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Medical Author:

Mohamad El Mortada, MD

Medical Author:

MaryAnn Tran, MD

Medical Author:

Corrine Young, PharmD

Medical Author:

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• Herpes simplex infections (nongenital cold sores) facts
• What are herpes simplex infections?
• What causes cold sores?
• What makes herpes (cold sores) recur?
• How do cold sores spread?
• What are the signs and symptoms of cold sores?
• What is primary oral herpes?
• What does recurrent herpes look like?
• How long do cold sores last?
• What are the possible complications of oral herpes (cold sores)?
• What other conditions can look like oral herpes (cold sores)?
• What is angular stomatitis?
• What are canker sores?
• How is oral herpes diagnosed?
• What is the treatment for cold sores, are there any home remedies, and what medications are used?
• Patient Comments: Herpes Simplex Infections (Cold Sores) - Treatments
• Patient Comments: Herpes Simplex Infections (Cold Sores) - Symptoms
• Patient Comments: Herpes Simplex Infections (Cold Sores) - Describe Your Experience
• Herpes Simplex Infections (Non-Genital) Index

The hallmark symptom of herpes is a group of blisters on a red base. These blisters dry up rapidly and leave scabs that last anywhere from a few days to a few weeks, depending on the severity of the infection. This pattern has important implications for the many people who fear they have herpes but don't: If something lasts for weeks, it is unlikely to be herpes.

Herpes infections feel dry and crusty, and they sometimes itch. Some patients have a "prodrome," which is when certain symptoms occur before the actual sores becomes fully evident. The prodrome to herpes infections typically involves a burning or tingling sensation that precedes the appearance of blisters by a few hours or a day or two.

Primary herpes refers to the first episode of symptoms after infection, often presenting with painful sores on the lips, gums, and mouth.

In some people, the first attack (primary herpes) of herpes is associated with fever, swollen glands, and bleeding gums, together with painful sore(s) around the mouth (gingivostomatitis). These signs and symptoms may last several days. Difficulty in eating and drinking may lead to dehydration. The sores heal completely in two to six weeks, usually without scarring. Virus can be recovered from the saliva for days after the lesions heal. Primary herpes is usually contracted during childhood.

Not everyone has a severe primary attack when they are first infected with herpes. In some people, the virus infects the body without causing any symptoms. The process generates an antibody response, causing the immune system to produce antibodies against the herpes virus. This antibody response helps reduce recurrences and keep them mild. Antibodies also make it hard for the virus to get a foothold anywhere else on the body. (If this weren't so, cold sores would spread to other parts of the body from routine actions, such as face washing, which doesn't happen.)