online doctor logo

Oral Herpes: Symptoms, Causes And Prevention

Oral herpes
Medically reviewed by Dr. Fizza Imtiaz


A cold sore on your lip or tongue can make you panic. Herpes infection can be more than an annoyance. Two types of the herpes virus can affect various areas of your body. Although the condition is lifelong, symptoms of an outbreak can be dealt with if you have the correct information at your fingertips. The following article provides the right information about oral herpes, which will equip you on how best to manage oral herpes.

What is Herpes?

Herpes simplex virus causes skin infections. The infection results in painful or itchy sores and blisters that appear and resolve with time, and sores can recur. Herpes simplex virus usually doesn’t cause severe health problems, but it can be dangerous to infants and people with weakened immunity.

There are two types of herpes simplex:

  • Herpes simplex 1: HSV-1, more widely known as oral herpes, usually affects your mouth or face. It causes cold sores. Herpes sores appear on the tongue, and HSV-1 is transmitted through contact with saliva.
  • Herpes simplex 2: HSV-2, also called genital herpes, is a sexually transmitted disease. It leads to genital sores.

Additionally, a herpes infection can affect other parts of your body, including your eyes or other regions of your skin.

Difference Between HSV-1 and HSV-2

HSV-1 spreads through contact with the saliva or skin of an infected person. It usually affects your face or your mouth. HSV-2 spreads through sexual contact and affects your genital or anal region. Either form of HSV can lead to an infection in the area of the skin that comes into contact with the virus.

Mode of Transmission of Oral Herpes

Herpes virus commonly resides on the skin or is presented in saliva. Hence close contact with a person who has the infection results in a condition. The transmission of the virus is more likely if the person has an outbreak or the presence of sores. Although, you can infect someone else even if you have no symptoms. This is known as asymptomatic viral shedding.

HSV-1 can be passed on by: 

  • Kissing
  • Coming in contact with a person’s skin near the mouth, especially if he has symptoms of herpes on lips
  • Sharing food utensils, lip balm or razors
  • Receiving oral intercourse from someone with a cold sore may spread a herpes infection to your genitals

Risk Factors for Contracting Herpes Simplex

Herpes can infect anyone. However, the following are some risk factors that make you more prone to developing herpes:

  • If you have multiple sex partners
  • Becoming sexually active at a young age
  • Having a prior sexually transmitted disease (STD)
  • If you are assigned female at birth
  • If you have a weakened immune system
  • Not practicing safe sex by not using protection such as condoms or dental dams during intercourse

Most people contract HSV-1, which usually causes cold sores during childhood. It spreads when an adult has the virus or cold sore on the tongue or lips and has close contact with a child. For example, one way of transmission is by kissing a child. Both types of HSV can infect both the mouth and the genitals. Once an individual is infected, they will have the herpes simplex virus for the rest of their life. Even though the virus is not active, it resides in a group of nerve cells. This is primarily why an outbreak can occur at any time. However, they are many people who do not experience any symptoms. 

Common Triggers That Cause Herpes on Tongue

It is still unclear what triggers the virus to return, but the following factors may play a role:

  • Exposure to sunlight
  • Physical injury
  • Emotional stress
  • Fever
  • Menstruation
  • Surgery
Talk with a doctor to get a prescription and a lab test for herpes

Symptoms of Herpes on Tongue

Herpes symptoms in the mouth usually start about 2-12 days after getting the infection and can last 7-10 days. Oral herpes symptoms include: 

  • Pain, burning, tingling, itching at the site.
  • Blisters initially appear as small, shallow ulcers on a red base and then soon become dry and crusted, appearing yellow. You can also develop herpes blisters on the tongue or herpes under the tongue.
  • Sores can appear on the lips, nose, tip of the tongue, under the tongue, gums, cheeks, throat, roof of the mouth, chin, or neck.
  • Swollen and red gums or bleeding from the gums.
  • Swollen and painful neck lymph nodes.
  • A sore throat with ulcers. A greyish coating on the tonsils can develop.

Diagnosis of Oral Herpes

Your doctor may diagnose herpes simplex by looking at the sores. Your physician may take a sample from the sore as well. This is known as the viral culture and is done to confirm or rule out the herpes virus. A blood test can be ordered to check for HSV-1 and HSV-2 antibodies if you don’t have any sores. The results can help determine if you’ve been exposed to the virus. The blood test doesn’t show active infection, but it can show if you’ve previously been exposed to the herpes virus. If you have just been exposed, you may not test positive for herpes. This is mainly because there hasn’t been enough time for your body to develop antibodies post-exposure. Therefore, the antibody test may be repeated in 8 to 12 weeks.

