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Oral herpes (commonly called cold sores, fever blisters or facial herpes) is typically caused by the HSV-1 virus and generally contracted through saliva or direct contact with infected skin.


Millions of people worldwide are infected with facial herpes. Studies show that up to 90% of people 50+ are infected with the HSV-1 virus, but only a small fraction of those infected will have symptoms: facial herpes recurrences occur in 20% to 40% of adults. In America, there are an estimated 500,000 new cases of facial herpes annually. Studies show that in some countries, there is a rise in genital herpes cases caused by HSV-1 - in some studies more than 50% of new genital herpes instances are caused by HSV-1. This may be partly associated with changing sexual behaviors.


Generally, individuals who have HSV-1 contracted it during childhood. For 70% of people infected, there are no symptoms. Typically there is no way to determine exactly how or when you contracted facial herpes. It is probable that you were infected during childhood through contact with a family member or another child who had the HSV-1 virus. Many individuals have no symptoms and may go a lifetime without knowing they are infected. Greatest risk of contracting the virus is during the time the blisters appear until they have completely disappeared. However, it is still possible to spread herpes even after the skin has healed and the infection is no longer visible.


Cold sores are unlike canker sores, although people oftentimes confuse the two. Although many people believe the two are related, cold sores differ greatly from canker sores. Cold sores are triggered by reactivation of the herpes simplex virus, and are contagious. Canker sores on the other hand, are not contagious, and are actually ulcers that exist in the soft tissues inside the mouth, where cold sores very rarely exist.





Facial herpes is contagious and is passed by close physical contact with someone who has the virus. It is most typically contracted during childhood from kissing or hugging close contact with other infected children. Likewise, facial herpes is often passed among adults by kissing and it can also be transmitted by sharing drinkware, cosmetics, toothbrushes or face towels during an active period.


The time when the virus is the most contagious of facial is when the blisters burst, but it can be passed before blisters are visible or when a person has no symptoms at all (asymptomatic shedding).


It is very common for people to have cold sores. While they are not curable, there are things that have been shown to decrease the frequency and duration of an outbreak.







In the event that there are symptoms of oral herpes, they typically include a fever, flu-like symptoms, a sore mouth and throat (pharyngitis). Painful blisters may appear on the tongue, in the mouth and near and on the lips. These blisters are most often mild. The blisters, which develop into ulcers, last for about 12 days. The amount of blisters generally peaks around day 6 and then decreases. Neck pain and enlarged lymph nodes may occur. There can be bad breath and drooling. Children who are infected may turn down food and drink due to pain in severe cases. If this occurs, guardians should consult a doctor. In older people (such as teenagers), the symptoms may be more severe than in small children.





After HSV has attacked the body, it passes along the nerve paths to the trigeminal ganglion, a bundle of nerves close to the inner ear, where it stays throughout a person's life. Some people don’t ever have another outbreak, but some people experience occasional recurrences. When reactivated, the virus travels back up the nerves towards the mouth causing a new outbreak, although the symptoms may not be at the same site as the initial infection symptoms. People often experience milder, shorter symptoms during recurrences.

Many who experience cold sores have two or three outbreaks each year. Blisters typically are more localized than during initial infection and normally heal within 8–10 days. Pain dissipates quickly, frequently in 4–5 days. Factors like sunlight, fever, stress, or surgery are thought trigger HSV-1 outbreaks, but these claims have not been scientifically proven.

Generally, outbreaks will clear up totally in about two weeks. This can typically be decreased if you use antiviral drugs.

*The following information is not a substitute for medical advice and is not intended for diagnosis or treatment. Consult a physician to confirm suspicion of herpes and for treatment advice.





Many things can be done to protect yourself and your partner from contracting herpes and to avoid spreading it to other body parts. Here are helpful tips to prevent the spread of herpes:

* Do not kiss or have skin contact with infected persons during an outbreak. Oral herpes is passed most easily when there are moist secretions from cold sores. For people who have suppressed immune system, herpes can be contracted even when there are no visible signs of an outbreak.

* Do not share items like eating utensils, towels, and lip balm because these can carry the herpes virus during an outbreak.

* Wash your hands carefully and regularly prior to touching others during an outbreak.

* Use caution when touching other body parts. Eyes and genital region can be particularly vulnerable to the spread of herpes.

* Avoid activities known to trigger outbreaks. Try to avoid stressful situations, like cold or flu, lack of sleep or prolonged sun exposure without sunblock.

* Use sunblock on lips and face prior to prolonged sun exposure— in winter and summer to avoid outbreaks.

When you are experiencing an outbreak, the aforementioned good hygiene practices will decrease chance of transmission. Also steer clear of:

* Kissing - even a friendly peck on the cheek could pass facial herpes

* Oral sex

* Sharing face towels, eating/drinking utensils, toothbrushes—anything that may pass the virus.





Commonly, cold sores heal without the use of medicine. But, you may want to seek medical attention if:

*The blisters don't go away within one to two weeks

*There is a pre-existing health condition that has put your immune system at risk

*Symptoms are severe

*You have frequent outbreaks

*Eye irritation occurs

If your facial herpes condition does not warrant medical attention, use the following tips to control oral herpes episodes.

* Guard face from extreme sunlight by wearing a hat and applying sunblock on and around lip region

* Begin treatment right away when you notice signs.

* If you have intense or frequent outbreaks, suppressive therapy <link to glossary> to reduce recurrences may be the best option for you.

* Use antiviral therapy as a preventive measure to reduce the chance of an outbreak if you will be exposed to a trigger(i.e. extreme weather conditions).

* Do not touch sores. This can cause a bacterial infection or possibly pass the virus to other body parts.

* Wash your hands immediately after touching sores and before and after you apply any medication to affected area.

* Be careful when applying or removing eye make-up because the virus can be passed to the eye.

* Wash hands prior to inserting and removing contact lenses and never moisten lenses with saliva.

* Boost the body's immune system by following these practical steps to leading a healthy lifestyle: adequate sleep, a regular exercise regiment and a balanced diet.




*The following material regarding HSV-1 (cold sores) has been extracted and adapted from MayoClinic.com