Herpes simplex is a type of virus known to affect both the mouth and the genitals.

There are two distinct types of virus that can cause herpes on the tongue:

  • Herpes simplex virus type 1 (HSV-1). HSV-1 is the type that most commonly causes cold sores.
  • Herpes simplex virus type 2 (HSV-2). HSV-2 is commonly associated with genital herpes.

HSV-1 is generally the one that causes herpes on the tongue. But it’s also possible to contract an HSV-2 infection in the mouth from sex without a condom or other barrier method.

There’s currently no cure for either HSV virus, but both can be treated and prevented.

Once a virus gets into your body, it uses proteins on its surface to enter a host cell.

Inside of the host cell, the virus makes additional copies of itself. These new viruses eventually leave the host cell, going on to infect new cells.

Many people who contract HSV-1 or HSV-2 are asymptomatic. This means that they have no symptoms and may not know that they have the virus.

In addition to sores and lesions, people with a recent infection may also experience flu-like symptoms. These can include:

  • fever
  • body aches
  • swollen lymph nodes

HSV-1 and HSV-2 can lie dormant in your nerve cells (neurons). When the virus is dormant, you can go for months or years without showing any symptoms.

Sometimes, the virus can reactivate. Although some causes of reactivation are unclear, it can be due to factors such as:

  • stress
  • injury
  • prolonged exposure to sunlight

During reactivation, you’ll often experience symptoms.

How HSV-1 is spread

In this case, HSV-1 attaches to the cells in and around your mouth. The virus then replicates and spreads to surrounding cells. Someone with an active HSV-1 infection may have symptoms like cold sores.

The herpes simplex virus, especially HSV-1, can spread through contact with the skin or saliva of someone who carries the virus or who has an active herpes infection, like a cold sore.

For example, kissing someone who has an infected cold sore in their mouth can spread the HSV-1 virus easily.

Sharing items that a person with the infection has used, such as lipstick, utensils, or shaving equipment, can put you at risk for contracting the virus and getting symptoms on your tongue.

How HSV-2 is spread

HSV-2 can also cause herpes symptoms on the tongue.

HSV-2 is mainly spread through sex without a condom or other barrier method. Therefore, you won’t necessarily get it just by touching or sharing items with someone who has the infection.

Here are some possible ways HSV-2 can be transmitted to your mouth or tongue:

  • Giving or receiving oral sex without a barrier method with someone who has an infected herpes sore on or around their genitals. It can spread especially easily if the sore is producing pus or discharge.
  • Making oral contact with sexual body fluids like semen or vaginal discharge with someone who carries the virus or who has an active infection.
  • Making contact between the mouth and anus when the anus skin has an open, infected sore on it.

Herpes symptoms on your tongue usually come in the form of red, swollen, sensitive blisters. The blisters start with mild discomfort and progress to increasingly painful sores.

Here are the stages of a herpes infection that you can typically expect from tongue herpes:

  1. You’ll notice redness, swelling, itchiness, or pain in a specific area of your tongue. This is likely where the sore will appear.
  2. On the tongue, you may see a white substance that turns into yellowish ulcers.
  3. Ulcers also might appear on your throat, the roof of your mouth, and inside your cheeks.

Your doctor will most likely be able to identify and diagnose an HSV-1 infection by looking at sores on your tongue or mouth.

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Herpes blisters on the tongue. Photo Credit: CDC/ Robert E. Sumpter, 1967.

This is part of a physical exam in which your doctor may also check the rest of your body for any other symptoms. This can also help rule out other causes like HSV-2.

Your doctor can use a cotton swab to collect fluid from a sore and send it to a lab to test for the presence of HSV-1 virus RNA. This is called a herpes culture. This test can also diagnose HSV-2 if that’s the actual cause.

Your doctor may suggest a blood test if you don’t have open, active sores on your tongue.

An HSV-1 blood test involves taking a small sample of your blood and sending it to a lab to check it for antibodies. Your immune system creates these antibodies to fight off HSV-1 viral infections.

There’s no cure for the HSV-1 virus. Instead, you can manage symptoms, such as tongue sores, and reduce the chance of frequent outbreaks.

Sores will sometimes just go away on their own — no treatment needed.

But if you have severe or frequent outbreaks, your doctor may prescribe one of the following antiviral treatments as a pill, topical cream, or ointment:

You may also get one of these medications as an injection if your symptoms are severe. Antiviral medications help reduce the chance you’ll transmit the virus to others.

Here’s what you can do to prevent exposure to the herpes virus:

  • Don’t make direct physical contact with others, particularly if they have an active infection.
  • Wash your hands frequently for at least 20 seconds at a time. If the virus is present on your hands, this will prevent it from passing to other parts of your body or to other people.
  • If any clothes, blankets, or sheets have made contact with infected sores, wash them in hot water as soon as possible.
  • Don’t share items that can make contact with people’s skin or mouths, such as:
    • lip products
    • makeup
    • towels
    • cups
    • utensils
    • clothes
  • Use a cotton swab to put antiviral medication on open, infected sores so that the virus doesn’t pass to your hands.
  • Don’t have oral, anal, or genital sex during an outbreak, including a tongue herpes outbreak.
  • Use condoms or other protective barriers, such as dental dams, whenever you have sex.

See your doctor if you notice any of the following symptoms along with herpes-like blisters or sores in your mouth:

  • pain or discomfort in your mouth or tongue that gets increasingly worse over time, especially after a week or longer
  • flu-like symptoms, such as fatigue or fever
  • unusually cloudy or discolored discharge that comes out of your genitals

Tongue herpes is usually not a cause for concern. Sores will often go away on their own and only come back occasionally during outbreaks.

But herpes can be spread easily through close contact, particularly if you have an active infection. Because of this, you’ll need to take precautions to make sure you don’t pass the infection to others.

Taking these same precautions can help prevent you from contracting the infection in the first place, too.