Treatment of Oral Herpes

Avoidance of known triggers such as stress can help reduce herpes outbreaks. Unfortunately, once you have the herpes simplex virus, you have it for a lifetime as there is no cure. However, some treatment options that help ease symptoms during an outbreak of oral herpes include:

Antiviral drugs may be used as pills or creams or intravenously. Some options for oral medications include: 

  • Acyclovir (Xerese, Zovirax)
  • Valacyclovir (Valtrex)
  • Famciclovir (Famvir)

Over-the-counter creams include:

  •  L-lysine, benzocaine (Orajel) 
  •  Docosanol (Abreva)

These can help manage herpes symptoms.

Pain management includes:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), ibuprofen (Advil)

Home Remedies to Manage Oral Herpes Symptoms include:

  • Application of zinc oxide cream or lip balm.
  • Applying cool compresses or ice packs to reduce redness and irritation.
  • Drinking plenty of fluids.
  • Take lysine supplements in the form of a pill or a cream.
  • Applying rhubarb-sage cream for managing pain. 
  • Apply sunscreen to avoid sun exposure to avoid the trigger.  
  • Use aloe vera gel. It can help heal a cold sore.
  • Propolis is commonly used in formulations such as ointment to treat cold sores.
Talk with a doctor and start treatment for herpes

Prevention of Herpes on Tongue

You can reduce your risk of contracting herpes by avoiding physical contact with someone who has a cold sore. People can still spread HSV-1 when cold sores aren’t present, but it’s less likely. 

For herpes prevention, you should avoid:

  • Kissing
  • Oral sex
  • Contact with the skin near their mouth
  • Sharing utensils, lip balms or other personal care products

Potential Complications of Herpes

Once you get HSV, the virus resides in your nerve cells forever. It mostly remains inactive, but it can reactivate periodically, resulting in symptoms.

Many people living with HSV can remain asymptomatic, while others experience symptoms every few months. This is known as an outbreak. Usually, you may experience more episodes or outbreaks, but eventually, the severity and frequency decrease over time. Symptoms typically improve over time, and the infection is not considered life-threatening in healthy individuals. However, the virus may cause complications for certain groups, including:

  • newborns
  • immunocompromised individuals such as those with chronic health conditions, namely HIV and cancer

Some complications include:

Herpes Keratitis

You can get herpes keratitis, herpes in the eyes if you touch a herpetic sore and then touch your eye with the same hand.

Symptoms of herpes keratitis include:

  • redness and pain in the eye
  • discharge or watering eyes
  • sensitivity to light
  • blurred vision
  • a gritty sensation in the eye

Untreated herpes keratitis can lead to corneal scarring and, ultimately, vision loss. Therefore, if you’re diagnosed with HSV and notice such symptoms, contacting a doctor as soon as possible is necessary to prevent herpes complications.

Herpes esophagitis

The esophagus is known as the food pipe, carrying food and liquids from your mouth to the stomach. Herpes esophagitis is an infection of this pipe caused by the herpes simplex virus. Herpes type 1 most commonly causes herpes esophagitis. Although, type 1 and type 2 can result in this. 

Herpes esophagitis is uncommon in healthy individuals. However, individuals with a weak immune system, particularly those with cancer, HIV, or AIDS, are at an increased risk.

Herpes esophagitis leads to:

  • inflammation of the oesophagus
  • damage to the lining of the oesophagus
  • painful or difficult swallowing
  • chest pain
  • throat pain

Your doctor will monitor you if you develop such a condition. 

How Long do Sores from Herpes Simplex Last?

If you’re infected with oral Herpes or Herpes inside the mouth, you may experience tingling or burning around your mouth a few days before an actual cold sore appears. These blisters break open and ooze fluid before forming a crust. Usually, sores last for 7 to 10 days. Similarly, oral herpes on the tongue or oral herpes throat can initially present as burning and itching on the tongue or in the throat. 

When to Consult a Doctor

If you are worried about a cold sore on your lip or have symptoms of a herpes outbreak connect with our online doctor at Your Doctors Online. You can get a prescription instantly.

Do you have a cold sore? Chat with a doctor to get a prescription

FAQs About Oral Herpes Answered by Your Doctors Online Team

What does herpes look like on your tongue?

Initially, you may notice redness, swelling, itchiness, bumps on your tongue or pain in a specific region. The sore will appear at this site. Next, a white mark can appear on the tongue and develop into yellowish ulcers.

What does herpes sore look like?

Herpetic sores look like blisters which initially appear as small, shallow ulcers on a red base and then soon become dry and crusted, appearing yellow. You can also develop herpes blisters on the tongue or herpes under the tongue.

What causes an HSV mouth infection?

HSV infection can be passed by kissing, sharing infected objects such as lip balm or utensils or touching the infected person’s skin. 

What is the best prescription for cold sores?

Treatment options include over-the-counter creams, benzocaine (Orajel), and docosanol (Abreva). Some oral antiviral pills include famciclovir or valacyclovir.

Get Started Today

Talk to online doctors now and get medical advice, online prescriptions, refills, and medical notes within minutes. On-demand healthcare services at your fingertips.

talk to online doctor 24/7 free