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What is recurrent herpes simplex labialis?

Recurrent herpes simplex labialis, also known as oral herpes, is an infection of the mouth area caused by the herpes simplex virus. It’s a common and contagious infection that spreads easily. According to the American Sexual Health Association, over half of adults in the United States carry this virus.

The infection causes blisters and sores on the lips, mouth, tongue or gums. After an initial infection, the virus stays dormant inside the nerve cells of the face. Later on in life, the virus can reactivate and result in more sores. The herpes is recurrent when this happens. These are commonly known as cold sores or fever blisters.

Recurrent herpes simplex labialis is usually not serious, but relapses are common. Many people choose to treat the recurrent episodes with over-the-counter creams. The symptoms will usually go away without treatment in a few weeks. A doctor may prescribe medications if relapses occur often.

Herpes simplex labialis is the result of a virus called herpes simplex virus type 1 (HSV-1). The initial infection usually occurs before age 20. It typically affects the lips and areas around the mouth.

You can get the virus from close personal contact with someone who has the virus. You can also get oral herpes from touching objects where the virus may be present. These include towels, utensils, razors for shaving, and other shared items.

After the first infection, the virus lays dormant inside the nerve cells of the face for the rest of a person’s life. This means that symptoms aren’t always present. However, certain events can make the virus reawaken and lead to a recurrent herpes infection. Events that trigger a recurrent infection of oral herpes might include:

  • fever
  • menstruation
  • a high-stress event
  • fatigue
  • hormonal changes
  • upper respiratory infection
  • extreme temperature
  • a weakened immune system
  • recent dental work or surgery

The primary infection may not cause symptoms at all. If it does, blisters may appear near or on the mouth within one to three weeks after your first contact with the virus. The blisters might last up to three weeks. In general, a recurrent episode is milder than the initial infection.

Symptoms of a recurrent episode may include:

  • blisters or sores on the mouth, lips, tongue, nose, or gums
  • burning pain around the blisters
  • tingling or itching near the lips
  • outbreaks of several small blisters that grow together and may be red and inflamed

Tingling on or near the lips is usually a warning sign that the cold sores of recurrent oral herpes are about to appear in one to two days.

A doctor will typically diagnose oral herpes by examining the blisters and sores on your face. They might also send samples of the blister to a laboratory to test specifically for HSV-1.

Recurrent herpes simplex labialis can be dangerous if the blisters or sores occur near the eyes. The infection can lead to scarring of the cornea. The cornea is the clear tissue covering the eye that helps focus images that you see.

Other complications include:

  • a frequent recurrence of the sores and blisters that requires constant treatment
  • the spread of the virus to other parts of the skin
  • a widespread bodily infection, which can be serious in people who already have a weakened immune system, such as people with HIV

You can’t get rid of the virus itself. Once contracted, HSV-1 will remain in your body forever, even if you don’t have recurrent episodes. Symptoms of a recurrent episode usually go away within one to two weeks without any treatment. The blisters will usually scab and crust over before they disappear.

At-home care

Applying ice or a warm cloth to the face or taking a pain reliever like acetaminophen (Tylenol) might help reduce any pain. Some people choose to use over-the-counter skin creams. However, these creams usually only shorten an oral herpes relapse by one or two days.

Shop for ice packs and acetaminophen online.

Prescription medication

Your doctor may prescribe oral antiviral medicines to fight the virus, such as:

These medications work better if you take them when you experience the first signs of a mouth sore, such as tingling on the lips, and before the blisters appear. These medications don’t cure herpes and may not stop you from spreading the virus to other people.

For cases of recurrent herpes simplex labialis that result in frequent mouth sores, your doctor may advise you to use the medication all the time.

The following tips may help prevent the infection from reactivating or spreading.

  • Wash any items that may have had contact with the infected sores, like towels, in boiling water after use.
  • Don’t share food utensils or other personal items with people who have oral herpes.
  • Don’t share cold sore creams with anyone.
  • Don’t kiss or participate in oral sex with someone who has cold sores.
  • To keep the virus from spreading to other parts of the body, don’t touch the blisters or sores. If you do, wash your hands with soap and water immediately.

Symptoms usually go away within one to two weeks. However, the cold sore episodes can frequently return. The rate and severity of the sores usually diminish as you get older.

Infections near the eye or in immune-compromised individuals can be serious. See your doctor in these cases.