Oral herpes, commonly known as cold sores or fever blisters, is a widespread viral infection causing painful sores, primarily in and around the mouth. It is caused by the herpes simplex virus type 1 (HSV-1). Many people carry the virus, and outbreaks can occur periodically throughout life.
Recognizing Symptoms on the Tongue
Herpes lesions on the tongue follow a distinct progression of symptoms. An outbreak begins with a tingling, burning, or itching sensation in a specific area of the tongue, sometimes with redness and swelling. This initial phase, known as the prodrome, signals a sore is about to appear. Within a day or two, small, fluid-filled blisters, also called vesicles, emerge on the affected part of the tongue. These blisters may appear reddish, whitish, or yellowish.
The blisters are often sensitive and can cause discomfort. After a few days, these fluid-filled blisters tend to rupture, releasing a clear or slightly yellowish fluid. This stage, sometimes called the “weeping phase,” can be particularly painful. Unlike cold sores on the lips, herpes lesions on the tongue do not form a hard, crusty scab. Instead, they appear as open sores, sometimes with a thin white coating, due to the moist environment of the mouth. These sores eventually begin to heal, and the pain subsides, usually within 7 to 10 days.
Beyond the Tongue: Other Oral Symptoms
While herpes can appear on the tongue, it commonly affects other areas in and around the mouth. The lips are a frequent site for cold sores. These lesions progress similarly to those on the tongue, healing within one to two weeks.
Oral herpes can also manifest on the gums, the roof of the mouth (palate), and the inside of the cheeks. In these locations, the appearance and progression of the sores are generally similar to those on the lips or tongue. During a first outbreak, individuals might also experience more widespread symptoms such as fever, a sore throat, headache, muscle aches, or swollen lymph nodes in the neck.
Understanding Oral Herpes and Its Transmission
Oral herpes is most often caused by the highly contagious herpes simplex virus type 1 (HSV-1). This virus is transmitted through direct contact with sores, saliva, or skin surfaces in or around the mouth of an infected person. Transmission can occur through activities like kissing, sharing eating utensils, or sharing personal items such as lip balm.
Once infected with HSV-1, the virus remains in the body for life, often lying dormant in nerve cells. Even when no sores are visible, the virus can still be shed and transmitted, though the risk is highest during an active outbreak. Various factors can trigger the virus to reactivate and cause an outbreak, including stress, illness, fever, sunlight exposure, hormonal changes, or a weakened immune system.
When to Seek Medical Advice
While many oral herpes outbreaks resolve on their own, seeking medical advice is recommended. A healthcare professional can provide an accurate diagnosis, as other mouth sores like canker sores can sometimes be confused with herpes. Medical consultation is particularly important if it is your first oral herpes outbreak, as initial infections can be more severe.
You should also consult a doctor if symptoms are severe, widespread, or accompanied by a high fever, swollen glands, or significant pain affecting eating or drinking. If sores do not heal within two weeks, or if you experience frequent outbreaks, medical guidance can help manage the condition. Individuals with a weakened immune system due to other medical conditions or medications should seek prompt medical attention for any oral herpes symptoms, as the infection can be more serious.