Oral Herpes

Oral Herpes
Herpes simplex, the virus that causes genital herpes, also causes oral herpes. Herpes infections cause small, painful sores (ulcers) that tend to recur and are especially painful when they come in contact with hot, spicy, or salty foods. During the first outbreak, the sores are usually scattered around the inside of the mouth, on the inner cheeks, and possibly on the gums. In subsequent outbreaks, only one or a few sores appear, usually on the outside of the lips.

In each patient, the sores always appear in the same place. For example, in one patient, the sores might always appear on the top left corner of the lower lip, and another patient may develop sores in the middle of the lower lip. Patients who have been infected more than once get recurring sores in more than one place.

In most cases, patients experience burning, tingling, or itching before the sores appear. Patients who have oral herpes should be especially aware of these early symptoms because treatment is much more effective if it is started early.

Treatment for oral herpes is the same as for genital herpes. Several oral medicines, including famciclovir (Famvir®), valacyclovir (Valtrex®) and acyclovir (Zovirax®) have proven effective against oral herpes, especially when started at the first sign of an outbreak. Topical creams and ointments also can be used to treat the outbreaks, although they are not usually as effective as pills. Patients who experience frequent recurrences of oral herpes often take continual small doses of famcyclovir, valacyclovir, or acyclovir to prevent recurrences.