Difference in cold sore and canker sore

At Medway Dental, we know many people have experienced some form of mouth sores or irritation. Some mouth sores are harmless and go away on their own after a few days, while others are more serious and should not be ignored. Mouth sores occur for many different reasons, but bacterial infections, viruses, or funguses often trigger them. The best way to tell the difference between a canker sore and a cold sore is that canker sores occur inside the mouth while cold sores occur on the outside the mouth.

The most common mouth sores are:

Canker sores: A non-contagious, small, grayish ulcer with a red border, canker sores appear inside the mouth. While outside factors such as stress, fatigue, or allergies may increase the chances of developing a canker sore, most health experts believe they stem from bacteria or a virus that attacks the immune system. Canker sores typically heal within a week or two.

Cold sores: Also called fever blisters, cold sores are contagious groups of fluid-filled blisters that often erupt around the lips and sometimes under the nose or around the chin. Cold sores are the result of the herpes simplex virus, and once infected, the virus remains in the person’s blood stream.

Leukoplakia: A potential warning sign of oral cancer, leukoplakia is a premalignant lesion that appears as a white patch on the inside of the mouth, tongue, or gums. The lesions, which are caused by excessive cell growth, usually afflict those who smoke tobacco. Dr. Richard Berry may choose to have the lesion biopsied if the outbreak appears severe.

Oral candidiasis: Also called oral thrush or moniliasis, this condition is caused by the overgrowth of a type of yeast called candida. Common symptoms of oral candidiasis include white spots inside the mouth and on the tongue, redness or discomfort in the mouth area, sore throat,difficulty swallowing, and cracking at the corners of the mouth. It is important to visit Dr. Richard Berry if you have oral candidiasis. If left untreated, it may infect your bloodstream, which can be very dangerous. Healthy adults do not usually get thrush, and the condition is most often seen in infants, the elderly, patients undergoing chemotherapy, or people with AIDS or other diseases that are known to weaken the immune system.

Should you have a mouth sore that lasts a week or longer, we encourage you to give us a call and schedule an examination at our Medway office.

Canker sores show up inside the mouth, whereas cold sores appear on the outside of the lip or around the mouth.iStock; Shutterstock

Distinguishing a cold sore from a canker sore isn’t always easy. Both types of sores affect the mouth area, and they sometimes mimic each other in appearance. But a cold sore isn’t the same as a canker sore. These sores differ with regard to causes, locations, symptoms, and transmission.

Can’t tell them apart? Here are a few tips to help you make the distinction.

How the Symptoms and Appearance Differ Between Cold Sores and Canker Sores

Canker sores, also known as aphthous ulcers, are mouth ulcers that look like a shallow disc and are often oval or round. These lesions can be whitish, grayish, or yellowish, and they are usually less than 1 millimeter in diameter. (1)

A canker sore can develop as a single sore, or you may have clusters of tiny sores. These sores can be painful, making it difficult to eat, talk, and brush your teeth. But the pain usually improves after a couple of days. (2)

More on How Cold Sores Look

Difference in cold sore and canker sore

Difference in cold sore and canker sore

Is It a Cold Sore, a Canker Sore, or Something Else?

A cold sore, also known as a fever blister, causes clusters of tiny fluid-filled blisters. You may notice itching or tingling one to two days before the blisters appear. These sores can cause skin redness and pain, and they eventually rupture and ooze before a scab forms. (3)

During a first cold sore outbreak, additional symptoms may include a fever, swollen glands, sore throat, headache, and muscle aches. (3)

Location Matters When Figuring Out if It’s a Cold Sore or a Canker Sore

The location of these lesions is another way to determine a cold sore from a canker sore. Canker sores develop on the mucous membranes inside the mouth. Therefore, you’re more likely to find these sores on the skin inside the cheeks and lips, on your soft palate, and on your tongue. (1)

Cold sores, on the other hand, don’t usually appear inside the mouth, although this is possible when you are first exposed to the virus. (3) Instead, cold sores often develop on or around the lips.

