Oral Herpes: The Best Ways to Treat the Flare-Ups

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Clinical Content Reviewed by Dr. Jay Khorsandi, DDS
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Table of Contents

  1. What Is Oral Herpes?
  2. Causes
  3. Signs of an Outbreak
  4. Oral Herpes & Other Health Problems
  5. Treatment & Prevention
  6. References

The best ways to treat an oral herpes flare-up involve home remedies, such as cool compresses, anti-inflammatory medications like ibuprofen, and over-the-counter topical medications. Severe or frequent outbreaks may require a prescription from a doctor.

Oral herpes is a very common virus caused by the herpes simplex virus (HSV) I. The first outbreak is the most painful, but HSV I causes infrequent, short-lived outbreaks after the first. Many people go months or years between HSV I outbreaks, but when they do occur, home remedies can help to ease symptoms.

It is rare for people with oral herpes to receive a prescription for antiviral medication, but sometimes frequent or very serious outbreaks benefit from suppression. Taking care of your oral health means you are less likely to have secondary infections during an oral herpes outbreak.

What Is Oral Herpes?

Oral herpes is one type of herpes virus that affects humans, typically called herpes simplex virus (HSV) I or herpes labialis. Another common virus related to HSV I is herpes simplex virus (HSV) II, or genital herpes.

Oral herpes is also one of the most common viruses among humans. Between 50 and 80 percent of adults in the United States have oral herpes, with most people contracting it before they turn 20 years old.

After the first infection, it takes between 2 to 20 days for the first outbreak to occur, which is usually the most painful. Once that outbreak clears, the virus becomes dormant, and you may not experience another outbreak for months or years. People who have oral herpes typically have fewer outbreaks than those with HSV II, but outbreaks can still be very infectious.

Taking care of yourself during an outbreak is important. Work with your dentist to make sure you keep your mouth clean while you wait for it to heal.

Causes of Oral Herpes

Oral herpes is caused by a herpes virus, which is contracted from another person while they have an oral herpes outbreak. Although HSV I can be transmitted during kissing or other intimate contact, many people contract the virus during childhood.

Typically, HSV I goes dormant after the first outbreak, but another outbreak can occur. This might be triggered by different types of stress, including:

  • Emotional or mental stress.

  • Surgery or an injury.

  • Another infection like a cold or the flu.

  • Hormonal fluctuations, like from menstruation.

  • Direct sunlight, especially a sunburn.

An outbreak may also have no specific cause. You may not realize outbreaks are coming at first, but you can eventually identify the symptoms before sores appear.

Signs of an Outbreak

Oral herpes can appear inside and outside the lips, on the gums, on the tongue, in the throat, and along the skin between the nose and lips. You may not notice symptoms before an outbreak, but often, you will feel itching or pain on the skin as your nerves are triggered. You may feel heat like a fever emanating from the area, and you may experience some redness or initial swelling before sores appear.

Once an outbreak begins, you will likely experience:

  • Fluid-filled blisters that look like pimples appearing in one or several spots.

  • Redness, itching, and/or pain around the blisters.

  • Blisters bursting open after a few days.

  • The sores slowly healing after they open and going away in 10 days or less.

You may also feel full-body symptoms as the outbreak occurs, including these:

  • Fatigue or tiredness

  • Aches

  • Fever

If you are experiencing your first outbreak, you may wonder what is happening. You should contact your doctor to have a test in case the outbreak is an allergic reaction or irritation that can mimic HSV I. A viral culture test will confirm whether you have HSV I or not.

Oral Herpes & Other Health Problems

HSV I rarely has any serious impact on a person’s health. Although the sores can be painful and are very infectious, they do not cause other harm to your health like chronic pain or cancer.

If you have underlying health conditions, you may struggle with more frequent outbreaks, which might make some chronic health problems worse. For example, if you struggle with eczema, HSV I can make this skin condition worse, and the outbreak might last longer.

If oral herpes sores appear inside the mouth like on the gums or the tongue, it is possible that you can get a secondary infection that could cause gum disease. Even if the outbreak hurts, it is important not to neglect your oral health. Gently brush around the area if it is inside your mouth, and consider adding a rinse of warm saltwater to reduce the risk of infection. This rinse can also reduce inflammation and pain from the outbreak.

You can also ask your dentist for help keeping oral care devices clean, especially items like dentures or clear aligners that you will need to reuse.

Treatment & Prevention of Oral Herpes

There is no cure for herpes, but most people who have oral herpes rarely experience severe problems from it. When you do have an outbreak, you can ease symptoms at home with these remedies:

  • Apply a cold compress to the affected area to reduce swelling.

  • Take nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to ease pain and inflammation.

  • Avoid irritants like sugary, acidic, or spicy food and drink.

  • Avoid smoking, and consider avoiding alcohol.

  • Avoid irritating commercial mouthwashes that contain alcohol, and replace them with a saltwater rinse.

  • Keep the area moisturized. Consider using a topical over-the-counter lip ointment to ease itching and burning.

Rarely, symptoms can last for a long time, get worse, or spread. If symptoms do not go away after two weeks, the pain becomes severe, or the outbreak spreads to your eyes, you should contact a doctor immediately for help.

Doctors typically do not prescribe antiviral medication for oral herpes, but if you have frequent, severe, or very painful outbreaks, you may receive a prescription for oral medication to suppress the virus. If you have frequent outbreaks on your lips or the skin around your lips, you may receive a topical ointment to ease symptoms and reduce the outbreak. However, the ointments do not help outbreaks inside the mouth.

Oral herpes is a very common virus that rarely causes serious problems. If you experience the occasional outbreak, take care of yourself and prioritize your oral health.

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.