Have you ever experienced cold and painful sores on your tongue? If yes, there is a chance that could be a sign of tongue herpes.

Also known as a cold sore, oral herpes or tongue herpes is caused by HSV -1. It is a chronic, painful and recurrent viral infection.

Wondering what causes tongue herpes? How is it treated? What are the possible preventive measures you could take?

Karepedia is here to help you understand and simplify this disease. In this blog, we will discuss the causes, symptoms, treatment and more importantly the prevention of herpes.

What is Herpes?

Herpes is a virus. They are of 2 types:

HSV-1: Oral herpes, infection of oral cavity including lips, tongue and oral lining.

HSV-2: Also known as genital herpes. As the name suggests this causes blisters and painful sores around the genital area.

80% of Tongue herpes is caused by HSV-1. The remaining is caused by HSV-2.

Herpes Simplex Virus spreads through skin to skin contact, direct contact through open sores, while kissing, and oral sex. Genital herpes also spreads through sex.

It also spreads through sharing razors, toothbrushes, lip balms, spoons, straws etc.

It is highly contagious and spreads quickly more so with open sores. It is so common that about 67% of the total population is known to have oral herpes.

Symptoms

Most of you might not even realise you have herpes. This is because herpes infection takes 1-3 weeks from the day of infection to come up with signs.

Most remain with no symptoms. Herpes is so mild at times, most people ignore it as a pimple outburst or just a flu.

In the active stage, you may experience symptoms that are very specific to this virus.

Common symptoms of oral herpes are sores which are extremely painful, over the lips, tongue, and over oral mucosal lining.

You may experience the course of the infection as discussed here:

• The infection starts off with pain, redness and irritation at the site of the infection.

• Blisters then form at the site of infection.

• Blisters then burst to release oozy material.

• After rupture, open sores are formed. This stage is most infectious of all.

• In a few days crusts form and in a few weeks, it heals almost as if nothing happened.

You may also develop a fever in some cases with swollen glands.

If infected once with herpes, it is most likely you will have herpes throughout your life. This doesn't mean you will continuously experience these symptoms.

One unique feature about this virus is that it stays hidden in the nerve cells in your body. During this time it is latent, meaning inactive.

The virus is only activated when it leaves the nerve cells, leading to lesions in the oral cavity that are painful.

This cycle repeats itself time and again, making it a recurrent and chronic disease. Between the episodes, you will not face any problems.

The trigger to what and how the virus gets activated is still unknown. Several theories are in place, such as:

• Exposure to sunlight

• Exposure to any kind of stress, may it be emotional, surgery or trauma

• Menstruation

• Recent infection or fever

The virus more commonly clings onto people with an already compromised immune system, for instance, people with HIV, Tuberculosis, Diabetes and others.

However daunting it may sound, there's a bright side to this infection. The frequency and intensity of these recurrent attacks reduce with time. This also means you are more likely to experience more attacks in your first year of infection than the rest.

Diagnosis

Tongue Herpes is a clinical diagnosis. One look by an experienced professional is all it takes.

However, some cases present differently and can be difficult to diagnose. In these conditions, a blood test for antibodies, a biopsy showing the virus, viral culture or viral serology testing is useful.

Treatment

Tongue herpes is a viral infection. So it makes sense that antiviral medications play an important role.

It may be surprising if you are prescribed an antibiotic, but this is normal.

Antibiotics, mainly antibacterial drugs are given as a preventative measure to avoid bacterial infections in the future. This is a common occurrence seen with practice.

Antivirals and antibacterials can be given in different forms. Topical forms as in creams and ointments are given almost always.

Oral medications may be added as and when needed based on the severity of the disease. Other hygiene measures are of utmost importance. You need to keep the area dry and clean. Hydration is another key component of treatment. Painkillers and pain numbing creams are also used if required.

• Topical antivirals and topical antibacterial creams or lotion.

• Oral antiviral, most commonly valacyclovir tablets are used.

• Pain numbing creams and oral doses of painkillers like paracetamol and ibuprofen.

• Maintain hygiene.

Prevention

• Avoid skin to skin contact with an infected person.

• Avoid oral sex with someone who has oral herpes.

• Use separate utensils, lip balms, and possible other contaminated objects.

• Wash bedsheets, pillow covers and rugs separately. It is even better to wash after every use.

• Avoid triggers. Use sunblock with zinc oxide.

• Treat underlying cause of immunodeficiency, if any.

Complications

Wondering what are the complications of Herpes? Here you go:

Herpes can affect the brain in severe cases - HSV Encephalitis.

Skin conditions such as Herpetic whitlow and Eczema herpeticum.

It can also cause permanent damage to the eyes in the form of Herpetic keratitis.