A cold sore is a small fluid-filled blister or group of blisters that appear on the lips and around the mouth. Cold sores are also known as fever blisters, oral herpes or herpes labialis. Once the blisters break a crust forms resulting in a sore. Cold sores usually heal within a couple of weeks and do not leave a scar. Cold sores are viral infections caused by the herpes simplex virus (HSV). Cold sores are extremely common and typically are not serious, they are however highly contagious. After your first cold sore outbreak, your body should build antibodies and you may not have another infection again, but often many people get cold sores that are recurrent. The recurrence of a cold sore outbreak differs from person to person.
What Causes Cold Sores?
Cold sores are caused by certain strains of the herpes simplex virus (HSV). HSV-1 typically causes cold sores, while HSV-2 typically causes genital herpes. Either type of HSV can cause sores on the face or genitals. This virus is very common and contagious and spreads via saliva or close contact. It is often spread through kissing, sharing utensils, straws, towels, razors, or lip balm with someone who has a cold sore. Cold sores are most contagious when you have oozing blisters, but can be transmitted even if you don’t have blisters.
After you have been infected with the HSV-1 virus it never goes away. The virus remains inactive in a group of nerve cells in your face called the trigeminal ganglion. This inactive virus can be triggered, or activated, and can travel through your nerves to your lips to develop another cold sore. Each person affected with this virus may have different triggers and some people with HSV-1 may never develop a cold sore. Some common triggers include:
- Certain foods
- Sunburn or being in strong sunlight
- Dental work
- Hormonal changes, like those related to menstruation or pregnancy
Risk Factors and Complications of Cold Sores
People who have a weakened immune system may be at a higher risk of complications from the HSV and some medical conditions and treatments may increase your risk of complications, these include:
- Severe burns
- Cancer chemotherapy
- Anti-rejection drugs for organ transplants
In certain rare cases, the virus that causes cold sores can cause problems in other areas, including:
- Fingertips - HSV-1 and HSV-2 can be spread to the fingers, this is called herpes whitlow.
- Eyes - The virus can cause eye infections which can cause scarring and injury and may lead to vision problems, including blindness.
- Widespread areas of skin - people who have eczema are at high risk of cold sores spreading all over their body, called eczema herpeticum. This is extremely painful and can become a medical emergency
- Other organs - In people with weakened immune systems the virus can affect other organs like the spinal cord and brain
How do you know you have a cold sore?
Typical symptoms of a cold sore include a tingling sensation followed by redness, swelling, and blisters on or around your lips. Signs and symptoms vary from person to person depending on if it is your first outbreak or if it is a recurrence. Your cold sore may last several days and the sores may take up to 4 weeks to heal completely. Recurrences tend to appear in the same spot as the first time and are typically less severe. People may experience these symptoms with the first outbreak:
- Painful eroded gums
- Sore throat
- Muscle aches
- Swollen lymph nodes
Cold Sore Diagnosis &Treatment
A doctor can typically diagnose a cold sore just by looking at the infected area, they can also take a swab of the blister and test the fluid for HSV.
There is no cure for cold sores, and once you have the virus it stays in your body. It can take some time for a cold sore to heal, but there are some medications that can shorten the healing time and help the symptoms to be less painful. Common cold sore treatments include:
- Over-the-counter medications - there are many creams and ointments you can apply directly to the cold sore. If you start applying the creams at the first sign of a cold sore, tingling/itching, or before the sore forms you may be able to prevent the cold sore from appearing.
- Oral antiviral medication - this medication requires a prescription from your doctor and is taken by mouth. This medications could include acyclovir (Sitavig, Zovirax), famciclovir (Famvir), or valacyclovir (Valtrex)
- IV antiviral medication - in severe cases you may need medicine injected into your bloodstream, such as cidofovir (Vistide) or foscarnet (Foscavir).
To get relief from the uncomfortable symptoms of a cold sore try:
- Taking pain relievers - like acetaminophen and ibuprofen, or use creams with benzocaine or lidocaine to help ease the pain
- Wear sunscreen and SPF lip balm
- Avoid acidic foods - like tomatoes, oranges, etc
- Apply a cold compress - this can soothe a cold sore and reduce redness
Where to get treatment for Cold Sores Online
- Carie Health
- Blink Health
- Alpha Medical
Ways to Prevent Cold Sores
To reduce your risk of a future cold sore outbreak follow these steps:
According to the WHO “around 67% of the world’s population aged 0-49 had HSV-1 infection in 2016 - an estimated 3.7 billion people.” Having a cold sore caused by the virus HSV-1 is extremely common and symptoms are easily treatable. You can even receive diagnosis and treatment for your cold sore without ever having to leave your home. Through the use of telemedicine companies, you have access to hundreds of reputable doctors that can treat you for a number of medical conditions, including cold sores, all with a video visit using a phone or computer. We know that cold sores can be terribly uncomfortable, so we have created our list of the top online doctors who can treat your cold sore, check it out today.
- Get enough sleep
- Wear lip balm with sunscreen
- Avoid kissing or intimate contact with someone who has a cold sore
- Avoid sharing towels, razors, dishes, silverware, straws, and lip balm
- Wash your hands before touching your lips, eyes, or genitals
- Stay healthy, a fever could trigger a cold sore outbreak