appear on the hard and soft palate, tongue, gums and lining of the cheeks. In one-third of people, notes Dr. Corey, gingivostomatitis appears after pharyngitis. As with pharyngitis, gingivostomatitis is usually associated with the initial outbreak and rarely recurs, except in people with compromised immune systems.
Mouth Lesions
Lesions that appear around the mouth are probably the most recognizable sign of mouth herpes. Painful, tiny (1 to 2 mm) fluid-filled blisters with a central depression (umbilication) usually develop over the course of a few hours. According to a 2008 article in "Archives of Internal Medicine," 90 percent occur on the border of the lip, called the vermillion. Approximately 10 percent occur elsewhere on the face, such as on the chin adjacent to the mouth or around the nose. After about three or four days, the blisters spontaneously rupture and acquire granular, yellow crusts. The lesions may become itchy, painful or both and then heal without scarring over a period of one to four weeks. Recurrent lesions heal fastest; first time lesions take longer to heal.
References
- American Social Health Association: Learn About Herpes
- "Archives of Internal Medicine"; The Treatment of Herpes Simples: An Evidence-Based Review; C. Cernik, K. Gallina, and R.T. Brodell; June 2008
- Herpes Simplex Viruses; 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
