Cold sore sufferers, take heart. It turns out the crusty, oozing blisters that tempt you to turn down invitations and hide your lips from public view have been wreaking social havoc since ancient times. Victims of oral herpes date back thousands of years and run the gamut from classic literary characters to Roman emperors.

The herpes simplex virus type 1 (HSV-1) that causes oral herpes or cold sores “ain’t new,” says Richard M. Price, DMD, spokesman for the American Dental Association. “The Greeks called type 1 herpes simplex creeping or latent, and the virus was referenced in Shakespeare’s Romeo and Juliet where it was described as blisters on the lips,” explains Dr. Price, adding that the Romans even went so far as to impose a kissing ban in an attempt to stop the spread of the virus.

The Types of Herpes Simplex Virus

There are two types of herpes simplex virus. Categorized as type 1 and type 2, both are highly contagious and easily spread from person to person. Oral herpes is associated with the type 1 virus, which causes the outbreak of blister-like lesions often called cold sores or fever blisters.

Type 2 herpes simplex (HSV-2) outbreaks usually occur below the waist, producing sores in the genital region. While it is possible for HSV-1 to cause genital herpes and HSV-2 to lead to oral herpes, this scenario is much less common. Although rare, the virus can also appear in other parts of the body including the eyes and brain.

How Oral Herpes Spreads

Not everyone who harbors the herpes simplex virus type 1 gets fever blisters. Even individuals who have never had one have likely been exposed to the virus at one time or another. “Most of the population has been exposed to the herpes simplex virus,” says Price. “And once you get it, you have it for life.”

Researchers have recently identified a gene they say could be linked to cold sores. Individuals that carry the gene, known as C21orf91, appear to be susceptible to frequent oral herpes outbreaks, while those carrying variants of the gene may actually be protected from outbreaks.

Many times, exposure to the virus occurs in childhood. Symptoms during the first outbreak are usually more severe than those seen in recurrent herpes. One or more lesions appear around the mouth and fever, malaise, loss of appetite, headache and enlarged lymph nodes may also be present. The lesions are typically just irritating, but some cases can be quite painful.

Most children are exposed at a young age from simply touching another person who has the virus. The virus enters the body through small breaks in the skin such as abrasions, cuts and scrapes. Adolescents and adults can become infected with oral herpes through skin contact, kissing or even sexual contact.

The live virus remains in the body in a dormant state, but certain conditions can cause it to flare, producing new lesions. Whenever the virus reactivates and fever blisters appear, the virus is contagious. During this time, there are steps you can take to decrease the chance of contaminating others. “Don’t touch the cold sores,” says Price. “And avoid any oral contact with others.” He also advises keeping the lesions moist so they don’t crack.

What You Can Do to Treat Oral Herpes

There are no vaccines currently available for the herpes simplex virus, but it is possible to treat the symptoms of an outbreak and reduce the side effects. In most cases, treatment is most effective when started early.

Over-the-counter preparations or home remedies can provide relief from painful oral herpes lesions. Topical anesthetic creams and ointments can be applied directly to the sores every few hours and mild oral pain medication such as Tylenol or ibuprofen can also help. Abreva is a topical non-prescription medication approved by the Food and Drug Administration (FDA) to shorten the healing time of cold sores.

It’s important to keep the sores clean by washing gently with soap and water. (But be careful not to share towels with others.) Drink plenty of fluids to stay hydrated and apply ice or cool compresses for comfort and swelling.

Prescription strength topical medications used multiple times a day can be applied to reduce healing time and adults may be prescribed oral antiviral medications. Those who experience outbreaks on a frequent basis may benefit from long-term use of a daily antiviral medication.