Common condition
Cold sores or fever blisters are a common viral infection that presents as tiny, fluid-filled blisters. These blisters form near the mouth and on other areas of the face. In some cases, cold sores can appear inside the mouth, on the fingers, or nose. Cold sores are caused by the herpes simplex virus and are highly contagious. There is no cure for cold sores, but treatments are available to help manage symptoms of flare-ups.
What are Cold Sores, and what causes them?
Cold sores or fever blisters are a common viral infection caused by the herpes simplex virus (HSV). The strain Herpes simplex virus 1 is the most common strain that causes cold sores.
In rare cases, cold sores can be caused by the Herpes simplex virus 2. These cold sores present as red, fluid-filled blisters that develop near the mouth or on other areas of the face.
The blisters or sores usually last for around 7 to 10 days and usually clear up without treatment. These sores are highly contagious and transmitted through direct contact, such as sharing cutlery, kissing, sharing lipstick or lip balm, or sharing mugs.
Once you contract the HSV-1 strain, it then lies dormant in the body until an outbreak is triggered. Some people may experience frequent outbreaks of cold sores, while some people may go years without getting an outbreak.
Factors that can trigger an outbreak include:
- Stress
- A low immune system (due to an infection, illness, or underlying condition)
- Fever
- Hormonal changes during pregnancy or menstruation
- Sunburn
- Fatigue or tiredness
- Injury to the lips or mouth
Cold sores can also occur randomly without any triggering factor. Cold sores are highly contagious from the moment you feel symptoms presenting until it has completely healed.
In some cases, cold sores can result in complications that affect other areas of the body. People with eczema may be at a high risk of spreading cold sores across the body. The HSV can also cause an eye infection, which may cause injury or scarring. Both HSV-1 and HSV-2 strains can spread to the fingers.
Signs and symptoms associated with cold sores
Cold sores, for many people, will present with more severe symptoms the first time. A cold sore typically passes through multiple stages:
- The first stage of a cold sore is a burning, tingling, or itching sensation on or around the lips. These sensations occur 12-24 hours before the sore develops.
- The area on the lips or around the mouth becomes swollen, red, and painful as the sore forms.
- Over the next 2-3 days, the sore ruptures and oozes fluid. This fluid is either clear or slightly yellow. This stage is often called the “weeping phase.”
- Roughly 4-5 days after the cold sores appear, it drys, crusts, and scabs over. The scabbing may crack or bleed as it heals.
- The scab then falls off. The skin under the scab may be pink or reddish for a few days. A cold sore typically takes 1-2 weeks to heal completely.
You may experience the following symptoms in a first-time outbreak:
- Painful gums
- Swollen lymph nodes
- Fever
- Sore throat
- Muscle aches
- Headache
Children under the age of 5 may develop cold sores on the inside of their mouths. The sores are often mistaken for canker sores. The herpes simplex virus does not cause canker sores.
When to see a doctor
Colds sores usually clear up without treatment; however, see your doctor if:
- You have frequent outbreaks of cold sores
- You have severe symptoms
- You have a weekend immune system
- You experience irritation in your eyes
- Your cold sores do not heal within two weeks
Diagnosis
Cold sores can usually be self-diagnosed, especially if you have previously had them. You can go to your doctor for a diagnosis if you would like.
Treatment
There is no cure for cold sores, but there are multiple treatment options to help manage symptoms that may present.
Treatment and management options include:
- Ointments and creams. Antiviral cream such as Aciclovir 5% cream is a first-line treatment for reoccurring outbreaks of cold sores. It is important to use cold sore cream treatments as soon as the first stage of cold sores occurs. This can speed up healing and, in some cases, prevent further outbreaks. Antiviral cold sore creams are normally applied up to five times a day for nine days.
- Medications. Oral antiviral medications, such as famciclovir, acyclovir, and valacyclovir, are used to treat cold sores. These medications are only available by prescription. If you are experiencing complications or persistent cold sores, your doctor may prescribe antiviral medication to take regularly.
- Home remedies. Home remedies such as lysine supplements, aloe vera, petroleum jelly, and witch hazel can be used to ease symptoms and promote the healing of cold sores. Cold sore patches can also be purchased to protect the skin while it heals.
General tips for the treatment of cold sores:
- Do not share your cold sore cream with other people.
- To prevent your lips from becoming dry and cracking, ensure that your stay hydrated.
- Use an antiseptic mouthwash a couple of times a day if brushing your teeth is too painful.
- Try to avoid foods such as acidic or salty foods that may irritate the cold sore.
- Rather than rubbing in cold sore cream, try dab it and let it soak in.
- Wash your hands thoroughly if you touch your cold sore or the areas surrounding it.
Prevention
You can minimize the spread of cold sores by:
- Avoid kissing or having oral sex while you or a partner has a cold sore. Completely healed sores are no longer contagious.
- Avoid touching the cold sore and the surrounding areas.
- Do not share your cold sore cream with anyone else.
- Do not share any items that come into contact with your cold sore or the area around it.
- Make sure you wash your hand thoroughly if your touch your cold sore.
- If you have a cold sore, be especially careful around those that may have a low immune system.
Outbreaks of cold sores may be triggered by exposure to factors that are specific to the individuals. You can reduce the number of cold sore outbreaks by identifying these triggers and avoiding them.
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