Recurrent herpes simplex labialis, also known as oral herpes, is a condition of the mouth area caused by the herpes simplex virus. It’s a common and contagious condition that spreads easily.

According to the World Health Organization (WHO), an estimated two out of three adults in the world under age 50 carry this virus.

The condition causes blisters and sores on the lips, mouth, tongue, or gums. After an initial outbreak, the virus stays dormant inside the nerve cells of the face.

Later on in life, the virus can reactivate and result in more sores. These are commonly known as cold sores or fever blisters.

Recurrent herpes simplex labialis usually isn’t serious, but relapses are common. Many people choose to treat the recurrent episodes with over-the-counter (OTC) 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 acquisition usually occurs before age 20. It typically affects the lips and areas around the mouth.

You can get the virus from close personal contact, such as through kissing, 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.

Since the virus lays dormant inside the nerve cells of the face for the rest of a person’s life, symptoms aren’t always present. However, certain events can make the virus reawaken and lead to a recurrent herpes outbreak.

Events that trigger a recurrence 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
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The original acquisition may not cause symptoms at all. If it does, blisters may appear near or on the mouth within 1 to 3 weeks after your first contact with the virus. The blisters might last up to 3 weeks.

In general, a recurrent episode is milder than the initial outbreak.

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 or warmth on or near the lips is usually a warning sign that the cold sores of recurrent oral herpes are about to appear in 1 to 2 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 outbreak 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:

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

You can’t get rid of the virus itself. Once contracted, HSV-1 will remain in your body, even if you don’t have recurrent episodes.

Symptoms of a recurrent episode usually go away within 1 to 2 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) may help reduce any pain.

Some people choose to use OTC skin creams. However, these creams usually only shorten an oral herpes relapse by 1 or 2 days.

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.

The following tips may help prevent the condition from reactivating or spreading:

  • Wash any items that may have had contact with the contagious 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 a cold sore.
  • 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 1 to 2 weeks. However, cold sores can frequently return. The rate and severity of the sores usually diminish as you get older.

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