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Herpes on the lip during pregnancy in early pregnancy, 1st, 2nd and 3rd trimesters
Last reviewed: 04.07.2025
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The most common viral infection in the human population, known to modern medicine, is herpes. There are more than two hundred varieties of representatives of the viral family "Herpesviridae", only eight of which are considered dangerous to us. The lips are the most common and noticeable localization of herpes rashes. The appearance of fever, that is, blisters on the lips, is caused mainly by herpes of the first type, sometimes - the second, the so-called herpes simplex viruses, which infect most of the adult population of the globe. Many doctors do not believe at all that someone could avoid it. Therefore, herpes on the lips during pregnancy is not a rare phenomenon, one in three women during this period necessarily have itchy blisters.
It is extremely rare to live to fertile age and not encounter the herpes simplex virus, given its widespread prevalence in the human population. For most women, pregnancy after herpes on the lips should not cause particular concern if such rashes appear not for the first time. This indicates that antibodies to this virus have already appeared in the body. In this case, the probability of its adverse effect is considered significantly lower than with primary infection just before conception. In this case, the woman's body has not yet had time to respond to viral aggression by producing antibodies, and before the immune response is formed, which will take about a month and a half, there is a possibility of damage to any organs and tissues, including the embryo.
Epidemiology
The proportion of the world's population infected with both types of herpes simplex is estimated at 65-90% or more. The first type is much more common than the second, in the US, for example, 3.6 times more common.
Statistics show that only 10% of women of childbearing age have never encountered herpes on their lips. Cold sores on the lips "pop up" at least once every nine months in every third pregnant woman, and more than 70% of cases of rashes occur in the first months of bearing a child.
Based on the results of studies of the presence of characteristic antibodies in the body, it can be said with confidence that most people became infected with herpes type 1 in early childhood, and type 2 when they began to have sex.
Some people are immune to herpes infection, while others, the majority, on the contrary, have a hereditary predisposition to herpes infection, which is passed down from generation to generation.
Causes of herpes on the lip in pregnancy
The main reason for the appearance of herpetic rashes on the lips is a physiological decrease in the immunity of the expectant mother after conception. As a rule, this happens to women who have been infected for a long time, who encountered such rashes before pregnancy or in childhood. The virus could easily exist in their body without showing itself in any way. According to statistics, this happens quite often.
The lowest immune defense of a pregnant woman is at the sixth to eighth and 20-28 weeks of gestation, when conditions are created that favor the development of a "foreign organism", and then its own organs are actively formed. It is during this period that it is most likely not only to pick up some infection from the outside, but also to receive a message from infections that have been happily dormant in the body, in particular, herpes blisters on the lips.
Primary infection with the herpes simplex virus during pregnancy is rare, but it is still possible. Therefore, if you do not remember having such rashes before, and, in addition, their appearance is accompanied by the appearance of symptoms characteristic of a viral infection (fever, weakness, joint pain), perhaps this is exactly your case.
The most likely way to become infected is through contact with a sick person in the acute stage of the disease. The liquid flowing from the blisters on the lips of an infected person is especially dangerous. It is simply teeming with viruses. The saliva of a sick person is also dangerous. Infection can occur through a kiss, through a towel, dishes, lipstick and other objects. The virus can also get from a sick person to a healthy person through airborne droplets with microparticles of saliva or rhinobronchial secretions when talking, coughing, sneezing.
Carriers of the virus in the latent period can pose a threat only in case of direct contact of mucous membranes and only under the condition of abundant invasion or damage to the integrity of the mucous membrane or skin of a healthy person.
Infection with herpes simplex of any type can occur during oral-genital sex with an infected partner, and damage to the integrity of the skin is not necessary. Genital herpes is quite insidious in this regard, since most infected people have asymptomatic active phase or the symptoms are so erased that the patient does not pay attention to them.
Another source of infection is self-infection (touching the rash with your hands first and then touching another part of the body). For example, you can infect your genitals with the type 1 virus during active primary rashes on your lips. However, the appearance of antibodies six weeks after infection largely neutralizes this possibility.
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Does cold sores affect pregnancy?
There is no clear answer. At least, a relapse of herpes on the lips of a pregnant woman is considered a practically safe phenomenon, since the mother already has antibodies to it, and they will be transmitted to the child through the general bloodstream, and then through the mother's milk, protecting him from infection for the first six months after birth.
If we are to believe the statistics, the vast majority of women should be infected with the herpes simplex virus almost from childhood, however, almost all of them, sometimes more than once, became mothers of quite prosperous and healthy children.
