5 Things You Need to Know About Herpes in the Throat

Young Woman with Cold Sore
(Image: John Rensten/Corbis/GettyImages)

Herpes of the throat, also known as herpes esophagitis, is a viral infection that can lead to significant pain and discomfort. It's rare in healthy individuals, but can be a common infection in people with weakened immune systems. While this infection will heal on its own, antiviral medications can be helpful to speed healing time and reduce the frequency of outbreaks.

It's Linked to Cold Sores

Herpes esophagitis is a viral infection caused by the herpes simplex virus (HSV). This condition is most commonly caused by HSV-1, the same virus that causes cold sores, but may be linked to HSV-2, which causes genital herpes. This virus is spread through direct contact with infected individuals, and is transmitted via infected saliva or by contact with open sores in the mouth or genitals. HSV infections are lifelong, but there are steps you can take to reduce outbreaks and treat active infections early -- before they cause a lot of pain and discomfort.

It's Rare in Healthy People

Herpes esophagitis is rare in people with healthy immune systems. Herpes outbreaks -- and the spread of this infection into the throat and esophagus -- are more common in people with weakened immune systems. Herpes of the throat is more likely to occur in people who have kidney failure, cancer, human immunodeficiency virus (HIV) or AIDS, in organ transplant recipients, or in people who are undergoing treatment that suppresses the immune system.

It Can Be Painful

If you have ever had a cold sore, you know the discomfort of an HSV infection. When these sores extend to the throat and esophagus, they can lead to a great deal of pain. People with herpes esophagitis often complain of difficult and painful swallowing, throat pain and fever. Sometimes this infection causes esophageal tearing, which can cause chest pain and gastrointestinal bleeding.

It Gets Better

In order to diagnose herpes esophagitis, your doctor will use an endoscope to visually inspect the throat and esophagus, and may also perform a throat swab or other laboratory tests. This infection can heal without medication therapy. People with healthy immune systems tend to heal quickly, while those with weak immune systems often have a longer recovery time with more severe symptoms. Rarely, after an outbreak, the esophagus develops a hole, which can lead to bleeding, worsening of chest pain, or shortness of breath. Seek urgent medical attention of this occurs.

It Can Be Treated

Antiviral medications work by halting the replication of the virus, and can be used to reduce the frequency and severity of HSV infections. These medicines do not remove the HSV from the body, however. Common antivirals include acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex). These drugs are most effective when taken at the first sign of an outbreak, such as the tingling, itching or burning sensation, although your doctor may prescribe an antiviral on a long-term basis to prevent outbreaks. Over-the-counter pain relievers may also help counter the associated pain and discomfort.


HSV is most contagious during an outbreak, but can be transmitted when no obvious symptoms are present. People with active symptoms, such as blisters or open sores, should avoid contact with others -- including kissing, oral sex, and any other direct contact that can spread the virus via touching or saliva. If you think you are infected with the herpes simplex virus, see your doctor to discuss an appropriate management plan.

Reviewed by Kay Peck, MPH RD

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