Fever Blisters A small sore situated on the face or in the mouth that causes pain, burning, or itching before bursting and crusting over. The favorite locations are on the lips, chin or cheeks and in the nostrils. Less frequented sites are the gums or roof of the mouth. Fever blisters are caused by herpes simplex virus type 1. It lies latent (dormant) in the body and is reawakened (reactivated) by factors such as stress, sunburn, or fever from a wide range of infectious diseases including colds. Recurrences are less common after age 35. Sunscreen (SPF 15 or more) on the lips prevents recurrences of herpes from sunburn. The virus is highly contagious when fever blisters are present. It is spread by kissing. Children become infected by contact with someone who has a fever blister and then they spread the virus by rubbing their cold sore and touching other children. A person with fever blisters should be careful not to touch the blisters and spread the virus to new sites, such as the eyes or genitals. There is no cure for fever blisters. Medications that can relieve some of the pain and discomfort include ointments that numb the blisters, antibiotics that control secondary bacterial infections, and ointments that soften the crests of the sores. Acyclovir, an antiviral drug, prevents the herpes simplex virus from multiplying and, in pill form, has been reported to reduce the symptoms and frequency of recurrence. Fever blisters have plagued people for thousands of years. In ancient Rome, an epidemic of fever blisters prompted Emperor Tiberius to ban kissing in public ceremonies. Today, fever blisters still occur in epidemic proportions. About 100 million episodes of recurrent fever blisters occur yearly in the United States alone. Fever blisters are also called cold sores, labial herpes (herpes labialis, in Latin) and febrile herpes (herpes febrilis, in Latin).

Recurrent Herpes : By far the most common manifestation of herpes infections -- what people usually mean when they speak of "herpes" or "cold sores" -- is a recurrence of the virus when it is reactivated from its latent sleep in the nerves below the skin. What this looks like depends on where the virus has been hibernating: Labial herpes: This is the familiar cold sore that appears on the lip margins (labial refers to the lip). When labial herpes reappears, it usually occurs at most a few millimeters away from its previous location(s). Herpetic whitlow: Sometimes, the herpes virus shows up on the fingertip. This is especially common in dental and medical workers who have to put their fingers inside people's mouths, despite the use of gloves. Wrestlers' herpes: This has the picturesque name, "herpes gladiatorum." Gladiators, or nowadays just plain wrestlers, can contract herpes from an opponent who is shedding the virus. This form of herpes can appear all over the body. Wrestlers differ from most other patients with herpes who only develop recurrences in one spot. The reason for this is that although the antibodies in the bloodstream do not prevent the herpes from returning, they do make it hard for the virus to get a foothold anywhere else on the body.

Primary Herpes : The first time someone is exposed to herpes, the virus often infects the body without causing any noticeable problem. This process generates an antibody response in which the immune system produces specific proteins that are directed against the herpes virus. The antibody response usually makes recurrences mild. Sometimes, however, the first attack of herpes causes people to become very sick. It may cause fever, swollen glands, and bleeding gums, together with painful sore(s) around the mouth (gingivostomatitis). These signs and symptoms may last several days. Difficulty in eating and drinking may lead to dehydration. The viral infection typically lasts 10 to 14 days. The herpes blisters themselves may last anywhere from 2 to 6 weeks before they scab over and go away, usually without scarring. Primary herpes is typically contracted during childhood.

Genital herpes: A viral infection transmitted through intimate contact with the moist mucous linings of the genitals. This contact can involve the mouth, the vagina or the genital skin. The herpes simplex type 2 (HSV-2) enters the mucous membranes through microscopic tears. Once inside the body, HSV-2 travels to nerve roots near the spinal cord and settles there permanently. When an infected person has a herpes outbreak, the virus travels down the nerve fibers to the site of the original infection and when it reaches the skin, the classic redness and blisters occur. Outbreaks of genital herpes are closely related to the functioning of the immune system. Women who have suppressed immune systems, either through stress, disease, or medications, have more frequent and longer-lasting outbreaks. The antiviral drug valacyclovir (Valtrex), taken once a day, has been found to reduce the shedding of HSV-2 on genital mucosal surfaces and to reduce the rate of transmission of genital herpes among discordant couples (couples in which one partner is HSV-2-positive and the other is HSV-2-negative). The US Food and Drug Administration approved the use of valacyclovir (Valtrex) for the prevention of sexual transmission of HSV infection. Results of nationally representative study show that genital herpes infection is common in the United States. Nationwide, 45 million people ages 12 and older, or one out of five of the total adolescent and adult population, are infected with genital herpes (herpes simplex virus type-2).