The fact is that when an infection is introduced into the lip area, the viruses multiply locally not too far from the site of introduction - in this case, the facial tissues and nerve endings of the facial nerves are affected. The viruses do not reach the peritoneum, and especially the uterus with labial herpes. Moreover, women who sometimes had herpetic eruptions on the lips, after the formation of an immune response, become immune to genital herpes caused by the same virus.
However, the herpes simplex virus in the active phase is capable, as doctors believe, of infecting the fetus in the womb and causing congenital anomalies, fetal death and miscarriage, however, all this is relevant for genital localization. Both the first and second types, being activated on the genitals, can infect the child in utero and during childbirth. Primary genital herpes is considered the most dangerous for bearing a child, the probability of infection of the fetus in this case is estimated at 60%. This also applies to recurrent herpes, although in this case the risk of infection is reduced.
Primary infection of the mucous membrane of a woman's lips during pregnancy could hypothetically lead to damage to any tissue until an immune response has formed, although in reality this almost never happens.
However, rashes on the lips during pregnancy should not be ignored. They should be treated, and not independently, but under the supervision of a doctor.
Risk factors
People whose relatives are well acquainted with this fever have a high probability of getting infected with herpes. Heredity increases the probability of infection. Neglect of sanitary and hygienic standards also increases the risk of infection.
Immunodeficiency states caused by taking immunosuppressants, stress, physical or mental overload, chronic diseases, as well as hypothermia and colds increase the activity of the virus in the body and the number of relapses.
During pregnancy, the activity of immune killer cells is physiologically suppressed in the first months to allow the fertilized egg to freely penetrate the endometrium and begin its development. It is the deficiency of natural killers that provokes a relapse of herpes dormant in the body.
Pathogenesis
The herpes simplex virus of the first type, as a rule, affects the mucous membrane of the mouth and eyes, the skin of the face and neck, the facial, trigeminal nerves, spinal cord cells, the second - prefers the mucous membrane and skin of the genitals and anus. But both of these viruses are quite interchangeable and with oral-genital sexual caresses can become a source of infection of any localization.
The herpes simplex virus gets onto the mucous membrane or skin of a healthy woman by any of the above-described routes, moves with short breaks, bypassing protective barriers, until it reaches the nerve ending cell. Merging with the cell membrane, it penetrates the neuroplasm, where the viral deoxyribonuclease is released and, having advanced a little further, is integrated into the genetic apparatus of the sensory ganglion nerve cell. Here it settles forever, its replication occurs, as a result of which fragments of the viral DNA are integrated into human DNA. The immune system reacts to this by activating immunocytes and producing antibodies, which causes fragments of the viral deoxyribonuclease to be “preserved” in the trigeminal nerve ganglion.
As soon as a person's immunity decreases, the virus rears its head and begins to actively multiply. Blister rashes appear on the lip near the nerve ending of the trigeminal nerve. During an exacerbation, a great many fragments of viral DNA are formed, migrating along the processes of the neuron into the epithelial layer of the skin and mucous membrane, causing the formation of blisters, causing degenerative changes and necrosis of the epithelium. The replication cycle of the herpes simplex virus is ten hours. Over time, the host's body develops immunity against a specific type of virus, the number and severity of exacerbations decreases.
A person is an active virus carrier, as a rule, during the first year after infection. In immunodeficiency states, this period is extended, for example, in HIV-infected people.
Immunity is developed only against a specific type of virus. Thus, those infected with labial herpes type 1 will not be infected with it through the genitals, they will not develop herpetic keratitis or panaritium, caused by this type of virus.
Symptoms of herpes on the lip in pregnancy
Whatever the name of this disease - fever, cold or even malaria, the symptoms of labial herpes are the same for everyone, regardless of gender or age. Pregnant women are no exception. The stages of development of the acute period have a clear sequence.
The first signs are felt as a slight tingling and itching at the site of future rashes. This corresponds to the stage of the virus moving along the cells of the nerve endings from the ganglion of the trigeminal nerve to the epithelial tissues of the lip. At this point, active replication of viral DNA occurs. Externally, the lip area in this place is slightly hyperemic.
Then comes the inflammatory stage – the appearance of a group (sometimes one) of blisters with liquid contents, the size of which increases. The process is accompanied by itching and pain.
At the next stage, the bubbles that have reached their largest size burst and the contents, filled with virus genomes ready to be introduced into a suitable object, pour out. Ulcers remain in the place of the burst bubbles. At this stage, the patient poses the greatest danger to others.
Further regression occurs - scabs form over the ulcers, under which healing occurs. Usually, not even traces of the rash remain at the site of the rash.
