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 it is usually located on the tongue, lips, cheeks, gums, and roof of the mouth. Other areas like the throat, the inside of the nose, the chin, and the neck may also be affected- but this is not common.

The infection affects only humans and it is more common in children between the ages of 0 and 2 years. It is a highly contagious disease and appears as painful grey and red blisters on the tip of the tongue.
This article is about the causes, symptoms, and treatment of herpes on the tongue.

What Causes Herpes On Tongue?

Kissing

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 can be contracted from general activities such as eating with the same cutlery as an infected person, sharing lip balm or lipstick, and kissing. You can contract herpes by coming in contact with infected saliva, soft tissues, or skin. After becoming infected by the virus, it moves on to 3 stages.

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3 Stages Of Oral Herpes Infection

Primary Stage

This is the stage whereby the virus enters your skin or mucous membrane and reproduces. During this time, you may experience fever, muscle aches or gum pain. Before the sores on the mouth appear, burning, tingling or itching will be felt in that area. Sometimes there are no symptoms or sores so you may not even be aware that you have been infected. This is called an asymptomatic infection.

Latent stage

From the site of infection, the virus moves to the dorsal root ganglion in your spine, reproduces again, and then becomes dormant.

Pregnant

Recurrent Stage

This is the stage most people recognize. Here, the virus becomes reactivated and cause new symptoms and sores when you undergo certain stresses. These stresses could be medical such as infections, physical or even intense emotional stress can cause the cold sores to appear.

Oral herpes is highly contagious and can be gotten by anyone. This infection is more common in young children and also people living with HIV because their immune system is suppressed. People with HIV who are not undergoing treatment may experience more prolonged and severe sores.

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.

Drinking

  • 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 which 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.

Herpes on the tongue is 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.

Fever
Other symptoms include –

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

Self-Care Home Remedies

drinking water
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 like xylocaine 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.

Treatment Of Herpes on Tongue

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

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Blood

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.
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 will be prescribed to ease the pain. Analgesic tablets are also recommended.

Infusion
Intravenous administration of fluids may also be required in severe cases of dehydration.

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

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.

Preventing Herpes On The Tongue

Hand washing

The following measures can be taken to avoid contracting the virus, or to prevent transmitting it to another person.
1. Try as much as possible to avoid direct physical contact with other people.
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.

In Conclusion.

Herpes outbreaks on your tongue can be really frustrating and painful. Visiting your dentist for a proper diagnosis and the right treatment plan will go a long way improving your symptoms and reducing the duration.

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Onyeka Mgbemere, BDS

Dr. Onyeka Mgbemere is a graduate of Dentistry and a licensed dentist who is passionate about the promotion of oral health education and prevention of oral diseases. She is currently undergoing her residency program in Oral medicine after spending years working at a Naval hospital. Her hobbies are watching movies and reading.
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