According to MedlinePlus, a patient information website jointly maintained by the National Library of Medicine and the National Institutes of Health, herpes labialis is a common disease caused by infection of the mouth area with herpes simplex virus type 1. Most people in the United States, notes MedlinePlus, are infected with the type 1 virus by the age of 20. Herpes labialis infection follows characteristic stages.
Prodrome
In 60 percent of people, according to a 2008 article in the "Archives of Internal Medicine,"outbreaks of herpes labialis are preceded by a prodrome or early phase of premonitory symptoms. These symptoms may include tingling, itching, burning, stinging or hypersensitivity in or around the mouth where lesions later appear. In some cases, patient will discern mild swelling or redness in these areas. Prodromal symptoms may last between two hours to two days and end with the appearance of lesions.
Early Lesions
The most recognizable symptom of herpes labialis is the lesion, also known as a cold sore or fever blister. The lesion begins as a bump or elevation on a base of red skin, developing over the course of a few hours into the blister filled with clear or cloudy yellow fluid, according to an 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. Sometimes, according to MedlinePlus, several blisters will coalesce into a single, large blister.
Late (Healing) Lesions
After about three or four days, according to the "Archives of Internal Medicine" article, the lesion will rupture and ooze. At this point, the lesion may be painful, itchy or both. Oozing is accompanied by the formation of a yellow, granular crust or scab that will eventually slough to reveal pink, healing skin. Typically, counsels the American Social Health Association (ASHA), the process takes eight to ten days for recurrent lesions. Primary lesions usually take longer.
Latency
A distinguishing characteristic of herpes viruses described by ASHA is their ability to remain dormant in a person's nerve roots, also called a ganglion. Reactivations of the virus are usually, but not always, accompanied by symptoms. Symptomatic reactivations may occur as often as six times a year in some people or never in others. The point is, once you are infected with herpes, you are infected for life and you may be able to infect others, even if you are not symptomatic.
References
- MedlinePlus: Herpes Labialis
- The Treatment of Herpes Simplex: An Evidence-Based Review; In: "Archives of Internal Medicine"; 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
