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Herpes simplex infection of the mouth and face, known as orofacial herpes simplex, herpes labialis, cold sores, or fever blisters, is a common, recurrent skin condition associated with infection by the herpes simplex virus (HSV). HSV infections occur in people of all races, of all ages, and of both sexes.Increasing age is associated with increased likelihood of infection.
The most common locations for HSV-1 infections include: Lips Mouth (including gums, tongue, roof of mouth, and inside the cheeks) Nose Chin Cheeks Shortly after exposure to the virus, a newly infected person may develop fluid-filled blisters, occurring singly or in a cluster of several blisters. Acetaminophen or ibuprofen may help reduce fever, muscle aches, and pain caused by cold sores.
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This patient presented with herpes simplex lesions around her mouth due to the herpes simplex virus Type-1, (HSV1) pathogen.
Orofacial HSV usually appears as small blisters or sores around the mouth, nose, genitals, and buttocks, though infections can develop almost anywhere on the skin. Up to 80% of Americans are infected with HSV-1 by the time they are 30 years old.Only 20% of people who are infected with HSV actually develop visible blisters or sores.


These blisters may be yellow to gray and are fragile, so that many people never notice blisters but instead see tiny open sores (ulcers). Seek medical advice as soon as possible, especially if you are at risk for more serious complications. On occasion, however, a swab from the infected skin may be sent to the laboratory for viral culture, which takes a few days to grow.
Herpes simplex virus type1 usually is the cause for oral lesions sometimes referred to as “cold sores”, “fever blisters” or more technically known as “recurrent herpes labialis”. Furthermore, these cold sores may periodically come back in the same sites.Infections with HSV are very contagious and are spread by direct contact with the skin lesions.
That means that approximately 80% of people with HSV infections have not been diagnosed and are unaware of their condition. Blood tests may also be performed.Untreated HSV infections will go away on their own, but medications can reduce the symptoms and shorten the duration of outbreaks. There are 2 types of HSV: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).
Patients who get cold-sores continue to shed the virus in their saliva even when the cold-sore is no longer visible.
HSV-1 infections usually occur around the mouth, lips, nose, or face, while HSV-2 infections usually involve the genitals or buttocks. By age fifty, 90% of people will test positive for antibodies to HSV-1 meaning that they have either been infected or at least exposed to this virus. However, only about one third of those people will develop the clinical lesions that we call "cold-sores".


Because it so contagious, HSV causes a primary infection in most people who are exposed to the virus. In severe cases of HSV infection, cold sores may involve the entire lining of the mouth and both lips. Some studies show that as many   as 40% of the general population have experienced at least one cold-sore. However, only about 20% of people who are infected with HSV actually develop visible blisters or sores. These severe infections may be accompanied by fever, sore throat, foul breath, and difficulty eating.Repeat (recurrent) HSV infections are often milder than the primary infection, though they look alike.
However, some people never develop the symptoms of a primary HSV infection and may mistake a recurrent infection for a primary infection. Nevertheless, the virus remains in the body, hibernating in nerve cells.Certain triggers can cause the hibernating (latent) virus to wake up, become active, and travel back to the skin. These recurrent HSV infections may develop frequently (every few weeks), or they may never develop. Recurrent infections tend to be milder than primary infections and generally occur in the same location as the primary infection.Most people get cold sores as children, through contact with a friend or family member who is already infected with HSV. It can be spread (transmitted) by kissing, sharing eating utensils or drinking vessels, or by using the same towel.



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