Oral herpes, caused by the herpes simplex virus (HSV), typically HSV-1, is a widespread viral infection often recognized by blisters around the mouth. While commonly appearing as “cold sores” on the lips, the virus can also affect areas inside the mouth and throat, leading to herpes pharyngitis or, less commonly, herpes esophagitis if it affects the esophagus. This article explains what herpes in the throat might look and feel like, helping distinguish it from other conditions and guiding when to seek medical advice.
Visual Characteristics of Throat Herpes
Herpes pharyngitis begins with inflammation. The affected area may appear red and swollen, similar to a general sore throat. Small bumps then emerge, rapidly developing into fluid-filled blisters, also known as vesicles. These blisters are small, often clustered on a reddened base, and can be found on the tonsils, back of the throat, or soft palate.
As the infection progresses, these delicate blisters rupture, leaving shallow, painful ulcers. These ulcers often have a grayish-white base and are surrounded by a distinct red halo, indicating inflamed tissue. Appearance can vary; some present as a single sore, while others involve multiple distinct lesions. Healing involves a yellowish crust over the sores before they resolve, usually within one to two weeks, though the first outbreak might involve more blisters that take longer to heal.
Additional Signs and Sensations
Beyond visible lesions, herpes in the throat can cause uncomfortable sensations and systemic symptoms. A sore throat, which can be severe and persistent, is common. This is often accompanied by odynophagia (painful swallowing) and dysphagia (difficulty swallowing), making eating and drinking challenging and potentially leading to dehydration.
Individuals might also experience malaise, alongside flu-like symptoms such as fever, chills, and body aches. Headaches are commonly reported. The body’s immune response can also lead to swollen and tender lymph nodes in the neck, which may be felt as lumps.
Differentiating From Other Throat Issues
Distinguishing herpes in the throat from other common throat conditions can be challenging due to overlapping symptoms. Strep throat, a bacterial infection, presents with a sore throat, often with red and inflamed tonsils that may have white patches or streaks of pus, and small red spots on the roof of the mouth. Unlike herpes, strep throat lacks characteristic fluid-filled blisters or ulcers.
Viral pharyngitis, commonly associated with the common cold, also causes a sore throat but does not produce discrete, painful lesions or blisters like herpes. Canker sores (aphthous ulcers) are painful, non-contagious sores appearing on soft tissues inside the mouth, such as the tongue or inner cheeks. They are round or oval with a white or yellowish center and a red border, but are not caused by the herpes virus and do not present as ruptured blisters. Fungal infections, such as oral thrush, present as creamy white lesions, which can be scraped off, revealing reddened tissue underneath, a different appearance from herpes blisters.
When to Consult a Healthcare Professional
Consult a healthcare professional if you suspect you have herpes in the throat, especially if symptoms are severe or persistent. Medical attention is advised if you experience extreme pain, significant difficulty swallowing that impairs eating or drinking, or a high fever that does not subside. If you have a weakened immune system due to conditions like HIV, cancer, or organ transplantation, or if you are taking immunosuppressant medications, seek prompt medical care.
A healthcare provider can diagnose herpes in the throat through a physical examination, looking for characteristic lesions. A swab test from the sores can be taken to test for the herpes simplex virus, or a blood test might detect antibodies to HSV. Early diagnosis allows for timely treatment with antiviral medications, most effective when started within 48 hours of symptom onset, and can help reduce outbreak severity and duration.