Cold Sores (Orofacial Herpes):
Teen information

The most common locations for HSV-1 infections include:

• Lips
• Mouth (including gums, tongue, roof of mouth, and inside the cheeks)
• Nose
• Chin
• Cheeks

Shortly after exposure to the virus, a newly infected person may develop fluid-filled blisters, occurring singly or in a cluster. These blisters may be yellow to gray and are fragile, so that many people never notice blisters but instead see tiny ulcers. These ulcers subsequently become scabbed over and may appear dry and yellow. The scabs eventually fall off, leaving a red area that fades. The first (primary) outbreak typically lasts 1–3 weeks.

In mild cases of primary orofacial herpes simplex virus infection, an individual may develop 1 or 2 cold sores, or the newly infected person may notice no symptoms at all. The lymph nodes in the neck may or may not be swollen. In severe cases of herpes simplex virus infections, the infection may involve the entire lining of the mouth and both lips. These severe herpes simplex virus infections may be accompanied by fever, sore throat, foul breath, and difficulty eating.

Repeat (recurrent) herpes simplex virus infections are often milder than the primary infection, though they look alike. However, some people never develop the symptoms of a primary herpes simplex virus infection and may mistake a recurrent infection for a primary infection. A recurrent infection typically lasts 7–10 days. People who are prone to recurrent outbreaks tend to get them 3–4 times per year.

Many people with recurrent herpes simplex virus infections report that the skin lesions are preceded by sensations of burning, itching, or tingling (prodrome). About 24 hours after the prodrome symptoms begin, the actual lesions appear as one or more small blisters or open sores, which eventually become scabbed over.

Triggers of recurrent herpes simplex virus infections include:

• Fever or illness
• Sun exposure
• Hormonal changes, such as those due to menstruation or pregnancy
• Stress
• Injury, such as that caused by dental work or cuts from shaving
• Surgery