Difference in cold sore and canker sore

They can also form on other parts of the body, such as the cheeks and around the nose. The virus sometimes infects people’s eyes. (3)

Most Recent in Skin and Beauty

Cold Sores Causes and Prevention

Difference in cold sore and canker sore

Difference in cold sore and canker sore

10 Frequently Asked Questions About Cold Sores

Difference in cold sore and canker sore

Difference in cold sore and canker sore

Cold Sore Symptoms and Diagnosis

Difference in cold sore and canker sore

Difference in cold sore and canker sore

A Detailed Guide to Help You Get Rid of Cold Sores

Difference in cold sore and canker sore

Difference in cold sore and canker sore

The Cause of a Cold Sore Isn’t the Same as the Cause of a Canker Sore

Cold sores are most commonly caused by the herpes simplex virus type 1 (HSV-1). This is a common virus — more than 50 percent of Americans ages 14 to 49 carry it. Many people get the virus as a child after being kissed by someone who is infected. (4)

Some infected people never develop a cold sore because the virus can lie dormant in the body for years.

Certain factors can reawaken the virus and spark a cold sore: (4)

  • Exposure to strong sunlight
  • Stress
  • Tiredness
  • A fever or infections
  • Hormonal changes

HSV-1 and HSV type 2 (HSV-2) are viruses that can cause cold sores, as well as genital herpes. You can get HSV-2 cold sores if you engage in oral sex with someone who has genital herpes, but this isn’t the only way to spread these types of cold sores. A person with HSV-2 cold sores can infect another person with HSV-2 cold sores through kissing, too. (3) Likewise, HSV-2 can also be transmitted from a mother’s genital tract to her newborn infant, says Allison Arthur, MD, a board-certified dermatologist based in Orlando, Florida.

More on Genital Herpes

Difference in cold sore and canker sore

Difference in cold sore and canker sore

How to Treat Genital Herpes

Canker sores, on the other hand, aren’t caused by the herpes virus. The exact cause of canker sores is unknown. But it’s believed that certain factors can increase your risk. Some people get a canker sore after eating citrus fruits or acidic foods, whereas others develop sores because of a nutritional deficiency (in, for example, vitamin B12, folic acid, or iron). (2)

Other factors that can trigger a canker sore include smoking, stress, and an injury inside the mouth. (2)

How Cold Sores Are Spread Is Different From Canker Sore Transmission

Another difference is how these lesions spread. Cold sores are contagious. They don’t spread from person to person only through kissing but also through sharing eating utensils, drinks, and personal items. (3)

It’s important that you don’t kiss or share food or drinks with someone who has an active cold sore. You should also wash your hands after touching a cold sore. This prevents spreading a cold sore to others, as well as spreading the virus to other parts of your body. (5)

Cold sores are most contagious when blisters rupture. But you can still pass the virus to others until the sore is completely healed. (6)

A canker sore, on the other hand, isn’t contagious and doesn’t spread from person to person. (1)

Editor’s Picks in Skin and Beauty

What Bit Me? Spot These 11 Bug Bites

Difference in cold sore and canker sore

Difference in cold sore and canker sore

7 Eczema Myths, Debunked

Difference in cold sore and canker sore

Difference in cold sore and canker sore

What Causes Canker Sores, and How to Prevent Them

Difference in cold sore and canker sore

Difference in cold sore and canker sore

How to Identify the Best Rosacea Treatment for You

Difference in cold sore and canker sore

Difference in cold sore and canker sore

A Final Word on How Cold Sores Are Different From Canker Sores

Even though these sores differ, they do share some similarities. It usually takes between one and three weeks for cold sores and canker sores to heal, and they often go away on their own without treatment. (1,3)

Some people also deal with recurrent cold sores and canker sores. For a recurrent cold sore, ask your doctor about suppression therapy with a daily antiviral to reduce the frequency of outbreaks. You should also see a doctor for repeated canker sores. This can be a sign of an autoimmune disease or a vitamin deficiency.

