Key takeaways:
Herpes blisters can develop in the back of the throat. This is called herpes pharyngitis.
Herpes esophagitis is a condition where herpes blisters and ulcers develop inside the esophagus, which is the tube that connects the mouth to the stomach.
Antiviral medication can help blisters in the throat and esophagus heal faster.
The herpes simplex virus (HSV) causes painful blisters or sores in and around the mouth and the genitals.
Most people think of cold sores when they picture oral herpes because it causes blisters around the lips. But it can also cause ulcers inside the mouth, on the tongue, and in the back of the throat. Herpes can also cause sores inside the esophagus (the tube that connects the mouth to the stomach).
Can you get herpes in your throat?
Yes, you can get herpes in your throat. Throat herpes can describe either herpes pharyngitis (herpes sores in the back of the throat) or herpes esophagitis (herpes sores in the esophagus).
Search and compare options
Throat herpes is painful and can make it difficult to eat and drink, which can lead to dehydration. People experiencing throat herpes often need treatment to help them stay hydrated and comfortable. Here’s what to know to expect if you’re experiencing throat herpes.
How common is throat herpes?
Herpes pharyngitis and herpes esophagitis can both be considered throat herpes, but they’re very different. Herpes pharyngitis is more common than herpes esophagitis.
Herpes pharyngitis
Herpes pharyngitis is common among both children and adults. People typically develop herpes pharyngitis the first time they have an oral herpes outbreak.
Usually, the first herpes outbreak is the most severe. During the first outbreak, people have more blisters, and those blisters take longer to heal. People may experience blisters in and around their mouth, gums, tongue, and the back of their throat.
But future outbreaks are typically less severe. That means people don’t develop as many blisters, and those blisters go away faster. Most people only develop cold sores around the mouth, if they develop any symptoms at all.
Most people won’t develop herpes pharyngitis more than once in their lifetime.
Herpes esophagitis
Herpes esophagitis tends to develop when people have a weakened immune system.
You may have a weakened immune system if you:
Received a bone marrow or organ transplant
Take medications that lower your immune function, like chemotherapy, steroids, and immunosuppressants
Have a medical condition that can affect how well your immune system functions
It’s possible to develop herpes esophagitis if you don’t have a weakened immune system. But this isn’t common.
What causes herpes in the throat?
Throat herpes can develop when you have an oral herpes outbreak. In these cases, the infection spreads from the mouth. It can also develop without oral herpes. This is because the herpes virus lives dormant (inactive) in nerves. When the virus wakes up (“reactivates”), it can cause an outbreak.
Herpes esophagitis is usually due to HSV-1, the virus that typically causes oral herpes. Some cases of HSV-2 herpes esophagitis have been reported, but they’re rare. HSV-2 typically causes genital herpes.
Herpes pharyngitis can be due to either HSV-1 or HSV-2, but HSV-1 is more common.
What are the symptoms of herpes in the throat?
Common symptoms of throat herpes include:
Sore throat
Pain with swallowing
Trouble eating and drinking
Swollen neck lymph nodes
Fever
You may also notice herpes sores or blisters on your lips, gums, and tongue. If you have herpes pharyngitis, you may be able to see the sores in the back of your throat if you say “ah” while looking in a mirror.
Herpes esophagitis can cause additional symptoms like:
Chest pain in the middle of your chest
Heartburn
Pain in your upper abdomen
Nausea
You can’t see herpes esophagitis on your own.
How is herpes in the throat diagnosed?
Herpes pharyngitis is often accompanied by oral herpes sores, which makes diagnosis easier. A throat swab can help rule out other causes of a sore throat, such as strep throat. It can also detect herpes virus, with specific lab testing.
Herpes esophagitis is diagnosed with an upper endoscopy (EGD). During this procedure, a healthcare professional uses a small camera to look at the esophagus, stomach, and first part of the small intestine. Herpes esophagitis looks like small ulcers in the lower part of the esophagus. Biopsies of the ulcers can be tested for the HSV virus, which helps confirm the diagnosis.
How do you treat throat herpes?
There’s no cure for herpes. But throat herpes can heal without treatment. It can take up to 14 days for throat herpes to go away on its own. It can take even longer if you have a weakened immune system.
During that time, people can experience a lot of pain. They may also stop eating and drinking because of pain. This can lead to dehydration. People may also stop taking their medications, which can lead to other health problems.
That’s why most people receive treatment for throat herpes. Antiviral treatment will speed up healing time for both herpes pharyngitis and herpes esophagitis.
Antiviral treatment options include:
If you’re dehydrated or can’t eat or drink at home, you may need to be treated in a hospital. You can receive hydration, nutrition, and antiviral medication intravenously (through a vein). When the blisters start to heal, you can complete treatment at home with antiviral medications by mouth.
When should you get care for herpes in the throat?
It’s best to get care within 48 hours if you think you have throat herpes. Antiviral medications work best if they’re started within 48 hours of when symptoms or blisters first appear.
But get medical care immediately if you think you have throat herpes and you have a weakened immune system. Children and infants should also be seen by a medical professional right away.
You should also get care urgently if you have symptoms of dehydration like:
Extreme thirst
Dizziness
Confusion
Exhaustion
Dry, cracked skin
Sunken eyes
Dark urine
Making less urine
Fast heart rate
Frequently asked questions
Yes, it’s common to get a headache due to herpes. This is especially true of the first outbreak, when you can experience headache, body aches, and fever.
Yes, herpes can spread through kissing. As mentioned above, once you have oral herpes, it can also affect your throat.
Yes, it’s common to get a headache due to herpes. This is especially true of the first outbreak, when you can experience headache, body aches, and fever.
Yes, herpes can spread through kissing. As mentioned above, once you have oral herpes, it can also affect your throat.
The bottom line
Herpes in the throat can cause a sore throat and painful swallowing. Throat herpes makes it hard to eat and drink and can lead to dehydration. You’re at a higher risk of getting herpes in the esophagus if your immune system is weakened. Throat herpes can be treated with medication to make it go away faster. But you’ll need to start medication within 48 hours of symptoms first appearing to fully benefit from the medication. Get immediate care if you have a weakened immune system and symptoms of throat herpes.
Why trust our experts?
References
Arnold, J. C., et al. (2018). Pharyngitis. Principles and Practice of Pediatric Infectious Diseases.
Bordea, M.A., et al. (2020). Infectious esophagitis in Romanian children: From etiology and risk factors to clinical characteristics and endoscopic features. Journal of Clinical Medicine.
Hoversten, P., et al. (2019). Variations in the clinical course of patients with herpes simplex virus esophagitis based on immunocompetence and presence of underlying esophageal disease. Digestive Diseases & Science.
Shah, R., et al. (2023). Herpes simplex virus esophagitis in an immunocompetent patient. Cureus.
Zheng, T., et al. (2024). Association between human herpes simplex virus and severe headache or migraine among aged 20–49 years: A cross-sectional study. Frontiers in Neurology.
