Know the basics
What are cold sores?
Cold sores or fever blisters are caused by a herpes simplex virus (HSV-1). Cold sores are contagious, which mean they can spread from person to person through close contact such as kissing, oral sex. They are red, fluid-filled blisters that form near the mouth or on other areas of the face with patches.
Cold sores can also occur around the nose or on the cheeks. They may persist for two weeks or longer.
A cold sore goes through five stages:
- Stage one: tingling and itching occurs about 24 hours before blisters erupt.
- Stage two: fluid-filled blisters appear.
- Stage three: the blisters burst, ooze, and form painful sores.
- Stage four: the sores dry out and scab over causing itching and cracking.
- Stage five: the scab falls off and the cold sore heals.
How common is cold sores?
Cold sores are extremely common. It can affect patients at any age. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.
Know the symptoms
What are the symptoms of cold sores?
The common symptoms of cold sores are
- Tingling and itching sensation around the infected location for a day before a small, painful spot appears and blisters erupt – the cold sores, sometimes you might not know that is the first sign of cold sores.
- Small fluid-filled blisters at the outside edge of the lips. It could rarely appear on the fingers, nose, inside the mouth.
- Oozing and crusting. The small blisters may merge and then burst, leaving shallow open sores that will ooze fluid and then crust over.
- A sore throat.
- Painful eroded gums.
- Swollen lymph nodes.
- Muscle aches.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
You should contact your doctor if you have any of the following:
- Over 14 days getting cold sores;
- Severe symptoms;
- Having a weakened immune system;
- Recurrent cold sores;
- Irritated eyes.
Know the causes
What causes cold sores?
The herpes simplex type 1 virus (HSV-1) usually causes cold sores, and the herpes simplex type 2 virus (HSV-2) usually cause genital herpes. You can get the herpes simplex virus by coming in contact with infected individuals through kissing, sharing personal care items such as toothbrushes and razors, or sharing foods or drinks. Oral sex may spread to both cold sores and genital herpes. You can get the virus if you touch the saliva of someone who has the virus, even if there are no visible blisters or the fluid of a cold sore.
Your first cold sore may not appear for up to 20 days after you contract the herpes simplex virus. Once you’ve had an episode of herpes infection, the virus lies dormant in nerve cells in your skin and may emerge as another cold sore at the same place as before.
Know the risk factors
What increases my risk for cold sores?
There are many risk factors for cold sores, such as:
- Having weakened immune systems;
- Viral infection or fever;
- Changes in the immune system and hormone;
- Severe burns;
- Cancer chemotherapy;
- Anti-rejection drugs for organ transplants;
- Dental work.
Understand the diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How are cold sores diagnosed?
A visual exam will be done by your doctor. To make sure they are cold sores, the blister will be tested in a laboratory.
How are cold sores treated?
Commonly, cold sores disappear without treatment in two to four weeks. There are many antiviral drugs may speed the healing process:
- Acyclovir (Xerese, Zovirax);
- Valacyclovir (Valtrex);
- Famciclovir (Famvir);
- Penciclovir (Denavir).
Some ointments and creams such as penciclovir, docosanol may able to control pain and promote healing. These typical treatments need to apply at the first signs of a sore appear at many times a day. In general, the pills work better than the creams. For very severe infections, some antiviral drugs can be given with an injection.
Lifestyle changes & Home remedies
What are some lifestyle changes or home remedies that can help me manage cold sores?
The following lifestyles and home remedies might help you cope with cold sores:
- Apply a cold sore ointment. Docosanol (Abreva) is an over-the-counter cream for cold sores. It must be applied frequently and may shorten an outbreak by a few hours or a day.
- Try other cold sore remedies. Some over-the-counter preparations contain a drying agent, such as alcohol, that may speed healing.
- Using lip balms and cream contain zinc oxide or moisturizing elements to protect your lips from the sun and dryness.
- Apply a cool compress. A cool, damp cloth may reduce redness, help remove crusts and promote healing.
- Apply pain-relieving creams. Over-the-counter creams with lidocaine or benzocaine may offer some pain relief.
- Avoid kissing anyone who has a cold sore, and does not perform oral sex on anyone who has active genital herpes.
- Taking lysine supplements on a regular basis is associated with less frequent outbreaks for some people.
- Aloe vera, the cooling gel found inside the leaves of the aloe plant, may bring cold sore relief. Apply aloe vera gel or aloe vera lip balm to a cold sore three times a day.
- A petroleum jelly such as Vaseline won’t necessarily heal a cold sore, but it may ease discomfort. The jelly helps prevent cracking. It also serves as a protective barrier against outside irritants.
- Witch hazel is a natural astringent that may help dry out and heal cold sores. Even so, the verdict is still out on whether cold sores heal faster if they’re kept moist or dry.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Review Date: October 3, 2016 | Last Modified: September 13, 2019
Cold sores. http://www.healthline.com/health/herpes-labialis#Overview1. Accessed September 18,2016.
Cold sores. http://www.mayoclinic.org/diseases-conditions/cold-sore/basics/lifestyle-home-remedies/con-20021310. Accessed September 18,2016.