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Difference between Canker Sores and Herpes

Have you or someone you know recently developed a small sore on the lips, gums, or tongue? It is imperative to determine if the lesion stems from a herpes infection or the more benign and common canker sore.

A canker sore is scientifically known as an aphthous ulcer, which is a type of oral ulcer. A canker sore typically appears as a painful open sore inside of the mouth or in the upper region of the throat. Two basic forms exist: 1) minor ulceration, with a lesion size between 3 and 10 millimeters, and 2) major ulcerations, with a lesion size of greater than 10 millimeters. Minor ulcerations can be painful, but usually clear up on their own after two or three weeks. Major ulcerations are almost always extremely painful and can take over a month to properly heal. In both cases, the ulcer appears as a white or yellowish circle with a red and inflamed border. An ulcer may spontaneously appear at a seemingly random time.

Herpes, on the other hand, typically occurs in cyclical outbreaks that recur over extended periods of time. When the virus becomes active, blisters form that contain particles of the infectious disease. These blisters, which typically appear on or around the outer lips, last two to twenty-one days, which is then followed by healing and a period of remission. Over the years, as a person’s body adjusts to the disease, these active outbreaks ease in frequency and severity.

Unfortunately, you are not likely to be able to tell the difference between a canker sore and a herpes sore by sight alone.

Herpes is a viral disease caused by both herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Type 2 typically causes outbreaks to the genitals, while type 1 affects the mouth, eyes, and fingers. Both types of the virus are intensely contagious. Transmission occurs when a non-infected person comes in direct skin-to-skin contact with a lesion on an infected person, or in contact with bodily fluid from the infected person. Even when there are no lesions visible, the virus can be transmitted by skin-to-skin contact. There is no known cure and the herpes virus remains within an infected person’s body for the duration of their lives.

Canker sores are most often caused by trauma to the mucous membranes in the mouth. 10% of the population experiences recurring canker sores, so the exact cause is not known. In the case of trauma, a person may accidentally brush their teeth too hard, bite their lip, or cut their mouth against an abrasive piece of food. The onset of a canker sore is typically trumpeted by a burning or tingling sensation at the site of the future sore. An ulcer then appears as a white or yellow oval, sometimes accompanied by painful swelling of the lymph nodes below the jaw. Other possible causes are citrus fruits, stress, lack of sufficient rest, and food allergies. A recent studied published in the journal Oral Diseases, reports a link between certain food allergies, particularly cow’s milk, and recurring canker sore outbreaks.

Herpes cannot be cured, but the frequency and severity of outbreaks may be reduced with the use of antiviral medicines. If you suspect you may have herpes, the first step is an examination by your doctor who can then suggest a line of treatment.

Canker sores, though painful, eventually go away on their own. Over the counter pain relievers and topical creams may reduce the irritation and pain associated with an occurrence.

Talk to your doctor if you’re concerned, as only your doctor can definitively diagnose a canker sore or a herpetic lesion.