What Do Oral Herpes Sores Look Like at Different Stages?

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Oral herpes, also referred to as fever blisters or cold sores, go through distinct stages, just like genital herpes or herpes zoster (shingles). Herpes blisters look very similar in appearance, no matter what part of the body they affect. According to the Mayo Clinic, if you have oral herpes, you can expect your sores to heal in between seven and 10 days. But there are other symptoms aside from active sores that you may anticipate.

About Oral Herpes

Oral herpes is almost always caused by the herpes simplex virus type 1 (HSV-1), with which many people are infected, usually as children when a well-meaning relative or friend gives them a kiss on the face or mouth. According to the American Social Health Association, between 50 and 80 percent of the U.S. population has oral herpes, and by age 50, this percentage increases to 90. In rare instances, oral herpes can be caused by the herpes simplex virus type 2 (HSV-2) that's usually associated with genital herpes, when an uninfected person performs oral sex on someone infected with HSV-2. Once the virus is inside the body, it finds a safe haven in the ganglion, where it lays dormant until something causes it to reactivate. HSV-1 resides in the trigeminal ganglion at the top of the spine, closest to the face.

Before an Oral Herpes Outbreak

During the earliest stage of oral herpes, a sore isn't even present. Most people experience symptoms prior to an outbreak that include pain, tenderness or a tingling sensation in the part of the lip or mouth that will be affected two to three days before sores erupt. This is a sign that HSV-1 is "awake."

Oral Herpes Lesions

When herpes sores erupt, they may present as a single watery sore or a group of watery blisters that form a lesion. They are usually present on the lip or around the mouth, but every now and then, they might appear on the nostrils, chin or even the fingers. According to the Mayo Clinic, it's very unusual for herpes sores to erupt inside your mouth. Oral herpes sores are very tender when they first occur; eventually, these watery blisters will rupture and ooze.

The Healing Process

As oral herpes sores begin to resolve, you may notice a yellow crust appear over the ruptured blisters. This eventually flakes off to reveal new pink skin. Unless they are picked at excessively, the point where infection occurs, most oral herpes sores will not leave a scar.

Treating Oral Herpes

Some oral herpes outbreaks don't require treatment, but there are over the counter balms that contain topical anesthetics that can temporarily relieve pain and soreness. ASHA recommends that you use discretion when applying these, as frequent touching of oral herpes sores may cause them to heal more slowly. According to ASHA, only 25 percent of people with oral herpes experience a second outbreak. But some people do suffer numerous outbreaks of oral herpes. The same prescription antiviral medications--Zovirax, Famvir and Valtrex--that are used to reduce the frequency and severity of genital herpes outbreaks, can treat oral herpes effectively, particularly when they're taken when early signs are first noted.