What is a cold sore on lip

What are cold sores?

Cold sores are small blisters around the mouth, caused by the herpes simplex virus. They are sometimes called  fever blisters. The most common strain of the virus causing cold sores is herpes simplex virus 1. It can be spread by kissing or sharing eating utensils or even sharing towels. 

Herpes simplex is not curable, but may lie dormant for a long time. Episodes of the cold sores last no longer than 2 weeks. Hot sun, cold wind, a cold or other illness, or a weak immune system can cause an outbreak of herpes simplex virus.

What causes cold sores?

Cold sores are caused by the herpes simplex virus. Once the herpes simplex virus is in you, it can cause outbreaks of cold sores. Cold sore outbreaks are often triggered by exposure to hot sun, cold wind, a cold or other illness, a weak immune system, or even stress.

What are the symptoms of cold sores?

Some people don’t have any symptoms with the first attack; others have flu-like symptoms and ulcers in and around the mouth. While each person may experience symptoms differently, these are the most common:

• Tingling of the lips, commonly felt before cold sores appear 

• Small blisters on the lips and mouth that enlarge, burst, then crust over

• Itching, dryness, and irritation of the lips and mouth

• Soreness of the lips and mouth

How are cold sores diagnosed?

Your doctor can often diagnose cold sores by examining the sores. If the diagnosis is unclear, he or she may culture the sore by taking a sample of cells using a swab and examining it under a microscope.

How are cold sores treated?

Cold sores can’t be cured, but, if symptoms are severe, treatment may help relieve some symptoms. Treatment may include:

• Antiviral topical ointments (such as acyclovir and penciclovir)

• Antiviral oral medications (such as acyclovir, famciclovir, and valacyclovir)

• Over-the-counter topical anesthetics or anti-inflammatory agents may help with symptoms  

Cold sores take about 1 to 3 weeks to heal. The first time they appear, they can take up to 3 weeks to heal. But, when cold sores return, they usually take a week to heal if no medicines are used.  Antiviral medications may help, but they need to be started before day 3 or 4 of the blister formation. Antivirals are usually not recommended for otherwise healthy people. Always consult your health care provider or dentist if the sore does not heal or becomes worse as time passes. 

Can cold sores be prevented?

If you have never had a cold sore, avoid skin-to-skin contact with someone who has an active cold sore. If you have had a cold sore, you may prevent or reduce the number of recurrences by determining what triggers your outbreaks and avoiding the trigger. For instance, if sun exposure is a trigger, use sun screen when in the sun. If you have frequent outbreaks, consult with your health care provider. Starting treatment as soon as you know you are developing a cold sore can promote healing and reduce the time it takes a cold sore to heal.

Key points

• Cold sores are small blisters around the mouth, caused by the herpes simplex virus.

• Cold sores can be spread by kissing or sharing eating utensils or even sharing towels.

• Tingling often occurs prior to the appearance of blisters.

• Cold sores cause small blisters on the lips and mouth that enlarge, burst, then crust over.

• Early treatment can promote healing and reduce the time it takes a cold sore to heal.

Next steps

Tips to help you get the most from a visit to your health care provider:

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.

What are cold sores?

Cold sores are red, fluid-filled blisters that form near the mouth or on other areas of the face. In rare cases, cold sores may appear on the fingers, nose, or inside the mouth. They’re usually clumped together in patches. Cold sores may persist for two weeks or longer.

A common virus called herpes simplex causes cold sores. They can spread from person to person through close contact, such as kissing. The sores are contagious even when they’re not visible.

There’s no cure for cold sores, and they may return without warning. Certain medications can be used to treat cold sores and prevent them from coming back.

Cold sores are caused by the herpes simplex virus. There are two types of the herpes simplex virus. The herpes simplex type 1 virus (HSV-1) usually causes cold sores, and the herpes simplex type 2 virus (HSV-2) usually causes genital herpes.

The actual sores are similar in appearance for both forms of the virus. It’s also possible for HSV-1 to cause sores on the genitals and for HSV-2 to cause sores on the mouth.

Visible cold sores are contagious, but they may be spread even when they can’t be seen. You can get the herpes simplex virus by coming in contact with people with the herpes simplex virus. This may happen through kissing, sharing cosmetics, or sharing food. Oral sex may spread both cold sores and genital herpes.