Most often, herpes on the lips appears in the early stages of pregnancy, this is quite normal for a recurrent virus, which becomes active against the background of a natural decrease in immunity during this period. The mother's body is not able to control the "awakened" viruses, successfully migrating along the axons of neurons to the periphery to the sites of primary infection. Herpes on the lip that appears as part of an exacerbation of the disease during pregnancy in the 1st trimester is considered not dangerous, as well as throughout the entire gestation period. In the second half of pregnancy, immunity usually normalizes and herpetic eruptions appear much less often than in the early stages.
Primary infection often differs from reactivation of the virus by the presence of symptoms of systemic malaise - headache and joint pain, fever, weakness and nausea. Specific rashes are abundant with severe pain. Although some have vague symptoms, there may be no symptoms, such as a rash, but signs similar to ARVI remain.
Frequent herpes on the lips during pregnancy can be a symptom of a malfunction of the immune system of the expectant mother. This condition should be brought to the attention of the attending physician. This is precisely the rare case when, against the background of reduced immunity, the infection can spread to the fetus.
Herpes on the labia during pregnancy is an alarming symptom and the cause of major complications of pregnancy, childbirth and vertical infection.
Complications and consequences
Fetal death, spontaneous abortion, intrauterine infection with subsequent developmental disorders, infection of the newborn and neonatal herpes - such consequences of herpes infection are possible, however, only if it is localized on the genitals of a pregnant woman.
Primary infection in the first trimester of pregnancy with labial herpes does not pose a serious danger, although there is a slight risk of infection of distant tissues. If the expectant mother does not have a serious immunodeficiency (physiological immunosuppression does not count), then there is a high probability of no negative consequences. There is a danger only in the case of infection transfer to the genitals.
Herpes on the lip during pregnancy in the 2nd trimester, neither primary nor, especially, recurrent, is dangerous for the mother and child. Reactivation of the dormant virus during this period occurs much less frequently than in the initial stages. The danger, again, can only come in the case of transfer of the infection to the genitals during primary infection.
Herpes on the lip during pregnancy in the 3rd trimester is most dangerous with primary infection literally in the last week before delivery. In this case, the mother can infect the child while caring for him and not realizing that she is the source of the infection, and the child does not receive antibodies with mother's milk. The probability of such infection is estimated from 30 to 60%. Even with recurrent herpes immediately before delivery, there is a probability of neonatal infection within 3%.
Recurrence of herpes on the lips during pregnancy is not considered dangerous, however, traumatic procedures during childbirth are still recommended to be avoided. In addition, self-treatment of herpes rashes can be dangerous. Oral antiviral drugs can cause more harm to the developing fetus than labial herpes in its mother.
Diagnostics of herpes on the lip in pregnancy
Doctors know the clinical symptoms of herpetic lesions well, however, chronic forms of infection often proceed atypically or completely asymptomatically. Therefore, the final point in the diagnosis is usually made after laboratory tests. Classic and modern blood tests and scrapings from the affected skin surface (mucous membrane) give a fairly informative answer regarding the infection and the type of virus.
Diagnosis of malaria on the lips during pregnancy is carried out using different methods.
The most informative method is the polymerase chain reaction. This is a modern method that allows detecting viral DNA in biological material (vesicle contents, cell scrapings, blood) even at the initial stages of infection, when there are no antibodies to the virus yet. Its main drawback is that the presence of multiple copies of DNA does not allow judging the severity of the process occurring in the patient.
Among the methods for determining antibodies to antigens, enzyme immunoassay (serological) analysis is used, which is currently the most popular. It does not allow for the detection of infection in the initial stages of the disease (when there are no antibodies), in addition, the concentration of antibodies does not always correspond to the severity of the process. It is recommended to take it at least twice with an interval of seven to ten days in order to see the dynamics of antibody titers.
Immunofluorescence analysis allows one to determine the antigens of the herpes simplex virus in biomaterial treated with a special compound that causes fluorescence when they are present.
Cytomorphological analysis allows the detection of viruses in smears stained with special agents using a light microscope.
Virological studies are based on the isolation of the virus in the culture media of sensitized tissues. The method is characterized by high sensitivity (about 100%) and the same specificity. At the same time, its high cost, complexity and duration of implementation (sometimes up to two weeks) make it inapplicable in widespread medical practice.
To establish an accurate diagnosis, it is advisable to use several research methods. False positive results can be obtained due to insufficient sterilization of laboratory instruments after previous tests. False negative results are also influenced by the human factor: improper collection of biomaterial, its storage, transportation. Low-quality reagents can also cause a false result.
Instrumental diagnostics (ultrasound examination) is used to monitor the condition of the fetus of an infected woman in order to respond promptly if adverse symptoms appear.
