Herpes on Face and Tongue: What It Looks Like, What to Do

Herpes Outbreak on the Face and the Tongue: What It Looks Like and What to Do

Herpes on the face is usually caused by herpes simplex type 1, the same virus behind cold sores, and it can appear anywhere the virus reaches the skin: the lips, around the nose, the chin, the cheeks and sometimes near the eye. It shows up as a tingle, then a small cluster of fluid filled blisters that crust over within about 7 to 10 days. Herpes on the tongue is much less common. It usually looks like small blisters or shallow sores on the top or edges of the tongue, and it’s most often part of a first herpes infection, which can come with fever and sores all over the mouth. Most single, round sores on the tongue are canker sores instead. The care is the same as for any herpes outbreak: act at the first tingle, protect the sore, keep your hands off it and support your immune system. Herpes near the eye needs an eye doctor the same day. For the full picture, see our guides to herpes on lips, cold sores and natural herpes remedies.

The short version

On the face: a tingle, then a cluster of small blisters that crust, most often around the lips, nose or chin.
On the tongue: small blisters or shallow sores, usually with a first infection. One round white sore is more likely a canker sore.
Care: beeswax or propolis ointment at the first tingle, clean hands, your own towel, rest.
Tongue care: cool soft food, salt water rinses, plenty to drink.
Near the eye: see an eye doctor the same day.

What Does Herpes on the Face Look Like?

A facial herpes outbreak follows the same stages wherever it appears:

Tingling, itching or burning in one spot, for a few hours to a day.
Redness and slight swelling.
A cluster of small, clear blisters close together.
The blisters burst and weep, leaving shallow sores.
A yellow or golden brown crust forms and the skin heals, usually without a scar.

The whole outbreak usually lasts about 7 to 10 days. For a day by day timeline, see herpes outbreak stages and how long a herpes outbreak lasts.

Where Herpes Can Appear on the Face

Lips and around the mouth

By far the most common spot. This is what most people call a cold sore or fever blister. Read more in herpes on lips.

Nose

Herpes can appear on the edge of a nostril, just inside the nose or on the skin between the nose and lip. It often feels sore and swollen, and a blocked nose can make it worse. Keep tissues soft and throw them away straight after use.

Chin and cheeks

Herpes on the chin or cheek often follows touching a cold sore and then the skin, or a shave or scratch that lets the virus in. It can look like a cluster of pimples at first, but it tingles before it appears and the blisters sit close together.

Near the eye

Herpes on the eyelid or near the eye needs special care, because the virus can affect the eye itself. Herpes is one of the causes of infectious keratitis, an infection of the clear front of the eye that can damage your sight. If you have a painful red eye, blurred vision, sensitivity to light or blisters on the eyelid, see an eye doctor the same day. Don’t use ointments or oils near the eye.

Herpes from contact sports

Herpes on the face also spreads through close skin contact in sports like wrestling and rugby. At one wrestling camp, a third of the wrestlers caught herpes, and 73% had it on the head. This is sometimes called herpes gladiatorum or mat herpes. Athletes with an outbreak should stay off the mat until the skin has fully healed.

What Causes a Herpes Outbreak on the Face?

After a first infection, the herpes virus sleeps in a nerve cluster near the brain that supplies the face. When something weakens your immune control, it travels back down the nerve to the skin. That’s why facial outbreaks often come back in the same spot. Common triggers are:

Stress that goes on for weeks
Too little sleep
A cold, flu or fever
Sunlight and wind. In a trial, sunscreen prevented every sunlight triggered cold sore, while 71% of people without it got one.
Skin damage, such as shaving, a scratch, dental work, a facial treatment or picking at the skin

We go through each trigger, and how to avoid it, in how to avoid a herpes outbreak.

Is It Herpes or Something Else on the Face?

Pimples: single spots with a white head, often around a hair follicle, with no tingling beforehand. Herpes blisters are grouped and clear.
Impetigo: a bacterial skin infection, common in children, with honey coloured crusts that spread quickly. It needs a doctor.
Shingles: caused by a different herpes virus. It forms a painful band of blisters on one side of the face, often in older adults. See a doctor quickly.
Eczema or dermatitis: dry, itchy, red patches rather than blisters. People with eczema can get a widespread herpes infection called eczema herpeticum, which needs urgent care.

What Does Herpes on the Tongue Look Like?

Herpes on the tongue usually looks like small blisters that quickly burst into shallow, painful sores on the top or sides of the tongue. It often comes with sores on the gums, the inside of the lips or the roof of the mouth.

First herpes infection in the mouth

Most herpes on the tongue happens during a first infection, often in young children. This is called primary herpetic gingivostomatitis. It brings fever, swollen red gums, sores all over the mouth including the tongue, and trouble eating and drinking. The biggest risk is that a child stops drinking, which is why a review on managing it in young children puts fluids and comfort first. See your GP or paediatrician, and read our guide to cold sores in babies and newborns.

