Herpes in the mouth: on the tongue, inside the lip, on the palate and in the throat

Herpes on the lips is common, but the same virus can also affect the oral mucosa. Let us look at how to recognize herpes in the mouth in different locations and how it differs from similar lesions.

What oral herpes is and which virus causes it

Herpes simplex is a viral disease with characteristic grouped blisters on the skin and mucous membranes. It is caused by two neurotropic viruses: HSV-1 and HSV-2. The first usually affects the mouth, neck, face and eyes; the second more often causes anogenital lesions, although both types can change localization. Infection occurs through direct contact, often in childhood, after a kiss from a person with a "cold sore" on the lips. The virus remains in the body forever: it enters nerve endings and travels to a sensory ganglion, where it enters a latent stage. Herpes cannot be completely cured — existing drugs suppress viral replication but do not remove its fragments from neurons.

Herpes on the tongue and under the tongue

A typical "cold sore" begins with tingling, itching or burning, and within the next 48 hours one or more painful fluid-filled blisters appear. The blisters then become covered with a crust and usually heal within 10 days, but throughout this time the person is contagious — from the first tingling until complete healing. Exactly what the rash on the tongue and under the tongue looks like is determined by a doctor during examination; it is difficult to distinguish herpes from other lesions on one's own.

Herpes inside the lip, on the gum and on the palate

A blister on the inside of the lip or in the mouth may turn out to be an aphthous ulcer, whereas herpes is characterized by grouped blisters. Similar symptoms also occur in other conditions: a painful red spot with pus on the face is a furuncle, and red ulcers with golden-brown crusts are impetigo. There are no separate signs of herpes on the gum and on the palate — they are assessed by a doctor during examination.

Herpes in the throat

Throat involvement is assessed by a doctor during examination of the pharynx. Swollen, painful gums and ulcers in the mouth are cited as reasons to see a doctor — this picture is described as gingivostomatitis.

Herpetic stomatitis and how it differs from other lesions

The combination of swollen painful gums and ulcers in the mouth (gingivostomatitis) is a reason to visit a doctor; whether it is related to herpes is determined by the doctor. Oral herpes is easy to recognize when there are visible manifestations — sores or ulcers; in the early stages, when there are no symptoms, the diagnosis is possible only by laboratory methods, including a virological test (culture of the lesion) and antibody testing.

When to see a doctor

You should see a doctor if herpes has not begun to heal within 10 days, if it is very large or painful, if there is doubt about the diagnosis, and also with swollen gums and ulcers in the mouth in an adult or child. A separate group is people with weakened immunity, for example after chemotherapy or with diabetes: they need assessment by a specialist. The doctor assesses severity and determines further management; newborns, pregnant women and immunocompromised patients may be referred to hospital.

• Tingling, itching or burning before the rash
• Small painful blisters, then a crust
• Healing usually within 10 days
• Contagiousness — from the first tingling until complete healing

Oral herpes by itself is not a reason to call an ambulance; 103 or 112 — if the condition is life-threatening: for example, herpes in a newborn with worsening condition or a sharp deterioration in a person with weakened immunity.

This article is for reference: it helps to recognize herpes, but does not replace consultation with a doctor, who will assess the whole picture.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer