What are cold sores?
Cold sores, sometimes called fever blisters, are groups of small blisters on the lip and around the mouth. The skin around the blisters is often red, swollen, and sore. The blisters may break open, leak a clear fluid, and then scab over after a few days. They usually heal after several days to 2 weeks. See a picture of cold sores
What causes cold sores?
Cold sores are caused by the herpes simplex virus (HSV). There are two types of herpes simplex virus: HSV-1 and HSV-2. Both virus types can cause lip and mouth sores and genital herpes. The herpes simplex virus usually enters the body through a break in the skin around or inside the mouth. It is usually spread when a person touches a cold sore or touches infected fluid-such as from sharing eating utensils or razors, kissing an infected person, or touching that person's saliva. A parent who has a cold sore often spreads the infection to his or her child in this way. Cold sores can also be spread to other areas of the body.
The first symptoms of cold sores may include pain around your mouth and on your lips, a fever, a sore throat, or swollen glands in your neck or other parts of the body. Small children sometimes drool before cold sores appear. After the blisters appear, the cold sores usually break open, leak a clear fluid, and then crust over and disappear after several days to 2 weeks. For some people, cold sores can be very painful. Some people have the virus but don't get cold sores. They have no symptoms. How are cold sores diagnosed? Your doctor can tell if you have cold sores by asking you questions to find out whether you have come into contact with the virus and by examining you. You probably won't need any tests.
How are cold sores treated?
Cold sores will usually start to heal on their own within a few days. But if they cause pain or make you feel embarrassed, they can be treated. Treatment may include skin creams, ointments, or sometimes pills. Treatment may get rid of the cold sores only 1 to 2 days faster, but it can also help ease painful blisters or other uncomfortable symptoms.
The herpes simplex virus that causes cold sores cannot be cured. After you get infected, the virus stays in your body for the rest of your life. If you get cold sores often, treatment can reduce the number of cold sores you get and how severe they are.
The virus that causes cold sores is common. Most people have been infected with this virus (herpes simplex virus, or HSV) by the time they reach adulthood. Although most people have been exposed to HSV, only about 20% to 40% develop recurring cold sores. After a person becomes infected, the virus remains inactive in the body until it is triggered by something such as sunlight exposure or stress. When active, the virus results in a cold sore outbreak
How can you prevent cold sores?
- There are some things you can do to keep from getting the herpes simplex virus.
- Avoid coming into contact with infected body fluids, such as kissing an infected person.
- Avoid sharing eating utensils, drinking cups, or other items that a person with a cold sore may have used.
- After you have been infected with the virus, there is no sure way to prevent more cold sores. But there are some things you can do to reduce your number of outbreaks and prevent spreading the virus.
- Avoid the things that trigger your cold sores, such as stress and colds or the flu.
- Always use lip balm and sunscreen on your face. Too much sunlight can cause cold sores to flare.
- Avoid sharing towels, razors, silverware, toothbrushes, or other objects that a person with a cold sore may have used.
- When you have a cold sore, make sure to wash your hands often, and try not to touch your sore. This can help keep you from spreading the virus to your eyes or genital area or to other people.
- Talk to your doctor if you get cold sores often.
You may be able to take prescription pills to prevent cold sore outbreaks. There is no cure for cold sores, nor is there a cure for the herpes simplex virus (HSV) that causes them. Most cold sores will go away on their own. But medicines may slightly reduce the duration of cold sores and sometimes prevent a future outbreak.
Treatment with medicines depends on whether you are having a first outbreak or a recurrent outbreak or are trying to prevent future outbreaks. When treating a first outbreak of cold sores, oral antiviral medications may reduce pain and slightly improve healing time.
For treatment of recurrent cold sores, the following medicines may reduce the severity and duration of the outbreak:
- Topical creams or ointments, which are available with or without a prescription, can reduce pain, itching, and healing time.
- Oral antiviral medications, which are available by prescription only, may be used when the first symptoms (such as burning or itching) develop. These medicines have little effect once the sore develops.
- Oral antivirals may also be taken daily to prevent recurring cold sores, especially in people who have frequent and painful outbreaks.
If you have a weakened immune system and develop cold sores, you may need higher doses of these medicines to control your symptoms or daily doses to prevent outbreaks. Although it is rare, children and adults with weakened immune systems may also need to take antibiotics during severe episodes of cold sores to treat bacterial infections that may develop.
The first episode of cold sores can be so painful that you may have difficulty eating, drinking, and sleeping. A child who has a fever and many mouth sores may need to be encouraged to drink water and other fluids to prevent dehydration. Adults and older children who have a painful first episode of cold sores may sometimes need a prescription-strength medicated mouth rinse to reduce pain.
No complementary medicines have been proved through scientific studies to be effective in the treatment or prevention of cold sores. But several complementary treatments are available if you wish to try an alternative way to ease your symptoms. Vitamin C, lysine supplements, and lemon balm are examples of complementary treatments that may provide some relief during a cold sore outbreak. One study showed that zinc oxide/glycine topical cream reduced the duration of an outbreak.