Cold sore
Key points
- Herpes labialis is an infection caused by the herpes simplex virus, characterized by an eruption of small and usually painful blisters on the skin of the lips, mouth, gums or the skin around the mouth.
- Herpes labialis is an extremely common disease caused by infection of the mouth area with herpes simplex virus, most often type 1.
- Warning symptoms of itching, burning, increased sensitivity, or tingling sensation may occur about 2 days before lesions appear.
- Untreated, the symptoms will generally subside in 1 to 2 weeks.
Alternative names
Herpes labialis (oral Herpes simplex); Fever blister; Herpes simplex - oral
Definition
Herpes labialis is an infection caused by the herpes simplex virus, characterized by an eruption of small and usually painful blisters on the skin of the lips, mouth, gums or the skin around the mouth. These blisters are commonly called cold sores or fever blisters.
Causes, incidence, and risk factors
Herpes labialis is an extremely common disease caused by infection of the mouth area with herpes simplex virus, most often type 1. Most Americans are infected with the type 1 virus by the age of 20.
The initial infection may cause no symptoms or mouth ulcers. The virus remains in the nerve tissue of the face. In some people, the virus reactivates and produces recurrent cold sores that are usually in the same area, but are not serious. Herpes virus type 2 usually causes genital herpes and infection of babies at birth (to infected mothers), but may also cause herpes labialis.
Herpes viruses are contagious. Contact may occur directly, or through contact with infected razors, towels, dishes, and other shared artcles. Occasionally, oral-to-genital contact may spread oral herpes to the genitals (and vice versa). For this reason, people with active herpes lesions on or around the mouths or on the genitals should avoid oral sex.
The first symptoms usually appear within 1 or 2 weeks - and as late as 3 weeks - after contact with an infected person. The lesions of herpes labialis usually last for 7 to 10 days, then begin to resolve. The virus may become latent, residing in the nerve cells, with recurrence at or near the original site.
Recurrence is usually milder. It may be triggered by menstruation, sun exposure, illness with fever, stress, or other unknown causes.
Symptoms
Warning symptoms of itching, burning, increased sensitivity, or tingling sensation may occur about 2 days before lesions appear.
- Skin lesions or rash around the lips, mouth, and gums
- Small blisters (vesicles) filled with clear yellowish fluid
o Blisters on a raised, red, painful skin area
o Blisters that form, break, and ooze
o Yellow crusts that slough to reveal pink, healing skin
o Several smaller blisters that merge to form a larger blister - Mild fever (may occur)
Signs and tests
Diagnosis is made on the basis of the appearance or culture of the lesion. Examination may also show enlargement of lymph nodes in the neck or groin.
Frequently asked questions
What is cold sore?
Herpes labialis is an infection caused by the herpes simplex virus, characterized by an eruption of small and usually painful blisters on the skin of the lips, mouth, gums or the skin around the mouth. These blisters are commonly called cold sores or fever blisters.
What are the risk factors for cold sore?
Herpes labialis is an extremely common disease caused by infection of the mouth area with herpes simplex virus, most often type 1. Most Americans are infected with the type 1 virus by the age of 20. The initial infection may cause no symptoms or mouth ulcers. The virus remains in the nerve tissue of the face. In some people, the virus reactivates and produces recurrent cold sores that are usually in the same area, but are not serious. Herpes virus type 2 usually causes genital herpes and infection of babies at birth (to infected mothers), but may also cause herpes labialis. Herpes viruses are contagious.
What are the symptoms of cold sore?
Warning symptoms of itching, burning, increased sensitivity, or tingling sensation may occur about 2 days before lesions appear.
- Skin lesions or rash around the lips, mouth, and gums
- Small blisters (vesicles) filled with clear yellowish fluid o Blisters on a raised, red, painful skin area o Blisters that form, break, and ooze o Yellow crusts that slough to reveal pink, healing skin o Several smaller blisters that merge to form a larger blister
- Mild fever (may occur) Signs and tests Diagnosis is made on the basis of the appearance or culture of the lesion. Examination may also show enlargement of lymph nodes in the neck or groin.
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.