Copyright (c) 2010 JB Harrison

Tingling on my lip, is that a symptom of oral herpes? We'll explain that and more regarding the signs and other symptoms of oral herpes or "cold sores."

The herpes simplex virus remains in the human body, it does not vacate after the first breakout. The virus will remain dormant in the nerve centers at the top of the spine until another breakout is triggered.

It is estimated 80 to 90% of Americans have been exposed to the herpes simplex virus, but the majority of these do not develop symptoms.

For the minority, however, symptoms can occur once or repeatedly with varying frequency. Symptoms of oral herpes are sequential and usually follow a unique pattern.

Incubation

After contact with the oral herpes virus, incubation of the virus typically takes 2 to 12 days. The average period before appearance of symptoms is 4 days.

Prodromal

Prodromal means symptoms that precede the physical onset of an outbreak. With oral herpes, prodromal symptoms are commonly burning, itching or tingling at a specific site or locations on the face. The skin may redden in the same areas as the itching, burning and tingling. The prodromal stage is present for anywhere from a few hours to a couple of days.

Inflammation

During this phase, the herpes virus is actively multiplying and infecting nerve end cells. Swelling and redness become apparent as antibodies respond to the virus's attack. This part of the breakout lasts only a day or so.

Pre-Lesion

Tiny inflammatory gray blisters or sacs form in clusters on the reddened skin. These are solid and do not contain pus. They may be painful to touch and itchy. Blisters may appear on lips, the edges or corners of the lips, the chin or the skin between the upper lip and the nose. The pre-lesion stage extends 24 to 48 hours.

Lesion

Often the most painful stage of an outbreak, the tiny blisters burst to create a lesion and exude a watery fluid. The lesion remains an open weeping sore for approximately 24 hours while blood vessels and inflamed tissue excrete liquid. This is the most contagious stage of all. Swollen lymph glands and a fever may occur with severe outbreaks.

Crusting

The three days following the lesion stage hails the commencement of healing. A yellow crust composed of blood serum proteins forms over the open lesion. The crust may break open or split with facial movement or eating. This can cause some pain. Fluid will leak from cracks in the scab. This substance is filled with the herpes virus.

Healing

The virus returns to its dormant position at the nerve center from days 9 through 14 permitting new skin to form underneath the scab. The scab will diminish and fall off after 7-10 days. Itching may return as the scab heals.

Post Scab

After the final scab has fallen off, the skin may remain red for a time until it is fully rejuvenated. Viral shedding and contagion may still happen during this final stage.

Duration

The duration of an outbreak of oral herpes symptoms to complete healing is usually 2 weeks, but may last up to 3 weeks.

Oral herpes symptoms vary from person to person. Some people may experience only 1 or 2 outbreaks yearly, while others have multiple episodes. Remission between attacks can last weeks to months to years.

The same is true with the severity of symptoms. They range from mild with a fast recovery to more severe symptoms with prolonged healing.

Sharing cups, utensils, dishes, towels, pillowcases and makeup, kissing and any skin-to-skin contact whatsoever should be stringently avoided during an outbreak to prevent transmission of the oral herpes virus.

Oral herpes is highly contagious and can be transferred to any body part, including genitals, of another person during the symptomatic outbreak.