[Question #5335] HSV1 Inside Mouth?

21 months ago

Hi Terri, I was wondering if you could help me.  I had an encounter with a csw about three months ago (I posted a separate [and basically unrelated] question about it a few days ago which Dr. Hook answered). I suspect that I might have contracted HSV1 from her. We had a couple of extended periods of passionate kissing. About ten days later, I experienced what began as a fairly mild sensation of tingling/burning inside my mouth - starting toward the back of my mouth but eventually spreading throughout. My doc seemed skeptical that it was HSV1 but wrote me a valacyclovir prescription. This didn't seem to have much effect though. There do not seem to be any obvious sores inside my mouth and I have not experienced any "traditional" cold sores on my lips or anywhere close to my mouth. The symptoms were pretty mild most of the time, though occasionally they were more painful. They did persist for a while though - about 7 weeks I would say. I then went a few weeks with no symptoms. A week and a half ago they started again with the same pattern - mild sore throat type sensation in the back of the mouth, gradually spreading throughout the mouth with a tingling/burning sensation. I'm in the midst of those symptoms right now, but still nothing on the lips or resembling a cold sore.


Does this sound like HSV1 to you?

Is it possible to get HSV1 which only breaks out within the mouth and doesn't produce the more visible cold sores?

If you suspect HSV1, what would recommend regarding management? Once I'm in the midst of an outbreak, is the valacyclovir effective at all, or do I just need to wait it out? What sort of dosage and regimen is appropriate to suppress outbreaks over time? 

And what sort of dosage is appropriate to shorten an outbreak if I feel the same initial symptoms again once this outbreak has cleared up?


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
21 months ago
This sounds absolutely nothing like herpes to me:
1) HSV 1 orally does not last 7 weeks
2) brand new HSV 1 oral infection would likely present with lesions, which yours did not.  Tingling and burning without lesions are unlikely to represent a herpes infection
3) Valtrex does not seem to be making things any different. 

Before you decide that you have HSV 1 and start treating for a lifetime, find out if you are actually infected!  If you do the IgG test and it is negative for HSV 1, remember that that test misses 30% of HSV 1 infections, compared to the gold standard herpes western blot