Differential diagnosis
Differential diagnosis is carried out with allergic or aphthous stomatitis, impetigo, bacterial infections, and mycoses.
Treatment of herpes on the lip in pregnancy
Therapy for herpes in pregnant women involves the use of mainly external antiviral agents with the active substance acyclovir, the first substance with antiviral activity, the effect of which during gestation has been well studied.
Ointments for herpes on the lips during pregnancy are sold in pharmacies without a prescription, however, they should not be used without the knowledge of a doctor. Although they do not have a significant systemic effect, they can cause side effects.
For example, Acyclovir cream has antiviral activity. It is used for infections of the lips and face. The active component of the cream is well absorbed into the blistered surface and penetrates into the cells affected by the virus. The viral enzyme thymidine kinase catalyzes the reaction of phosphorylation of acyclovir to triphosphate, which has an affinity for the viral enzyme that catalyzes the synthesis of its DNA. This property helps acyclovir triphosphate inhibit the enzymatic activity of the viral enzyme and, with its help, integrate into the DNA chain of the virus, stopping its reproduction and forcing the virus to go into "sleep mode". The cream is applied with a cotton swab to the affected lip once every four hours. Usually healing occurs quite quickly. According to the instructions, it is not used for more than five days.
Fenistil Pencivir cream can also be used for herpes on the lips during pregnancy. Its active ingredient penciclovir exhibits antiviral activity, directed mainly against the reproduction of the herpes simplex virus. When applied to the skin with vesicles, it is not detected in the systemic bloodstream, but it quickly stops the reproduction of the virus and the exacerbation stops. The cream is applied every two hours for no more than four days in a row. Precautions and features of use are similar to the previous remedy.
A natural-based remedy (the active ingredient is purified potato shoot extract) can be used – Panavir gel for herpes on the lips during pregnancy. The bioactive substances contained in the extract have the ability to block the synthesis of viral DNA, thereby preventing its reproduction. The gel can be applied to the skin and mucous membranes in the areas of rashes. Five-fold treatment is performed daily for four or five days.
Any external preparation can cause local allergic reactions. When applying it, it is recommended to put on a glove on your hand, and after the procedure - wash your hands well.
The effectiveness of treatment is increased if it is started in the prodromal stage, when symptoms are just beginning to develop.
As soon as the blisters dry up and the final “scab-forming” stage begins, you can use softening and regenerating agents, for example, an oil solution of vitamins A and E (Aevit) or sea buckthorn oil.
Pain is relieved with Lidocaine gel or Benzocaine ointment.
During pregnancy, oral and parenteral antiviral drugs are not prescribed in most cases. In exceptional cases, when there is a risk of complications, they may be prescribed by a doctor.
In addition to antiviral drugs, hygienic lipsticks have antiherpes activity: Hygiene-herpes, lip balm against herpes and others, which have a natural (as manufacturers claim) composition and, according to reviews, are quite effective.
In addition to treatment, any pregnant woman, and one infected with the herpes virus in particular, should take care of her immunity. First of all, ensure a complete diet, including all the necessary products containing vitamins and microelements, and also take vitamin complexes intended for expectant mothers.
Physiotherapy can complement and even replace medication. The procedures should be prescribed by a doctor, since a pregnant woman, in addition to her condition, may have other contraindications to certain procedures. In the acute stage of herpes on the lips, ultraviolet irradiation of the area with rashes and infrared laser therapy can be prescribed.
Folk remedies
Traditional healers' recipes are certainly the safest for pregnant women. However, most doctors are skeptical about them. Official medicine does not recognize the treatment of herpes with traditional methods, and allows combining them with antiviral drugs as additional emollients and regenerating agents. And traditional remedies by themselves are considered ineffective. However, the pharmaceutical industry cannot offer a single remedy that destroys the herpes virus in the body. Therefore, you can try some of the traditional healers' recommendations, not forgetting about the possible intolerance of any of their ingredients.
Folk remedies will also be more effective if you start treatment at the first signs of exacerbation. It is recommended to frequently lubricate the lips with the following improvised means:
- beaten egg white;
- toothpaste;
- pharmaceutical tincture of propolis;
- cut a clove of garlic or an onion, rubbing the juice into the skin;
- sea buckthorn oil;
- juice from alder or aspen leaves, the above-ground part of wormwood;
- ointment made from yogurt and coffee (mix in ½ cup of yogurt, a spoonful of instant coffee, two cloves of garlic squeezed through a garlic press, a tablespoon of honey and flour).
