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Herpes labialis is
an infection caused
by the herpes simplex
virus, characterized
by an eruption of
small and usually
painful blisters on
the lips, mouth, or
the skin around the
mouth. These blisters
are commonly called
cold sores or fever
blisters.
Overview, Causes, & 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. |
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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 but
can also cause herpes
labialis.
Herpes viruses are contagious.
Contact can occur directly,
or through contact with
infected razors, towels,
dishes, etc. Occasionally,
oral/genital contact
can spread oral herpes
to the genitals (and
vice versa), so people
with active herpes lesions
on or around their mouths
or on their 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, after
which, 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
& Signs
Warning
symptoms such as itching,
burning, increased
sensitivity, or tingling
sensation may occur
about 2 days before
lesions appear.
- Skin lesion/rash
located around the
lips, mouth, and
gums
- Small blisters
(vesicles), filled
with clear yellowish
fluid
- blisters appear
on a raised, red,
painful skin area
- blisters form,
break, and ooze
- yellow crusts
slough to reveal
pink, healing
skin
- several smaller
blisters may merge
to form a larger
blister
- Mild fever (may
occur)
Prevention
Avoid
direct contact with
cold sores or other
herpes lesions. Minimize
the risk of indirect
spread by thoroughly
washing infected items
in hot (preferably
boiling) water before
re-use. Do not share
items with an infected
person, especially
when herpes lesions
are active. Avoid
precipitating causes
(especially sun exposure)
if prone to oral herpes.
Avoid performing oral
sex when you have
active herpes lesions
on or near your mouth
and avoid passive
oral sex with someone
who has active oral
or genital herpes
lesions. Condoms can
help reduce, but do
not entirely eliminate,
the risk of transmission
via oral or genital
sex with an infected
person.
Unfortunately, both
oral and genital herpes
viruses can sometimes
be transmitted even
when the person does
not have active lesions.
Diagnosis
& Tests
Diagnosis
is made on the basis
of the appearance
and/or culture of
the fluid or scrapings
from the lesion. Examination
may also show enlargement
of lymph nodes in
the neck or groin.
Treatment
Untreated,
the symptoms will
generally subside
in 1 to 2 weeks. Antiviral
medications along
with analgesics may
be given by mouth
to shorten the course
of the symptoms and
decrease pain.
Washing the blisters
gently with soap and
water helps to minimize
the spread of the
virus to other areas
of skin. An antiseptic
soap may be recommended.
Applying ice or warmth
to the area may reduce
pain.
Take precautions to
avoid infecting others
(see Prevention).
Prognosis
(Expectations)
Herpes
labialis usually disappears
spontaneously in 1
to 2 weeks. It may
recur. Infection may
be severe and dangerous
if it occurs in or
near the eye, or if
it occurs in immunocompromised
or immunosuppressed
individuals.
Complications
- Spread
of herpes to other
skin areas
- Secondary
bacterial skin infections
- Recurrence
of herpes labialis
- Generalized
infection may be
life-threatening
in immunosuppressed
people, including
those with atopic
dermatitis, cancer,
HIV infections
- Blindness
Herpes infection
of the eye is a leading
cause of blindness
in the US, due to
scarring of the cornea.
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