Cold Sores Causes, Prevention, Symptoms And Treatment


A frequent viral illness is cold sores, often known as fever blisters. On and around the lips, they are small blisters filled with fluid. These blisters frequently occur in patches. A scab that might last several days develops when the blisters rupture. Cold sores often disappear without a scar after 2 to 3 weeks.

Cold sores can spread from one person to another by close physical contact, such as a kiss. Herpes simplex virus type 1 (HSV-1) and, less frequently, type 2 (HSV-2) are responsible for their development. Both of these viruses are transferred by oral intercourse and can harm the mouth or genitalia. Even if you can not see the sores, the infection can still spread.

Cold sores cannot be cured, although therapy can help control outbreaks.

Sores can heal faster with the use of prescription antiviral medications or lotions. Additionally, they could shorten, lessen the severity, and lessen the frequency of the next epidemics.


Certain strains of the herpes simplex virus (HSV) are responsible for causing cold sores. Typically, HSV-1 produces cold sores. The HSV-2 virus frequently causes genital herpes. However, any form can spread by intimate contact, such as kissing or oral sex, to the face or genitalia. HSV-1 can also be transferred by shared towels, razors, and dining utensils.

When you have oozing blisters, cold sores are most prone to spread. However, even if you do not have blisters, you can still spread the infection. Many individuals with the virus that causes cold sores never experience any symptoms.

Once you have experienced herpes, the virus can lurk in skin nerve cells and trigger another cold sore in the exact same location. Recurrence of Cold sores might be brought on by:

  • Fever or viral infection.
  • Hormonal changes, such as those brought on by a menstrual cycle.
  • Stress.
  • Fatigue.
  • Either the sun or the wind
  • Modifications to the immunological system.
  • Damage to the skin.

How to check if you have Cold Sores?

Cold sores often go away on their own without any medical intervention. Consult a medical professional if:

  • Your immune system is compromised.
  • Cold sores do not disappear after two weeks.
  • The signs are quite bad.
  • Cold sores frequently come back.
  • Your eyes are scratchy or hurt.

Risk Factors

Cold sores are a possibility for almost everyone. Even if they have never had symptoms, the majority of individuals have the virus that causes cold sores.

If you have a compromised immune system as a result of ailments or medications like those listed below:

  • Eczema due to atopic dermatitis.
  • Chemotherapy for cancer.
  • Medication that prevents organ rejection after a transplant.


A cold sore goes through the following stages:

Itching and tingling. Prior to a tiny, painful, hard patch appearing and blisters forming, many people experience itching, burning, or tingling around the lips for about a day.

Blisters. Along the lip's edge, small, fluid-filled blisters frequently develop. They can occasionally be seen within the mouth, on the cheeks, or around the nose.

Oozes and forms a crust. The tiny blisters might converge before bursting. A shallow open sore may result from this, which may leak and crust over.

Depending on whether this is your first outbreak or a recurrence, your symptoms will change. Cold sore symptoms may take up to 20 days to manifest after a person is initially exposed to the virus. The sores may persist for several

days. Additionally, the blisters may take two to three weeks to fully heal. When blisters do recur, they frequently do so at the same location and are not as bad as the initial outbreak.

During a first-time outbreak, you could also encounter:

  • Fever.
  • Aching gums.
  • Throat pain.
  • Headache.
  • Muscle pain.
  • Lymph nodes with swelling.

Cold sores in the mouth are common in children under the age of five. Canker sores are sometimes confused with these lesions. Canker sores are not caused by the herpes simplex virus and solely affect the mucosal membrane.


If you get cold sores more than nine times each year or if you have a high risk of developing significant consequences, your doctor may advise you to regularly take an antiviral medication. Apply sunscreen to the area where cold sores often appear if sunshine seems to exacerbate your illness. Or, before engaging in an activity that frequently results in a cold sore returning, discuss utilising an oral antiviral medication with your healthcare doctor.

Follow these recommendations to help prevent the transmission of cold sores to others:

  • Kissing and other skin-to-skin contact should be avoided while blisters are still open. When the blisters ooze fluid, the virus can spread more quickly.
  • Do not exchange things such as cutlery, towels, lip balm, and more.
  • Personal items could spread the infection if there are blisters.
  • Maintain a clean handshake. When you have a cold sore, wash your hands well before handling anyone, especially young children.


Without therapy, cold sores often heal in two to four weeks. Antiviral medications may be recommended by your doctor to hasten the healing process. Examples comprise:

  • Zovirax, or acyclovir.
  • Valtrex, or valacyclovir.
  • Famciclovir.
  • Denavir (Penciclovir).

Some of these items come in tablet form. Several times a day, you might apply lotions to the sores as an alternative. In general, tablets perform more effectively than creams. Some antiviral medications can be injected for infections that are really severe.

The docosanol (Abreva) cold sore ointment claims to speed up the healing process. Apply it to the afflicted skin as instructed on the packaging at the first indication of symptoms. When applying medication to a cold sore, use a cotton-tipped swab. This aids in limiting the lesions' ability to spread to other bodily regions.

To reduce the pain of a cold sore:

  • Consider additional cold sore treatments. Alcohol and other drying agents are used in certain over-the-counter medications, which may hasten the healing process.
  • Use creams and lip balms. Use a zinc oxide lotion or lip balm with sunscreen to shield your lips from the sun. Apply a moisturising lotion to your lips if they start to chap.
  • Construct a compress. An icy, moist towel might help with symptoms and assist in removing the crust. For pain relief, consider applying a warm towel to the blisters.
  • Try taking a nap and painkillers. If you have a fever or the cold sore is severe, take an over-the-counter pain reliever. Some pain relief may be provided by creams containing benzocaine or lidocaine.

Complications of Cold Sores

The virus that causes cold sores in some people can also affect other body areas, including:

Fingertips. The spread of HSV-1 and HSV-2 to the fingers is possible. Herpes whitlow is a common name for this kind of illness. The illness may spread from the mouth to the thumbs of kids who suck their thumbs.

Eyes. Sometimes the virus can invade the eyes. Recurrent infections may result in scarring and damage, which may impair vision or result in vision loss.

Extensive regions of skin. Atopic dermatitis, often known as eczema, is a skin disorder that increases a person's chance of developing cold sores all over their body. 

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Page last reviewed: May 25, 2023

Next review due: May 25, 2025

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