Herpes on Tongue: Symptoms, Causes, Treatments, and More

Oral herpes can manifest itself in many places, and one of the most uncomfortable is on the tongue.

Herpes sores, often referred to as cold sores or fever blisters, can be incredibly painful and unsightly, and the condition itself comes with a lot of stigma, despite the fact that it’s extremely common. 

If you’re one of the approximately 1 in 2 Americans who currently has the oral herpes virus, you’ve come to the right place to learn more about the condition—especially if your sores appear on your tongue (though you may also find them on your lips, cheeks, gums, and other places in and around your mouth). 

In the following article, we’ll discuss what herpes on the tongue looks and feels like, what causes it, and how it spreads.

We’ll also go into depth about how you can treat and manage it (after all, it is an incurable condition), and what precautions you can take to help protect yourself or others from becoming infected.

The more you know, the easier it is to make informed decisions about your health, so we’re glad you’re here to learn more.  

Herpes on Tongue Symptoms

Most people who become infected with oral herpes experience mild symptoms or no symptoms at all.

However, those who are symptomatic can experience extremely uncomfortable symptoms, especially when they’re in hard to awkward places, like the tongue.

When people experience these symptoms, it’s referred to as having an “outbreak.”

Oral herpes symptoms come in stages, and normally appear as the following:

• An itching, tingling, or burning sensation in the area of the outbreak before the herpes sores actually appear 
• Small red bumps begin to appear, often in clusters in the area of the outbreak 
• Bumps become blister-like, with yellowish fluid inside
• Eventually, these blisters rupture, and their insides leak (this is often called the “weeping period,” and is the most painful)
• The sores begin to crust over as they heal, before falling off and leaving behind pink skin

Most people will have their most intense set of symptoms during their first-ever outbreak of oral herpes, and recurrent outbreaks will be far less bothersome.

There are also some symptoms that typically only occur before and during a first outbreak, and are rare during recurrent outbreaks.

These include:

• Fever
• Swollen glands
• Painful swallowing
• Sore throat

Herpes on Tongue Causes

Herpes on the tongue is most often caused by the herpes simplex virus type 1 (HSV-1), which most often causes oral herpes.

It can also be caused by herpes simplex virus type 2 (HSV-2), which most often causes genital herpes. 

Once you have become infected with either type of the virus, there are several things that can trigger an oral herpes outbreak, which can cause herpes sores to appear on the tongue, as well as the lips, gums, roof of the mouth, and inside of the cheeks.

Common triggers include:

• Hormonal changes (like menstruation or pregnancy)
• Stress
• Extreme heat or cold
• Dry or cracked lips
• Sunburn
• Fever
• Illness (especially cold or flu)
• Trauma to the face
• Dental work

Herpes vs Canker Sores

Herpes sores and canker sores can be hard to differentiate visually—but they are very different when it comes down to it.

Like oral herpes, canker sores are painful red bumps with whitish centers that develop inside the mouth, sometimes in clusters.

They can be incredibly uncomfortable and make eating and drinking challenging. 

However, unlike herpes sores, canker sores are not contagious, and they are actually mouth ulcers, not fluid-filled blisters.

The exact cause of canker sores is unknown, but there are several things that can trigger them, including stress, hormone changes, food allergies, mouth injury, immune system issues, viral infections, and more.

Unlike herpes sores, canker sores are only inside the mouth and often appear on the tongue, inner lips, back of the throat, and inside of the cheek. 

Both herpes sores and canker sores tend to go away on their own after two weeks, and can be incredibly painful as they heal. 

How Does Herpes Spread?

As previously discussed, oral herpes is caused by either HSV-1 or HSV-2, two highly contagious forms of the herpes virus.

HSV-1 is the form that most often causes oral herpes, while HSV-2 most often causes genital herpes.

Oral herpes typically spreads when someone shares saliva or comes in close contact with a person who is infected with HSV-1.

This can happen through kissing, touching, or sharing personal objects like towels, makeup, or utensils with an infected person. 

Treatment and Management

Fortunately, there are many options for treating herpes on the tongue—and most are incredibly effective.

Your doctor will typically recommend the following treatment options for managing the condition:

Self-care: This is all about practicing proper hygiene in order to ensure the virus doesn’t spread to other parts of your body, and doing your best to care for any symptoms you may be experiencing. Herpes on the tongue can be extremely uncomfortable, and hard to treat because your tongue is made up of muscles that you use frequently. If you are experiencing sores on your tongue, try to avoid spicy or salty foods, and opt for cool, soft, nutritious foods instead. It’s also important to ensure that you don’t become dehydrated, even if drinking is painful. If necessary, use a straw and take small, frequent sips of cool water throughout the day. Make sure you also change your toothbrush or sanitize it after a breakout, herpes can live for many days after an outbreak starts.

Over-the-counter medication: If your sores are uncomfortable, there are a number of over-the-counter pain relievers you can take to soothe your symptoms. Your local pharmacy should carry oral pain relievers like ibuprofen and acetaminophen, as well as topical creams and ointments. These topical medications tend to work best if you apply them as soon as you feel an outbreak coming on, as they can stop it in its tracks. If you are using an OTC medication inside your mouth, make sure it is labeled to be used there, you can always ask your Pharmacist or Provider if you have any questions. 

Prescription medication: If proper hygiene and over-the-counter medications aren’t enough to reduce your symptoms, your doctor may decide to prescribe you a topical and/or oral medication to add to your treatment plan. Oral anti-herpes medications (like acyclovir, famciclovir, and valacyclovir) can be effective when taken as soon as you sense an outbreak coming on. If you frequently experience recurrent outbreaks, your doctor may also prescribe a daily antiviral medication, which can significantly reduce the risk of an outbreak coming on as well as the risk of spreading the virus. 

Prevention and Precautions

Whether you have already been diagnosed with herpes or are close with someone who has, there are multiple ways to keep yourself and the people around you safe and healthy. 

If you have already been diagnosed with herpes and have dealt with herpes on the tongue in the past, you should take the following precautions to reduce your risk of experiencing a future outbreak:

• Practice sun safety, and wear sunscreen on your face and lips, as a sunburn can trigger an outbreak
• Keep your lips moisturized, as dry and cracked lips can trigger an outbreak
• Keep your hands clean and avoid touching other parts of your body after touching an open herpes sore, as the virus can spread
• Do your best to stay healthy, as fever and illnesses can trigger an outbreak  

If you have never been diagnosed with oral herpes, take the following precautions to prevent yourself from becoming infected:

• Refrain from any form of intimate contact with anyone who has visible herpes sores (this includes kissing, genital sex, oral sex, and close touching)
• Refrain from sharing items like towels, lipstick, utensils, and shaving equipment with someone who has visible herpes sores
• Wash your hands thoroughly with soap and water after being around someone with visible herpes sores, especially before touching your eyes, mouth, and genitals

When to See a Medical Provider

Most cases of herpes on the tongue will heal on their own after a couple of weeks, with no need for medical intervention.

However, there are certain situations where it is crucial to check in with your doctor.

For example, you should see a medical professional immediately if you experience any of the following: 

• Your symptoms don’t go away after two or more weeks, and/or are very severe and uncomfortable
• You have herpes sores near your eyes (this can lead to a viral eye infection called herpes keratitis, which can cause blindness if untreated)
• You are experiencing an outbreak and know that your immune system is weak (due to HIV, chemotherapy, etc.) 

Did you know you can get affordable primary care with the K Health app? Download K Health to check your symptoms, explore conditions and treatments, and if needed text with a provider in minutes. K Health’s AI-powered app is based on 20 years of clinical data.