Mouth sores are a common symptom of HIV. In fact, between 32 and 46 percent of people with HIV develop mouth complications due to a weakened immune system.

These mouth sores can interfere with a person’s well-being. In the case of HIV, these sores and infections are more difficult to treat, and can also interfere with eating and medication.

Read on to see what these sores look like and learn how to treat them.

Fighting off infections and viruses is more difficult for a person with HIV. One of the most common viruses that people have is herpes simplex, or oral herpes. Oral herpes usually appears as red sores in the mouth.

When they appear outside the lips, they may look like blisters. Nicknamed “fever blisters,” these red, raised bumps can be painful. They’re also known as cold sores.

Anyone can get oral herpes, but in someone with HIV or a weakened immune system, oral herpes may be more severe and last longer.

Treatment: Oral herpes is treatable with medication. A healthcare provider will likely prescribe acyclovir, an antiviral treatment. This medication helps reduce new outbreaks.

Continue to take any prescription medications until a healthcare provider indicates otherwise.

Contagious? Yes. People with herpes may want to avoid sharing foods.

Canker sores are common mouth lesions that can cause pain, especially because they don’t go away on their own. They’re usually red, but can also be covered with a gray or yellow film. Canker sores are also known as aphthous ulcers.

They tend to develop inside the cheeks, inside the lips, and around the tongue. These locations may make the sores feel more painful because they move when a person speaks or eats.

Canker sores aren’t a symptom of HIV, but having HIV can increase the risk for recurring and severe sores. Other factors that can cause canker sores include stress, acidic foods, and mineral deficiencies that include:

Eating hot or spicy foods can also lead to increased pain from canker sores.

Treatment: In mild cases, over-the-counter (OTC) creams and mouthwashes can reduce inflammation and sores. Canker sores can also be treated with salt water.

If someone has a severe case of canker sores, they may be prescribed corticosteroids in pill form. For cases of prolonged sores that interfere with meals, try topical anesthetic sprays. These can help numb the area.

Contagious? No.

HPV can cause warts anywhere around the mouth or lips. Warts can look like small cauliflowerlike bumps or masses with folds or projections. They can sprout inside and around the mouth.

Most of the time warts are white, but they can also be pink or gray. They’re generally not painful, but they can be bothersome. Depending on their location, HPV mouth warts can be picked at and bleed.

HPV is also strongly associated with oropharyngeal cancer, or throat cancer.

Treatment: A healthcare provider will need to perform surgery to remove warts. A prescription cream may be used for warts on the lips, but there’s no oral medication to treat warts.

Contagious? Possibly, if broken and there’s fluid.

Thrush is a yeast infection that appears as white, yellowish, or red patches anywhere inside the mouth. The patches are sensitive and may bleed or burn when accidentally wiped.

In some cases, thrush will cause painful cracks around the mouth. This is known as angular cheilitis. Thrush may also spread to the throat, if left untreated.

Treatment: The normal course of treatment for mild thrush is antifungal mouthwash. But HIV can also increase this infection’s resistance. If this is the case, a healthcare provider may prescribe oral antifungal pills.

Contagious? No.

Although these aren’t sores, gum disease (gingivitis) and dry mouth are common problems.

Gum disease causes the gums to swell, and can be painful. In severe cases, it can lead to gum or teeth loss in as quick as 18 months. Gum disease may also be an indication of inflammation, which increases the risk for heart disease and stroke.

Dry mouth occurs when a person doesn’t produce enough saliva. Saliva can help protect the teeth as well as prevent infections. Without saliva, the teeth and gums are vulnerable to plaque development. This can also make gum disease worse.

Treatment: Drink water, floss, and brush consistently to keep the mouth clean and hydrated. For gum disease, a dentist will remove the plaque with a deep cleaning method.

If dry mouth persists, ask a healthcare provider about saliva substitutes.

Mouth sores can also interfere with HIV treatment. Having a decreased immune function can increase the spread of mouth sores, which tend to multiply in large numbers. This can make swallowing difficult, causing some people to skip medications or meals.

Talk to a healthcare provider if mouth sores make it difficult to take HIV medication. They can find other treatment options.

Infections

Untreated mouth sores can cause infections. Canker and cold sores can pop when a person is eating or brushing their teeth. Warts and thrush may accidentally be picked off. Open wounds leave a person even more vulnerable to infections.

Dry mouth also increases the risk for infection because there’s not enough saliva to naturally fight bacteria.

Talk to a healthcare provider about treatment for mouth sores. Prompt treatment reduces the number of mouth sores and the risk for infection.

One of the best ways to treat and prevent HIV-related mouth sores is to see a dentist for regular checkups.

A dentist can detect problems early on or help prevent sores from worsening. Let them know about ongoing mouth sores or infections that won’t go away. They can help with treatment and managing symptoms.

The key to managing HIV is to see a healthcare provider regularly and take medications. Having mouth sores may make taking medication more difficult. Consider talking to a healthcare provider if there are any concerns that interfere with medication.

Also consider contacting the CDC National AIDS Hotline at 800-232-4636, if interested in having a conversation. Someone will answer the phone and be able to offer accurate information about HIV and healthcare obstacles. They can also share their experiences.

Or check out other available hotlines at Project Inform. There are hotlines for people in nearly every state, for women, for people with disabilities, and more.

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