This first occurrence can appear as painful mouth, gum, throat, and lip sores which may more than 14 days if left untreated. Most patients will also require pain killers or even topical anesthetics in order to be able to continue to eat. By contrast, recurrent outbreaks generally cause mild to moderate discomfort with localized lesions that resolve after a week or so. A typical recurrence of facial cold sores progresses from prodrome to swelling, blisters, ulcers and then scabbing. Once the scabs have cleared away, a slight redness or other colour change of the skin may remain.
Recurrent infection is usually external and localized to a small area.
The most common areas for cold sores are at the vermilion border of the lip. Recurring ulcers inside the mouth, such as cankers or aphthous ulcers, are generally not caused by herpes simplex. Herpes is transmitted through direct skin contact with an active sore. These antibodies are our way of fighting the virus and do not cause infection themselves. It is important to know that some people may have antibodies to herpes, but not have any identifiable symptoms or signs of facial herpes.