Herpes On Tongue: Causes, Symptoms And Treatment

A sore or swelling on the tongue is fairly common and one of the causes of these sores is oral herpes, also known as cold sores.

Oral herpes is caused majorly by the Herpes Simplex type 1 Virus (HSV-1) and is usually located on the tongue, lips, cheeks, gums, and roof of the mouth. According to the World Health Organization, about 3.7 billion people under 50 years old have HSV-1. Most people have no symptoms.

It is a highly contagious disease and appears as painful grey and red blisters on the tip of the tongue.


What Causes Herpes On The Tongue?

Herpes Simplex Virus, the virus that causes oral herpes has two subtypes:

  1. Herpes simplex virus, type 1 or herpes-1 is responsible for up to 80% oral herpes infections.
  2. Herpes simplex virus, type 2 or herpes-2. This usually causes genital herpes but can also cause the remaining 20% of oral herpes. The rising popularity of oral sexual intercourse is partly responsible for finding genital herpes in the mouth.

HSV-1, the one responsible for most cases of cold sores can be contracted from general activities such as eating with the same cutlery as an infected person, sharing lip balm or lipstick, and kissing.

Symptoms of Oral Herpes

The time between contact with the virus and the appearance of symptoms is about 2-12 days and the severity of the symptoms vary. These symptoms may last an average of 7 to 10 days before resolving.

  • Intense pain in the mouth
  • Sores on the lips, the gums, front of the tongue, inner cheeks, the throat, and the roof of the mouth
  • Difficulty eating and drinking due to pain

Herpes on the tongue usually starts out with pain, burning or tingling sensation before the sores appear. The sores then form clusters of blisters that rapidly break down and appear as tiny, shallow, grey ulcers on a red base at the tip of the tongue. The gums may become swollen.

It can be accompanied by cold sores around the border of the lips – the most common symptom of this infection. Some people also get these sores between their upper lip and nose, on the inside of their nose, down their chin and neck, or even inside of their throat.


Other symptoms include:

  • Swollen and painful lymph nodes
  • Fever
  • Muscle aches
  • Irritability
  • Loss of appetite
  • Sore throat
  • Drooling of saliva


Going to the hospital for proper diagnosis and treatment is essential in the proper management of herpes on the tongue and its other symptoms. The appearance of the tongue herpes is very distinct so further tests are usually not required.

In rare cases, the infection may be so severe that it infects other organs. If the infection has spread to other organs or is very severe, other laboratory tests may be conducted by the doctor.

Some of these tests include the Tzanck smear, blood tests for antibody studies, and some complex lab tests that require a sample from the sores to identify the virus.

Self-Care Home Remedies

The following remedies can be used at home to relieve pain and also prevent infection.

  • Warm water-and-salt rinse helps to prevent bacterial superinfection and promote healing.
  • Topical analgesics gels can also be applied directly to the sores for pain relief.
  • Avoid spicy or hot foods.
  • Drink plenty of water to prevent dehydration.
  • Adequate rest.


Specific treatment of herpes on the tongue is usually not required except in severe cases, children, and the immunocompromised such as HIV and transplant patients.


In cases of severe pain that may interfere with eating or swallowing, topical analgesic gels might be prescribed to ease the pain. Oral painkillers can also be prescribed.


There is no cure for herpes but there are antiviral medications that can speed up healing. These drugs (like Acyclovir, Valacyclovir, Famciclovir, and Penciclovir) may be administered as tablets, creams, or intravenously.

They are used only for people with weakened immune systems due to diseases like HIV, infants younger than 6 or 8 weeks, or people with severe disease. These medications can help reduce the risk of transmitting the virus to others and also help to lower the intensity and frequency of outbreaks.


The following measures can be taken to avoid contracting the virus or to prevent transmitting it to another person.

  1. If you suspect you have oral herpes, try as much as possible to avoid direct physical contact with other people till your symptoms leave.
  2. Don’t share any items that can spread the virus around, such as utensils, cups, towels, clothing, makeup, or lip balm.
  3. Abstain from oral sex, kissing, or any other type of sexual activity during an active infection.
  4. Wash your hands thoroughly and limit contact with sores by applying medication with cotton swabs.


Herpes outbreaks on your tongue can be really uncomfortable and painful. Going to your doctor for a diagnosis and the right treatment plan will go a long way improving your symptoms and reducing the duration.

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