Monkeypox Mouth Sores | What They Look Like & Treatment

Doctor checking patient's mouth for monkeypox

With news spreading about increased monkeypox cases popping up around the globe, it’s important to separate fact from fiction when it comes to how monkeypox is transmitted, who is most likely to get it, and what the warning signs are. For some, mouth and throat sores related to monkeypox infections have served as one of the warning signs that the disease is spreading in their community.[1] Are mouth and throat sores related to monkeypox, and if so, what should you look for?

What is Monkeypox?

The monkeypox virus was first discovered in a Denmark laboratory in 1958. The reason for the name is because the virus was isolated in infected monkeys, but that does not mean it is monkeys that are responsible for spreading the infection. Researchers actually think that monkeypox may originate in rodents, although it hasn’t been proven just yet.[2]

The World Health Organization declared the monkeypox outbreak a public health emergency on July 23, 2022, and the United States administration followed with a public health emergency declaration on August 4, 2022.

As far as monkeypox symptoms, mouth sores are just the tip of the iceberg. Monkeypox is a type of DNA virus known as an “orthopox” virus, similar to smallpox.[3]

The sores caused by monkeypox mimic other types of rashes like smallpox and chickenpox. The good news is that experts believe it is more difficult to transmit monkeypox than similar types of viruses.[4] The New England Journal of Medicine noted that of recent monkeypox cases in early 2022, 98% of known cases in 16 different countries were specifically found to impact men who have sex with men. However, that does NOT specifically mean that only those individuals can contract the virus, as it’s also been found in children and women. Some West African countries originally thought it was limited to children only.[5]

Monkeypox is NOT a sexually transmitted infection (STI) and does NOT spread exclusively among gay men.

Monkeypox typically has an incubation period between 1-2 weeks, but it can take up to three weeks for monkeypox symptoms to become evident. The infection usually causes blisters and sores across the skin, crusting and scabs over the open wounds, and swollen lymph nodes.

The good news is that the chances of dying from monkeypox are extremely low. The bad news is that the lesions or blisters caused by the virus are extremely painful and debilitating for people who are infected. All of that said, there have been some deadlier strains of the virus that are thought to have possibly killed hundreds of people in the Congo, but it is relatively less dangerous than the present COVID-19 pandemic.

Unfortunately, the virus is spreading so quickly that places like New York and California have declared a state of emergency. [6]

Monkeypox Mouth Sores Symptoms

For some people, mouth sores can accompany lesions across the face, groin, and rest of the body. Some medical doctors have even noted that the symptoms look a bit like chickenpox. The clinical monkeypox symptoms can make it difficult to diagnose, so samples are usually sent to a pathology lab for a firm diagnosis.[7]

Because the monkeypox virus can spread through mucosal surfaces—which includes your mouth—throat sores could be an indication that a viral condition is present. In addition to mouth and throat sores from monkeypox, other symptoms include nausea and vomiting, reduced appetite, swollen lymph nodes, and sores elsewhere on the body (particularly around the genitals.)[8]

What Do Monkeypox Mouth Sores Look Like?

Mouth sores associated with monkeypox have been noted as large “sores”, likely resembling ulcers or the pustules on other body parts associated with the monkeypox virus. In most cases, monkeypox mouth sores are not the only symptom of an infection. There will typically be other warning signs such as swollen lymph nodes, body aches, headaches, fever, respiratory illness, flu-like symptoms and most notably, a rash around the genitals. These monkeypox rashes typically create large, painful blisters that may scab over, so it isn’t unlikely that similar mouth blisters or throat sores accompany the infection. [9]

via The New England Journal of Medicine

Understanding how monkeypox is transmitted makes it especially important to avoid kissing, oral sex, or being intimate with someone if you or your partner has active mouth or throat sores.

Should You Be Concerned About Monkeypox If You Have Mouth Sores?

According to the CDC, most people with monkeypox will get a rash of some sort, but not particularly mouth sores, per se. So if you develop mouth or throat sores but have no other symptoms or suspected exposure to monkeypox, you probably aren’t infected with the virus. It might be something else, like a herpetic gingivostomatitis flare-up.[10]

However, if you are exhibiting other symptoms of monkeypox and—given what we know about how monkeypox is transmitted—you have an intimate partner who has lesions in their mouth or around their groin area, it could hypothetically be monkeypox.

Although monkeypox is not a sexually transmitted disease, doctors do know that certain “high risk” lifestyles—such as having multiple sexual partners or being with someone who does—raise the chances of contracting monkeypox. The World Health Organization and CDC (centers for disease control and prevention) are still studying whether it can be spread through respiratory droplets or bodily fluids. 

Treatment For Monkeypox Mouth Sores

So far, treatment for monkeypox mouth and throat sores symptoms include: 

If you notice, these treatments are strictly for analgesic (pain relief) purposes rather than actually reversing the presence of mouth sores. As of yet, there are no treatments for the monkeypox virus. But individuals who have compromised immune systems may be given antiviral medication by their physician.

How Long Do Monkeypox Mouth Sores Last?

Although what we know about monkeypox is still limited, research shows that the active infection usually lasts somewhere between 2-4 weeks. Mouth and throat sores related to monkeypox may not develop for as long as three weeks after exposure.

Because oral blisters can allow for viral transmission to other people, it’s important to avoid close contact with others and wear a mask until you can see a healthcare provider. Face-to-face contact, kissing, and being intimate with someone else can spread mouth and throat sores related to monkeypox. It’s even thought that coming into contact with something else—like sheets or clothes—that have been in contact with someone who has monkeypox can allow the virus to spread.

When To Get Tested For Monkeypox 

If you suspect you have been exposed to monkeypox or have monkeypox mouth sores symptoms, it’s important to follow CDC recommendations by seeing a medical professional or health department for appropriate testing. Although many small medical clinics or neighborhood hospitals do not have access to monkeypox tests, they can take samples and send them to the county or district health department if they feel you are exhibiting classic warning signs, especially if you have been around someone with monkeypox or traveled to an area where cases are high.

In communities where monkeypox cases are on the rise, more robust testing is available, made possible through public health departments that are funded by the government. 

If you have recently traveled to California, New York, or Illinois, have multiple sexual partners, or are a homosexual man, and are experiencing monkeypox mouth sore symptoms, you should isolate and speak to a medical professional at your earliest opportunity.