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.
Viral culture or Tzanck test of the skin lesion may reveal the herpes simplex virus.
Treatment
Untreated, the symptoms will generally go away in 1 to 2 weeks. Antiviral medications taken by mouth may shorten the course of the symptoms and decrease pain.
Herpes sores often come back again and again. The antiviral medicines work best if you take them when the virus is just starting to come back -- before you see any sores. If the virus returns frequently, your doctor may recommend that you take the medicines all the time.
Wash blisters gently with soap and water to reduce the spread of the virus to other areas of skin. An antiseptic soap may be recommended. Applying ice or warmth to the area may reduce pain.
Expectations (prognosis)
Herpes labialis usually disappears spontaneously in 1 to 2 weeks. It may recur. Infection may be severe and dangerous if it occurs in or near the eye, or if it happens in immunosuppressed people.
Complications
- Spread of herpes to other skin areas
- Secondary bacterial skin infections
- Recurrence of herpes labialis
- Generalized infection -- may be life-threatening in immunosuppressed people, including those with atopic dermatitis, cancer, or HIV infections
- Blindness
Herpes infection of the eye is a leading cause of blindness in the US, causing scarring of the cornea.
Calling your health care provider
Call for an appointment with your health care provider if symptoms indicate herpes labialis and symptoms persist for more than 1 or 2 weeks.
Call if symptoms are severe, or if you have a disorder associated with immunosuppression and you develop herpes symptoms.
Prevention
Avoid direct contact with cold sores or other herpes lesions. Minimize the risk of indirect spread by thoroughly washing items in hot (preferably boiling) water before re-use. Do not share items with an infected person, especially when herpes lesions are active. Avoid precipitating causes (especially sun exposure) if prone to oral herpes.
Avoid performing oral sex when you have active herpes lesions on or near your mouth and avoid passive oral sex with someone who has active oral or genital herpes lesions. Condoms can help reduce, but do not entirely eliminate, the risk of transmission via oral or genital sex with an infected person.
Unfortunately, both oral and genital herpes viruses can sometimes be transmitted even when the person does not have active lesions.
