Cold sores are a common and often frustrating skin issue. While they may look like harmless blisters, cold sores are actually caused by the herpes simplex virus (HSV).
What Causes Cold Sores?
Cold sores are caused by the herpes simplex virus (HSV), which comes in two types: HSV-1 and HSV-2.
HSV-1 is the primary cause of cold sores, usually appearing around the mouth.
HSV-2 generally causes
genital herpes but can also lead to cold sores.
While the appearance of cold sores caused by both HSV-1 and HSV-2 can look similar, their locations tend to differ. However, it is possible for HSV-1 to cause sores on the genitals and for HSV-2 to appear on the mouth.
How Do Cold Sores Spread?
Cold sores are highly contagious and can spread easily. The virus can be passed on through:
- Kissing or skin contact
- Sharing food, drinks, or cosmetics (such as lip balm)
- Oral sex, which can spread both cold sores and genital herpes
Even when a cold sore isn’t visible, the virus can still be spread through close contact. This makes prevention and management key to reducing outbreaks and the risk of infecting others.
Once someone contracts HSV, it stays in the body for life. While the virus remains dormant most of the time, it can reactivate and cause new sores, especially during periods of:
- Stress
- Illness
- A weakened immune system
Unfortunately, there’s no cure for the herpes virus, but the symptoms can be managed.
Symptoms of Cold Sores
Cold sores don’t just appear out of nowhere. Before the sore is visible, you may notice a tingling or burning sensation around the lips or face, which can occur several days before the sore forms. This is the best time to begin treatment to shorten the outbreak.
When a cold sore does appear, it often looks like a red, raised blister filled with fluid. The blister can be painful to touch, and there may be more than one. Cold sores usually last around two weeks and are contagious until they crust over and heal.
The Five Stages of a Cold Sore
Cold sores go through distinct stages as they develop and heal:
- Tingling and itching: You may feel these symptoms about 24 hours before the blister appears.
- Blisters: Small, fluid-filled blisters form, typically around the mouth.
- Bursting: The blisters burst and form painful sores.
- Scabbing: The sores dry out, scab over, and may itch or crack.
- Healing: The scab falls off, and the cold sore heals.
Risk Factors for Cold Sores
Certain factors can trigger the reactivation of HSV, leading to cold sores. These include:
- Infection, fever, or cold
- Sun exposure
- Stress
- Menstruation
- Dental work or injury
- Weakened immune system due to conditions like HIV/AIDS, eczema, or chemotherapy
Anyone who comes in direct contact with the fluid from a cold sore—whether by kissing, sharing utensils, or using personal items like razors or toothbrushes—can contract the virus.
Managing and Treating Cold Sores
There’s no cure for cold sores, but several treatments can ease the symptoms and help manage outbreaks.
Topical Ointments and Creams
Over-the-counter antiviral creams like docosanol (Abreva) or prescription ointments like penciclovir (Denavir) can help reduce the duration of an outbreak, especially if applied at the first sign of a cold sore.
Oral Medications
Prescription antiviral medications like acyclovir, valacyclovir, and famciclovir can also help, particularly for people who have frequent or severe outbreaks. Your doctor may recommend taking these medications regularly to prevent future outbreaks.
Home Remedies
There are also some home remedies that may provide relief, such as:
- Applying ice or a cold washcloth to the sore
- Using aloe vera gel or lemon balm lip balms
- Applying petroleum jelly to ease discomfort
Canker Sores vs. Cold Sores: What's the Difference?
While cold sores and canker sores may seem similar, they are quite different:
Cold sores are caused by the herpes virus, appear around the mouth, and are contagious.
Canker sores are not contagious and appear as ulcers inside the mouth or throat.
Preventing the Spread of Cold Sores
To avoid spreading cold sores:
- Wash your hands frequently
- Avoid close contact with others during an outbreak
- Don’t share food, drinks, or personal items like lip balm
If certain triggers, like sun exposure or stress, cause your cold sores to flare up, take preventive steps, such as using sunblock on your lips or practicing stress management techniques like meditation.
Cold sores can be a persistent issue, but with proper care and management, you can reduce the frequency of outbreaks and prevent spreading the virus to others.