A health condition that causes small fluid-filled blisters on and near the lips is called cold sores (also known as fever blisters). The blisters caused by this condition usually are grouped together in patches. Thereafter, the blisters break and scabs form that last a few days. In most cases, cold sores heal within 2-3 weeks without scars.
This condition can spread from one person to another through close contact (including kissing). It commonly happens due to herpes simplex virus type 1 (HSV-1) and less commonly due to herpes simplex virus type 2 (HSV-2). However, both viruses may negatively affect the mouth or genitals and can spread among people through oral sex. Moreover, HSV-1 and HSV-2 may spread to other people even if sores are not seen.
Unfortunately, there is no way to cure the condition but with proper treatment, you can reduce the symptoms and improve your quality of life. Healthcare professionals often prescribe creams and antiviral medicines to heal sores more quickly.
Symptoms
Commonly, cold sores go through a few stages. Check below some examples:
- Itching and tingling – Approximately all people with this condition experience itching, burning, or tingling around the lips.
- Blisters – In most cases, blisters appear along the lips border but sometimes may appear around the nose, cheeks, or inside the mouth.
- Oozing and crusting – Commonly, the tiny blisters merge and then burst causing open sores that ooze and crust over.
The symptoms usually appear differently among people depending on the first recurrence or outbreak. The symptoms may not appear for up to 20 days if you have cold sores for the first time. Thereafter, the sores may last a few days but a complete recovery may take 2-3 weeks. Furthermore, if you experience cold sores again at the same spot each day it tends to be less severe than the first time. Check below some symptoms that usually appear during the first outbreak:
- Painful gums
- Muscle aches
- Swollen lymph nodes
- Sore throat
- Fever
- Headaches
Sometimes, children under 5 years old may have cold sores inside the mouth that are usually mistaken for canker sores (a health condition that involves the mucous membrane only and is not caused by herpes simplex virus).
It is advised to see a doctor if any of the following cases occur. For example:
- Weakened immune system
- Cold sores that do not heal more than 2 weeks
- Severe symptoms
- Frequent recurrence of cold sores
- Eye pain
Causes
This condition usually occurs due to certain strains of the herpes simplex virus (HSV). While HSV-1 commonly causes cold sores, HSV-2 frequently causes genital herpes. In any case, both viruses can spread to the face or genital through close contact (including oral sex and kissing). In case you are sharing your utensils, razors, and towels also may get HSV-1.
There is an increased risk of HSV spreading if you have oozing blisters but the virus may infect other people even if you do not have blisters. Moreover, most people with cold sores never develop symptoms.
Once you get infected with this virus, it hides in the nerve cells in the skin, which may cause recurrent cold sores. Usually, it returns due to the following conditions and factors. For example:
- Stress
- Fatigue (extreme tiredness)
- Hormonal changes (especially during a menstrual period)
- Viral infection
- Fever
- Being in the sun or wind for a prolonged time
- Immune system changes
- Skin injuries
Risk Factors
Approximately everyone is at risk of developing cold sores. Mostly, adults carry the virus that leads to this condition and usually never develop symptoms. Check below some factors that put you at higher risk of developing cold sores.
- Eczema (atopic dermatitis)
- Cancer chemotherapy
- Weakened immune system
- Medicines to prevent organ transplant rejection
- HIV/AIDS
What Are The Possible Complications of Cold Sores?
Sometimes, this condition may cause problems in other body parts. Examples include:
- Fingertips – This type of infection is usually called herpes whitlow and it may occur in children who suck their thumbs. Furthermore, both viruses (HSV-1 and HSV-2) may spread to the fingers.
- Eyes – In some cases, the virus may spread to the eye causing infection. Recurrent infections may lead to injuries and scarring of the eye, which often leads to vision problems or even blindness.
- Other skin areas – Those who have eczema (atopic dermatitis) are at increased risk of spreading cold sores throughout the body. This is a medical emergency and you should go to the nearest emergency room or call 911 once it happens.
How to Prevent Cold Sores?
In some cases, physicians may prescribe antiviral medications on a regular basis if you experience cold sores more than 9 times per year. In such cases, you are at higher risk of developing complications. Some people may experience cold sores due to the sunlight, and you should apply sunblock everywhere the cold sores may appear. Check below some tips that help prevent the spreading of the condition:
- Avoid kissing and close contact with people who have blisters because the virus can spread more easily to other people when the blisters leak fluid.
- Do not share your items including towels, utensils, lip balm, and others.
- Regularly wash your hands with soap and water or use hand sanitizer, especially before touching babies.
Diagnosis
Commonly, a physical examination is usually enough to diagnose cold sores. However, sometimes, to confirm the condition doctors may take a sample of blister and send it to the laboratory for testing.
Treatment
Usually, cold sores go away on their own without treatment in 14-30 days. However, physicians may prescribe some antiviral medicines to speed the healing. For example:
- Penciclovir
- Famciclovir
- Valacyclovir
- Acyclovir
Some previous medicines come in pill form but others in cream form that should be applied several times a day. Generally, pills work better than creams, and for people with severe infections, doctors prescribe injectable antivirals.
Home Remedies
To reduce the time of the healing process, you may also use cold sore ointment Docosanol. It is advised to apply it right after the symptoms appear. In addition, it is recommended to use a cotton swab to apply the ointment. Check below some additional tips that may help lessen the discomfort of cold sores:
- Over-the-counter (OTC) products that contain a drying agent (including alcohol) also may speed healing.
- Lip balms and creams help protect you from the sun.
- To reduce the symptoms you can apply a compress.
- Nonprescription pain medications are effective if cold sores are painful or you have a fever. These include creams with Lidocaine or benzocaine.
Frequently Asked Questions
What are the main triggers of cold sores?
- Menstrual periods
- Strong sunlight
- Injuries
- Fatigue (extreme tiredness)
- Emotional distress
- Fever
- Other infections (including respiratory tract infections)
What are the primary symptoms of cold sores?
- Headaches
- Nausea
- Pain
- Fever
- Swollen lymph nodes
- Difficulty swallowing
- Sore throat
- Burning feeling in the mouth
If you experience any of the symptoms listed above, immediately visit a doctor.
Is it possible to prevent cold sores?
Yes, doctors usually prescribe antiviral medications to prevent cold sores. These medicines may also speed up the healing process once the condition occurs. Ask your healthcare professional if you have additional questions.
