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Oral herpes, commonly referred to as mouth herpes, is a viral infection of the mouth and gums primarily by the Herpes simplex virus type 1 (HSV-1) but may also be due to the genital variant (HSV-2). Oral herpes is also known commonly as cold sores and fever blisters but is different entity from oral canker sores although canker sores may sometimes be associated with HSV infection.
This can occur at any time in life but tends to recur in young adults and presents as a mild cold sore. Other signs and symptoms are usually absent in a recurrence unless the person has a co-existing infection like the flu (seasonal influenza). Ask a Doctor Online Now!The pictures below were sourced from the Dermatology Atlas, courtesy of Samuel Freire da Silva, M.D. Ask a Doctor Online Now!Please note that any information or feedback on this website is not intended to replace a consultation with a health care professional and will not constitute a medical diagnosis. Symptoms of HSV infection include fever, lymph-node enlargement, painful lesions, and a sluggish, lethargic feeling.1 The area can become red in color, and then tiny fluid-filled blisters may form.
It is very important to understand that people can spread herpes from one part of the body to another part of the body (autoinoculation).
Viral shedding makes herpes one of the more difficult STIs to cope with on an emotional level, as there is currently no available cure.
Although there is no cure for herpes, there are some treatments available that can decrease the frequency, length, and intensity of each outbreak. HSV-1 most often infects a person’s lips, creating fever blisters or "cold sores.” Cold sores appear on or at the edge of the lip, the corner of the mouth, or on the facial skin near the lip.
HSV is the most common herpesvirus, however there are three others which can have adverse effects on a person’s health. The site is maintained by students from the University of California, Santa Barbara who have studied advanced topics in human sexuality. Oral herpes is easy to diagnose when a patient has visible sores or ulcers, but early stages of herpes on the face and mouth as well as on the genitals are harder to diagnose.
Herpes should be distinguished from herpes zoster, chicken pox, impetigo, and drug eruptions.
Herpetic sores are classified as heat sores in TCM because the lesions are red and follow febrile disease conditions. As with all treatment protocols, be sure to tailor and modify the basic treatments below to fit your patient's specific constitution, root cause, and symptoms. Treatment principle: Drain Spleen and Stomach damp heat, nourish yin, drain deficient heat .
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They use to distinguish between oral herpes and genital herpes but then we started 69ing all over the place and the two Hs became one.

The virus HSV-1 may be transmitted by droplet spread – direct contact with saliva or even respiratory droplets. This is known as the incubation period and is the time during which the virus multiplies profusely.
The exact reason why the infection may recur is poorly understood but it appears to be associated with one or more of the following factors.
There are more than 70 different strains of the herpes virus, although humans are subjective to only four of them.[1] There are two types of HSV. Although HSV-1 is primarily found in the mouth, it can easily be transferred to the genitals through sexual behavior, such as oral sex. People with herpes can learn to pay attention to tingling sensations or warmth in the infected area before a sore appears. The herpes diagnosis may become somewhat easier to accept once a person realizes how common herpes is. Some antiviral medications can be used when experiencing prodromal symptoms in order to lessen the severity of the oncoming outbreak. The sores usually run their course within 8-12 days, during which they undergo five stages: tingling, blistering, weeping, crusting, and finally healing.
Cytomegalovirus (CMV) is spread through contact with an infected person’s bodily fluids, including saliva, urine, semen, and breastmilk. Most people who have CMV are asymptomatic. During active disease phases there are blisters on the skin which contain the infectious virus. The infection of the mouth typically causes small fluid-filled blisters known as vesicles on the roof of the mouth (palate), inside of the cheeks (buccal muscosa), tongue, gums and even the lips (herpes labialis). These droplets must make contact with broken skin or the mucous membranes in order to infect a person. Herpes Type I is most commonly found above the waist, in the mouth, nose, and eyes, though it can be spread to the genitals via oral sex.
They can then refrain from participating in sexual behavior with their partner(s) that might spread HSV. Other medications can be taken daily for more serious cases.1 Please contact a physician if you think you might have herpes and discuss possible treatment options.
Canker sores are usually found on the movable parts of the mouth, such as the tongue or the inside of the lips and cheeks. This can be dangerous however, because CMV can transfer from a pregnant woman to her fetus, which may cause death or retardation. Accompanying symptoms may include high fever and swelling of tenderness of the lymph nodes. It may also occur on the skin around the mouth and extend to the nose and into the nasal cavity. Most of the time HSV-1 causes mouth symptoms and in a minority of cases it may also be responsible for genital symptoms.

This arises as the virus starts destroying cells at the site and causes intense localized inflammation.
Herpes Type II is most commonly located below the waist-on the genitals, thighs, and buttocks- but can be spread to the mouth via oral sex. A person can also use their prodromal symptoms to their benefit by applying preventative ointments to the tingling areas.
Varicella-zoster virus (VZV) can cause chickenpox and shingles.1 The fourth type of herpesvirus is Epstein-Barr virus (EBV), which can cause Burkitt’s lymphoma. Crusting of the lesions begins after three to four days of onset and complete healing within three weeks. The opposite is true for HSV-2 – it causes genital symptoms in the majority of cases while only a few cases of HSV-2 infection will result in mouth symptoms. These small vesicles or sometimes the larger bullae may either burst resulting in ulcer or heal completely with no scarring. The main sites of the sores in men include the tip (glans) of the penis, and the shaft of the penis.
It is possible to transmit herpes even when sores are not present because of a process called viral shedding-during this process, viruses are released from the body even when no sores are present. The ruptured sores-covered by a thin white or yellow membrane and are edged by a red halo-typically heal within two weeks. Viruses are transported along the sensory nerves to the nerve cell bodies where they go dormant and reside as long as the host is alive.
HSV-1 infection may be seen in all ages, including children, but when genital herpes is seen in children, sexual abuse needs to be a consideration. It is also possible for a person to be infected with herpes to be asymptomatic  (never show any symptoms), so they may be unaware that they are a carrier.
To learn more about the differences between cold sores and canker sores, see the following website.
They may come out of dormancy because of a variety of triggers (one of which is immunosuppressant drugs).
The intensity of the breakouts typically decreases with each subsequent breakout, and after a year of infection the breakouts usually become quite manageable. When it becomes active the virus multiplies, travels along the axon of the neuron to the nerve terminals in the skin and releases the virus particles.

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