Cold sores are common blisters which can occur around the lips. Though there is no cure, monitoring of cold sore symptoms can help with which cold sore treatment option is best used.

What is a cold sore?

Cold sores are small blister like spots caused by a common viral infection called herpes simplex virus (HSV). They usually occur near the mouth, next to the lips however sometimes they may appear on the nose, chin or inside the mouth. They do clear up on their own within 2 weeks.

Cold sores are highly contagious and can spread with direct physical contact so skin to skin contact is best avoided. They are usually harmless however can be uncomfortable and socially unappealing.

The main cause of cold sores is herpes simplex infection and is transmitted through oral contact with an infected person. There are various other trigger factors which can reactivate the virus, leading to development of sores. Commonly its stress, fatigue, sunlight, hormonal changes and a weakened immune system.

Cold sore symptoms

Tingling/itching sensation – before the sore appears, individuals often feel a tingling/itchy sensation around the affected area.

Blisters – small, fluid filled blisters can occur alone or in clusters.

Ulcer – the blisters may open, forming ulcers/sores that can ooze fluid and develop crust.

Pain– cold sores can cause discomfort especially during eating and talking.

Symptoms vary depending on first outbreak or recurrence. The first episode of cold sore may begin showing symptoms up to 20 days after being exposed to the infection. The sores may last a few days and the blisters can take 2-3 weeks to heal completely. Often the recurrence of blisters would happen in the same spot.

Once infected, the virus remains in the body and can be reactivated by various triggers, leading to the development of cold sores.

Cold sore treatment

Although there is no cure for herpes simplex virus, several treatments can help alleviate symptoms and promote faster healing.

There are prescription antivirals such as Aciclovir, Valaciclovir and Famciclovir, which can reduce the severity and duration of cold sores when taken early in the cold sore outbreak. Some of these are available over the counter in small pack sizes. 

Over the counter antiviral creams can be applied to the affected area to reduce discomfort and promote healing. It should be used in the first few days of the tingling sensation or raised sore period before crusting of a blister occurs.

Applying a cool compress to the site and using lip balms and moisturizing agents to help treat cold sores. Individuals should refrain from touching a cold sore, and should ensure they wash their hands if they do.

Cold sore Prevention

If you suffer from frequent episodes of cold sores the doctor may prescribe regular antiviral medicine to limit serious complications. If sunlight is a trigger, applying sunblock to the spot can limit the cold sore from returning. 

To prevent spreading of the sores, individuals should avoid close contact with infected people, refrain from sharing personal items. Individuals should avoid physical contact while the blisters are present as the virus spreads more easily. This includes intimate activities like kissing and oral sexual activities. Sharing of towels, lip balm and other items should be limited. Hands should be washed regularly before touching the blister or other people, especially babies.

In the majority of people cold sores get better with over the counter treatments however for people with weak immune systems the cold sores can be severe and it can take longer for sores to heal. For any sore on eyes, hands, genitals or another part of the body, or for painful sores a healthcare professional should be consulted. 

Consult a doctor

Resources:

Cold sores: Diagnosis and treatment (aad.org)