Herpes labialis

Herpes labialis is infection of the lips, mouth, or gums with the herpes simplex virus. It leads to the development of small, painful blisterscommonly called cold sores or fever blisters.

Causes, incidence, and risk factors:

Herpes labialis is a common disease caused by infection of the mouth area with herpes simplex virus type 1. The initial infection may cause no symptoms or mouth ulcers. The virus then remains dormant (asleep) in the nerve tissue of the face. Herpes virus type 2, which usually causes genital herpes and can infect babies during birth to infected mothers, can also cause herpes labialis.

Herpes viruses are contagious. Spread may occur through intimate and personal contact, or through contact with infected razors, towels, dishes, and other shared articles. Occasionally, oral-to-genital contact may spread oral herpes to the genitals (and vice versa).

Symptoms:

The first episode may be mild or severe. It usually occurs in children between 1 and 5 years old.

·         First symptoms usually appear within 1 or 2 weeks, and as long as 3 weeks, after contact with the virus. Sore throat and fever that can last up to 5 days may occur before the blisters appear. There may also be swollen glands in the neck.

·         First episode may last 2 to 3 weeks. The lesions may be on the gums, in the mouth and throat, or on the face. It may hurt to swallow.

An outbreak usually involves:

·         Skin lesions or rash around the lips, mouth, and gums

·         Small blisters (vesicles) filled with clear yellowish fluid

o    Blisters on a raised, red, painful skin area

o    Blisters that form, break, and ooze

o    Yellow crusts that slough to reveal pink, healing skin

o    Several smaller blisters that merge to form a larger blister

Signs and tests:

Diagnosis is made on the basis of the appearance or culture of the lesion. Examination may also show enlargement of lymph nodes in the neck or groin.

Treatment:

Untreated, the symptoms will generally go away in 1 to 2 weeks. Antiviral medications taken by mouth may help the symptoms go away sooner and decrease pain. Acyclovir, famciclovir, and valacyclovir are the three oral treatments currently available.

Expectations (prognosis):

Herpes labialis usually goes away by itself in 1 to 2 weeks. It may come back. Infection may be severe and dangerous if it occurs in or near the eye, or if it happens in immunosuppressed people.

Complications:

·         Recurrence of herpes labialis

·         Spread of herpes to other skin areas

·         Secondary bacterial skin infections

·         Generalized infection -- may be life-threatening in immunosuppressed people, including those with atopic dermatitis,cancer, or HIV infections

Avoid direct contact with herpes sores. Minimize the risk of indirect spread by thoroughly washing items such as towels in hot (preferably boiling) water before reuse. Do not share items with an infected person, especially when they have herpes lesionsAvoid performing oral sex when you have active herpes lesions on or near your mouth and avoid receiving oral sex from someone who has oral or genital herpes lesions. Condoms can help reduce, but do not entirely eliminate, the risk of catching herpes from oral or genital sex with an infected person.