You can apply grated apple, garlic or potato to the vesicles. Herbal treatment of herpes rashes is carried out persistently, it is recommended to apply the products to the affected areas as often as possible and until the skin is cleansed.
An ointment based on Vaseline is used with the addition of a teaspoon of freshly squeezed juice of calendula petals or sage infusion in the following proportions: a tablespoon of the herb is brewed for 20 minutes in 200 ml of boiling water, filtered. The infusion can not only be used to lubricate rashes, but also to rinse the mouth with herpetic stomatitis.
To strengthen the immune system and prevent rashes, it is recommended to take a mixture of walnuts and honey three times a day. It is infused for a month before taking in a cool, dark place.
Homeopathy
An alternative direction of medicine, using negligible doses of drugs that almost never have side effects, can also be very useful for herpes on the lips of pregnant women. Treatment with homeopathic drugs aims to activate the body's defenses and make it overcome the disease. Treatment regimens are always prescribed individually.
For herpes on the lips, Rhus toxicodendron, Acidum nitricum, Graphit, Apis mellifica, Atropa Belladonna, Mercurius solubilis are used. Homeopathic preparations should be prescribed by a specialist, then the effect will be obvious.
In pharmacies you can buy a special antiherpetic drug Herpes simplex-Nosode-Inyel. This drug is made from the herpes simplex virus in homeopathic dilutions. The so-called heteronosode drugs, psoriatic, syphilitic, gonorrheal, have long been successfully used in homeopathy. They are made from the tissues or secretions of a sick person or animal, which are sterilized during the manufacturing process and no longer contain pathogens. These drugs are not vaccines.
Herpes simplex-Nosode-Inyel has a strengthening immune system, cleansing and detoxifying effect. It is developed and used to treat herpes virus infection of any type and localization. There are no contraindications to it.
It is a solution in ampoules. It can be used in the form of injections or a drinking solution.
Injections are given intramuscularly, intradermally or subcutaneously. The contents of the ampoule can be drunk without dilution or dissolved in clean water (volume - 100 ml), drinking in small sips throughout the day at equal intervals.
Compatible with any medications.
It should be noted that as a result of taking this drug, an exacerbation of the disease often occurs. This is interpreted as a favorable signal that the immune system has been activated and has responded to the treatment. It will be more effective to use Herpes Simplex-Nosode-Inyel after a course of drainage of the body during the two or three weeks preceding treatment with Galium-Heel and/or Lymphomyosot.
In treatment regimens for patients infected with herpes, various drugs from the Heel series can be used: Aflubin, Anaferon, Arbidol, Immunal, Engystol and others.
Drugs
Prevention
When planning a pregnancy, it is a good idea for both future parents to get tested for antibodies to the herpes virus, even if they do not remember any flare-ups with rashes. At least if a pregnant woman gets herpes on her lip, she will know about her status.
Seropositive pregnant women should try to avoid exacerbations of the disease if possible, maintaining their immune system in the norm, not overcooling, being less nervous and not overdoing it with treatment with antiviral drugs without medical advice. Since antibodies in the body are formed only to the type of virus that the patient is infected with, and the article is about herpes on the lips, which is considered the safest, then infected persons should not forget about precautions.
Uninfected pregnant women should be even more careful about safety rules – personal hygiene, and also teach their partner to think the same. Herpes on his lips during your pregnancy can cause infection, and during oral sex – even a more dangerous genital form. Oral-genital contact with an infected partner in the last stages of pregnancy is considered especially risky.
Pregnant women should avoid kissing and other physical contact with girlfriends, friends, and even relatives, especially if they have any minor injuries on their lips. Wash your hands regularly when returning home and after touching shared items. Do not share lipstick, cigarettes, handkerchiefs, or other similar items with anyone. Do not drink from other people's cups and glasses.
For your information, the herpes virus lives on plastic for up to four hours, on damp fabrics - until they dry, on metal objects - up to two hours. At room temperature and normal air humidity, the herpes simplex virus can remain viable for a whole day, at frost up to -70℃ - five days. Half an hour at a temperature of 50℃ is enough for it to die.
If infection does occur, in principle, with normal immunity it does not pose a great danger.
Do not transfer the infection from the lips to the genitals and eyes. Control your actions, do not scratch the rash, do not touch it with dirty hands, do not pierce the vesicles and do not tear off the scabs. In addition to the risk of self-infection, there is a possibility of introducing a secondary infection.
If you become infected in the last weeks of pregnancy, you should not kiss your baby until the symptoms have completely disappeared. You should breastfeed him in a sterile protective bandage. It should be taken into account that it takes one and a half months for antibodies to appear in your blood and, therefore, in your breast milk.