Difference in cold sore and canker sore

Difference in cold sore and canker sore

NEWSLETTERS

Sign up for our Sexual Health Newsletter!

Enter your email

Subscribe

By subscribing you agree to the Terms of Use and Privacy Policy.

Editorial Sources and Fact-Checking

  1. Canker Sores. Cleveland Clinic. June 9, 2022.
  2. Canker Sore: Symptoms and Causes. Mayo Clinic. April 3, 2018.
  3. Cold Sore: Symptoms and Causes. Mayo Clinic. June 17, 2020.
  4. Cold Sores: Who Gets and Causes. American Academy of Dermatology.
  5. Cold Sores (HSV-1). Nemours KidsHealth. February 2019.
  6. Cold Sore. NHS Inform. April 2, 2021.

Additional Sources

  • Cold Sores: Overview. American Academy of Dermatology.

Show Less

The Latest in Cold Sores

What Are Uterine Fibroids? Symptoms, Causes, Diagnosis, and Treatment

By Lisa RapaportDecember 9, 2022

Difference in cold sore and canker sore

Difference in cold sore and canker sore

BDSM Role Play: How Does It Work?

Doctor and patient. Master and slave. BDSM role play comes in endless varieties.

By Julie Lynn MarksNovember 28, 2022

Difference in cold sore and canker sore

Difference in cold sore and canker sore

Get Ready for Sex Again

Great tips for getting back in the game when you haven’t been in a sexual relationship for a while.

By Beth LevineNovember 28, 2022

Difference in cold sore and canker sore

Difference in cold sore and canker sore

Cold Sores Causes and Prevention

By Valencia HigueraAugust 18, 2022

Difference in cold sore and canker sore

Difference in cold sore and canker sore

10 Frequently Asked Questions About Cold Sores

Got questions about cold sores? Here’s a look at 10 frequently asked questions to help you recognize, treat, and avoid these blisters.

By Valencia HigueraAugust 10, 2022

Difference in cold sore and canker sore

Difference in cold sore and canker sore

Cold Sore Symptoms and Diagnosis

By Valencia HigueraAugust 8, 2022

Difference in cold sore and canker sore

Difference in cold sore and canker sore

A Detailed Guide to Help You Get Rid of Cold Sores

By Valencia HigueraAugust 3, 2022

Difference in cold sore and canker sore

Difference in cold sore and canker sore

What Are Cold Sores? Symptoms, Causes, Diagnosis, Treatment, and Prevention

By Valencia HigueraSeptember 18, 2020

Difference in cold sore and canker sore

Difference in cold sore and canker sore

What Is HSV-1?

By Lindsey KonkelMarch 2, 2016

Difference in cold sore and canker sore

Difference in cold sore and canker sore

How to Hide a Cold Sore

There's never a good time for a cold sore, but stressing about it can make it worse. Here, how to cover up so you feel like your most confident self.

How do I know if its a cold sore or canker sore?

Is it a cold sore or a canker sore? Cold sores are a cluster of blisters that first appear clear then become cloudy. First infection may be inside the mouth, but cold sores generally appear outside the mouth on the lips. Canker sores are gray or white sores surrounded by a red inflamed area.

Is a canker sore a type of STD?

No. Canker sores aren't herpes or any other type of sexually transmitted infection (STI). In fact, they're not contagious at all. So, you can't spread them through kissing or sexual contact.
The oral lesions caused by canker sores and cold sores may appear and feel similar, but they actually have different causes. Canker sores occur only in the soft tissues of the mouth, such as on your gums or inside your cheeks.

Do canker sores mean you're getting sick?

Several studies have found that people tend to have outbreaks of canker sores when they experience stress, which can take a toll on the immune system. “A lot of people get canker sores if they have had a cold, been sick or really stressed at work, haven't been eating properly or haven't been getting enough sleep,” Dr.