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Oral herpes is a common viral disease of childhood. This condition produces sores (“cold sores”), blisters (“fever blisters”), and swelling of the inside of the mouth and lips. (When most people hear the word herpes, they associate it with genital herpes, the sexually transmitted disease; however, a different strain of this virus usually causes cold sores in children.) Oral herpes is highly contagious, and is spread by direct contact, frequently by kissing. Most infants are protected by their mothers’ antibodies up to about age six months, but they become susceptible after that.

When the virus is transmitted to a child for the first time, she is said to have primary herpes. This may cause pain, swelling and reddening of the gums, and an increase in saliva, followed a day or two later by blisters inside the mouth. When the blisters break, they leave sore areas that take several days to heal. The child also may develop a fever and headache, act irritably, lose her appetite, and have swollen lymph glands for a week or so. Many children, however, have such mild symptoms that no one realizes they have the virus.

Once a child has had primary herpes, she becomes a carrier of the virus. This means that the virus, usually in an inactive state, remains within her system. However, during episodes of stress (including other infections), injury to the mouth, sunburn, allergies, and fatigue, the virus can become reactivated, producing what’s called recurrent herpes. This condition is milder than the primary infection, and usually doesn’t occur until later in childhood or adulthood. Cold sores and fever blisters are the symptoms of recurrent herpes.


If your child complains of symptoms resembling those of herpes, consult your pediatrician. Primary herpes is not a serious illness, but it can make your child uncomfortable. The treatment, which should be aimed at reducing this discomfort, includes:

  • Bed rest and sleep.
  • Plenty of cold fluids, including nonacidic drinks like apple or apricot juice.
  • Acetaminophen, if there’s fever or excessive discomfort. 
  • Mouth rinse or gargles prescribed by your pediatrician. These medications may contain a painkiller that will numb the areas affected by the mouth sores. Carefully follow the directions for these preparations.
  • A soft, bland, but nutritious diet. 
  • Antiviral medication (such as acyclovir or a similar type of drug) that may be prescribed by your pediatrician. They will stop the virus from multiplying, but will not prevent reactivation after the medication is stopped.

Occasionally a child infected with primary herpes refuses to drink fluids because of the associated mouth pain. In some cases, such a child must be hospitalized if she is showing signs of dehydration.

Never use any creams or ointments containing steroids (cortisone) if there is the slightest suspicion that the mouth sores are due to herpes. These preparations can make the viral infection spread.


Direct contact is required to spread the herpes virus, so you should not let anyone with herpes blisters or sores kiss your child. People with a history of oral herpes often shed the virus in their saliva even when they have no sores, and these sores are contagious. In general, discourage individuals from kissing your baby or child directly on the lips.

Also, try to discourage your child from sharing eating utensils with other children. (This is more easily said than done.) If your child has primary herpes, keep her home to prevent other children from getting this infection from her.


Last Updated
Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.