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When reactivation occurs, the virus travels down the nerves to the skin where it may cause blisters (cold sores) around the lips, in the mouth or, in about 10% of cases, on the nose, chin, or cheeks.
It is comparable in effectiveness to prescription topical antiviral agents.
Due to its mechanism of action, there is little risk of drug resistance.
Other symptoms may also develop, including headache, nausea, dizziness and painful ulcers—sometimes confused with canker sores—fever, and sore throat.
Primary HSV infection in adolescents frequently manifests as severe pharyngitis with lesions developing on the cheek and gums.
When a person is not experiencing any symptoms, a blood test alone does not reveal the site of infection.