A first infection with the cold sore virus is often different from recurrent cold sores that many people have. Often there are no symptoms. Sometimes a nasty mouth infection develops. Treatment aims to relieve symptoms while the infection gradually takes over 1-3 weeks.
On this page
- What is a primary infection with herpes labialis?
- What are the symptoms of a primary infection with herpes labialis?
- What are the treatments for primary infection with herpes labialis?
- When should I see a doctor?
- Recurrent herpes labialis
What is a primary infection with herpes labialis?
Cold sores are caused by the herpes simplex virus (HSV). The first time you get infected with this virus is called primary infection. The mouth is the area commonly affected. This is because the normal skin is resistant to the virus, but moist skin inside the mouth is not. The first infection is usually in childhood. Often caught by kissing a family member who has a cold sore. Primary infection with herpes sores can be worse than recurrent mouth ulcers, but luckily some people experience no symptoms at all.
This booklet will address primary infection with herpes labialis. For more information on recurrent herpes labialis, see separate leaflet called "cold sores".
What are the symptoms of a primary infection with herpes labialis?
Symptoms of primary infection are often different from recurring cold sores.
- You may have no symptoms, or only the most trivial. For example, you may not realize that a small dot in the mouth is a cold sore first. However, you can develop typical cold sores occasionally in the future.
- You may have a more severe infection in and around the mouth.
- Small blisters or ulcers (sores) can develop in the mouth, tongue, gums, lips or throat. This is called gingivostomatitis. There may be only a few blisters, but sometimes there are many.
- The blisters and ulcers are painful. Swallowing or eating can become quite painful. Pain can make the pool (collect) saliva in the mouth, and kids can dribble (dribble).
- The glands of the neck may swell and become tender.
- You may develop a fever (high temperature), general aches and pains.
- The infection gradually decreases and is within 1-3 weeks.
What are the treatments for primary infection with herpes labialis?
- Painkillers such as paracetamol or ibuprofen can help relieve pain.
- Benzydamine mouthwash or spray (brand Difflam ®) may be helpful in relieving the pain of a sore mouth wound.
- Choline salicylate gel (Bonjela ® dental gel) can be used in the mouth to reduce pain. Bonjela ® should not be used in children younger than because of a possible risk of Reye syndrome 16 if it is overused. This is the same reason you can not use aspirin in children too. Note: Bonjela Teething Gel ® contains choline salicylate and reformulated with lidocaine, a local anesthetic (cause temporary numbness). This means that Bonjela teething gel ® can be used in children.
- They have plenty to drink. It can be painful to drink, but it is important to drink to avoid dehydration.
- If it's too painful to clean teeth, mouthwash with chlorhexidine (Corsodyl ® or Chlorohex mark) can be used instead of brushing. You can help adults and children old enough to use it to keep your mouth and teeth clean to prevent plaque buildup and secondary bacterial infection.
- Sloppy foods like yogurts and soups are easier to eat when your mouth is painful. Cold foods cold or may be less painful than hot foods.
- An antiviral drug (such as acyclovir, Zovirax ® brand) may be prescribed if the symptoms are severe. It is taken orally, rather than used topical creams to rub on cold sores. Do not remove the virus, but prevents the virus from multiplying. You may not have much effect once the blisters and ulcers are well developed. However, if taken early in the infection, can reduce the duration of pain, and the recovery of a bit rate.
- Preparations barrier lips as Vaseline ® or ® Lypsyl lips can make them feel more comfortable and can prevent sticking or crusts together.
- General measures include trying to minimize the chances of transmitting the virus of cold sores to others. Wash hands thoroughly with soap and water after handling is important mouth and cold sores. You should avoid contact with cold sores or mouth sores associated with primary infection, except when applying the medication. You should not have oral sex when you have either a primary infection with herpes labialis or cold sores individual. Finally, it is important not to share things that come into contact with infected areas – this includes lipsticks and lip balms.
Young children can be afflicted with pain and refuse to take medication or drinks. Tips to help include:
- Try using a syringe (which you can buy at pharmacies) to medicine jet on the side of the mouth slowly. Do not spray in the back of the mouth, which can cause choking.
- Keep offering cool drinks. You can also use a syringe for a few drinks. Again, slow stream into the side of the mouth, not at the back of the mouth.
- Sucking on popsicles or ice cubes can help relieve pain, and also a way to give fluids.
Sometimes a child stops drinking due to pain in the mouth. They are then in danger of dehydration. If your child has stopped to urinate, or if your urine is dark in color and strong odor, is likely to be dehydrated. See a doctor if you are concerned that your child is not drinking enough fluids and is dehydrated. Some children who are at risk of dehydration are admitted to the hospital for a short time until the infection settles, and drink normally. In the hospital can have their controlled fluids can be given an intravenous drip if required.
If your child is doing well with a herpes virus infection primary, need not be kept out of school or daycare.
When should I see a doctor?
You should consult a doctor at any time if you are worried about you or your child. This is especially important if you have a weakened immune system (immunocompromised). Immunocompromised persons are those with diseases such as AIDS or those receiving chemotherapy or other drugs that lower the body's resistance to infections. Pregnant women and mothers with a young child who is affected, should also seek immediate medical attention. Anyone with a primary infection with herpes labialis in which symptoms are not the solution after five days, you should see your doctor.
Recurrent herpes labialis
After primary infection has cleared, the virus remains dormant (inactive) in the nerve sheath. For most of the time not cause problems. In some people "live" virus occasionally to cause sores around the mouth and nose. Recurrent cold sores may be unpleasant, but do not cause severe mouth infections as some primary (first) infections. About 1 in 5 people in the UK have recurrent herpes labialis.