Herpes on the tongue in adults

Repeat herpes on the tongue is rare in healthy adults. When it does come back inside the mouth, it more often appears on the gums or the roof of the mouth. In people with a weakened immune system, herpes can cause a painful branched crack down the middle of the tongue, known as herpetic geometric glossitis or honeycomb herpes. That needs a doctor.

Herpes or a canker sore on the tongue?

This is the most common mix up. A canker sore is one round ulcer with a white or yellow centre and a red border, often on the side or tip of the tongue, and it isn’t contagious. Herpes on the tongue is usually a group of tiny blisters or sores, often with a fever or sores elsewhere in the mouth. Read more about a canker sore on the tongue and how to tell a cold sore or a canker sore apart.

How to Treat Herpes on the Face

Act at the first tingle. The amount of virus and pain are highest in the first 24 hours, so early care makes the biggest difference.
Use a beeswax or propolis ointment. A propolis lip cream healed cold sores in a median of 3 days in a large trial. I put a beeswax ointment on at the very first tingle, and in my experience it’s usually gone within about two days.
Try honey. Honey made lip outbreaks 35% shorter in a trial.
Cover it with a hydrocolloid patch, which healed cold sores as well as an antiviral cream in a trial, and stops you touching it.
Keep your hands off it. Wash your hands after applying anything, and don’t touch your eyes.
Use your own towel and pillowcase, and don’t share razors, make up or lip products.
Skip shaving and facial treatments on the area until it has healed.

The ointment I use at the first tingle

The Aromafisis beeswax ointment with oregano is handmade from olive oil, beeswax, oregano oil, clary sage and mastic oil, with no preservatives. It doesn’t sting, and in my experience the outbreak is usually gone within about two days.

See the beeswax ointment

Not an affiliate link. For the skin of the face and lips, not inside the mouth or near the eye. Comfort care, not a cure.

For pharmacy options, see cold sore remedies over the counter.

How to Treat Herpes on the Tongue

Ointments aren’t made for the inside of the mouth, so tongue care is about comfort, hydration and letting your immune system work.

Drink plenty, little and often. Cool water, milk or diluted juices without citrus. For children, ice lollies can help.
Eat soft, cool food: yogurt, porridge, mashed potatoes, soups that have cooled down, smoothies without citrus.
Avoid salty, spicy, acidic and crunchy food until the sores heal.
Rinse with salt water (half a teaspoon in a glass of warm water) a few times a day, if you’re old enough to spit it out.
A little honey on the sores can soothe them in adults and children over one year old. Never give honey to a baby under one.
Ibuprofen or paracetamol for pain and fever, following the dose on the pack.
Rest, and don’t share cups, cutlery or kisses.

Support Your Immune System

How often herpes comes back and how long it lasts depends a lot on how strong your immune system is. Researchers found that the body clears about half of all herpes reactivations within 12 hours, before a sore appears. Protein at every meal, five portions of fruit and vegetables a day, enough sleep and less stress all help your body do that. We explain it in more depth in how long a herpes outbreak lasts, and for tips on resting during an outbreak, see how to sleep during a herpes outbreak.

When to See a Doctor

Blisters near the eye, a painful red eye or blurred vision. See an eye doctor the same day.
A child with mouth sores who won’t drink, has a high fever or fewer wet nappies. See your GP or paediatrician the same day.
A baby with any blister or fever. Go to the emergency room straight away.
Blisters spreading over eczema. See a doctor urgently.
A painful band of blisters on one side of the face. See your GP quickly, as it may be shingles.
An outbreak that hasn’t healed after two weeks, keeps spreading or comes back very often. See your GP or a dermatologist.
A weakened immune system and sores on the tongue or in the mouth. See your doctor.

Knowing exactly what you’re dealing with is what lets you care for it the right way naturally. Herpes can also appear in the genital area; for that, see genital herpes outbreak treatment at home.

Frequently Asked Questions

What does herpes on the face look like?

It starts with a tingle, then a small cluster of fluid filled blisters appears, usually around the lips, nose or chin. The blisters burst and form a yellow or golden brown crust, and the skin heals in about 7 to 10 days.

What does herpes on the tongue look like?

Small blisters that burst into shallow, painful sores on the top or sides of the tongue, often with sores elsewhere in the mouth and a fever. A single round white sore with a red border is more likely a canker sore.

Can you get herpes on your tongue?

Yes, but it’s uncommon. It usually happens during a first herpes infection, especially in young children. Repeat herpes on the tongue is rare in healthy adults.

How do you treat herpes on the face?

Start a beeswax or propolis ointment at the first tingle, cover the sore with a patch, keep your hands off it and use your own towel. Support your immune system with rest, a balanced diet and less stress.

Is herpes on the face contagious?

Yes, from the first tingle until the skin has fully healed. Avoid kissing, close face contact and sharing towels, razors or make up during an outbreak.

This article is for general information and does not replace a diagnosis. If a sore is near your eye, doesn’t heal, or you feel unwell, see a doctor.

Veronique Cleas D'erckenteel

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