Reinfection

Once you get the herpes simplex virus, it can’t be cured but it can be managed. Once the sores have healed, the virus remains dormant in your body. This means that new sores can appear at any time when the virus reactivates.

Some people with the virus report more frequent outbreaks when their immune systems are weak, such as during illness or times of stress.

You may notice a tingling or burning sensation on your lips or face several days before a cold sore develops. This is the best time to start treatment.

Once the sore forms, you’ll see a raised, red blister full of fluid. It will usually be painful and tender to the touch. There may be more than one sore present.

The cold sore will remain for up to two weeks and will be contagious until it crusts over. Your first cold sore may not appear for up to 20 days after you contract the herpes simplex virus.

You may also experience one or more of the following symptoms during an outbreak:

• fever
• muscle aches
• swollen lymph nodes

You should call your doctor immediately if you develop any eye symptoms during a cold sore outbreak. The herpes simplex virus can lead to permanent vision loss when not treated promptly.

A cold sore goes through five stages:

• Stage 1: Tingling and itching occurs about 24 hours before blisters erupt.
• Stage 2: Fluid-filled blisters appear.
• Stage 3: The blisters burst, ooze, and form painful sores.
• Stage 4: The sores dry out and scab over causing itching and cracking.
• Stage 5: The scab falls off and the cold sore heals.

According to the Mayo Clinic, 90 percent of adults worldwide test positive for the herpes simplex type 1 virus. Once you have the virus, certain risk factors may reactivate it such as:

• infection, fever, or a cold
• sun exposure
• stress
• HIV/AIDS or a weakened immune system
• menstruation
• severe burns
• eczema
• chemotherapy
• dental work

You’re at risk of getting a cold sore if you come in contact with the fluid of a cold sore through kissing, sharing foods or drinks, or sharing personal care items such as toothbrushes and razors. If you come in contact with the saliva of someone who has the virus, you can get the virus, even if there are no visible blisters.

The initial contraction of herpes simplex can cause more severe symptoms and complications, as your body hasn’t built up a defense to the virus yet. Complications are rare, but can occur, especially in young children. Call your doctor immediately if you’re experiencing any of the following symptoms:

• high or persistent fever
• difficulty breathing or swallowing
• red, irritated eyes with or without discharge

Complications are more likely to occur in people who have eczema or a condition that weakens their immune system, such as cancer or AIDS. If you do have any of these conditions, contact your doctor if you think you’ve contracted the herpes simplex virus.

There’s no cure for cold sores, but some people with the herpes simplex virus rarely have outbreaks. When cold sores do develop, there are several ways to treat them.

Ointments and creams

When cold sores become bothersome, you may be able to control pain and promote healing with antiviral ointments, such as penciclovir (Denavir). Ointments tend to be most effective if they’re applied as soon as first signs of a sore appear. They will need to be applied four to five times per day for four to five days.

Docosanol (Abreva) is another treatment option. It’s an over-the-counter cream that can shorten an outbreak by anywhere from a few hours to a day. The cream must be applied several times per day.

Medications

Cold sores can also be treated with oral antiviral medications, such as acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir). These drugs are available by prescription only.

Your doctor may instruct you to take antiviral medications regularly if you’re experiencing complications with cold sores or if your outbreaks are frequent.

Home remedies

Symptoms may be eased by applying ice or washcloths soaked in cold water over the sores. Alternative treatments for cold sores include using lip balm containing lemon extract.

Taking lysine supplements on a regular basis is associated with less frequent outbreaks for some people.

Aloe vera, the cooling gel found inside the leaves of the aloe plant, may bring cold sore relief. Apply aloe vera gel or aloe vera lip balm to a cold sore three times a day.

A petroleum jelly such as Vaseline won’t necessarily heal a cold sore, but it may ease discomfort. The jelly helps prevent cracking. It also serves as a protective barrier against outside irritants.

Witch hazel is a natural astringent that may help dry out and heal cold sores, but it can sting with application. Scientists in one study demonstrated that witch hazel has antiviral properties that may inhibit the spread of cold sores. Even so, the verdict is still out on whether cold sores heal faster if they’re kept moist or dry.

Always apply home remedies, creams, gels, or ointments to cold sores using a clean cotton swab or cotton ball.

Canker sores and cold sores both cause pain and discomfort, but that’s where their similarities end. Canker sores are ulcers that occur on the inside of the mouth, tongue, throat, and cheeks. They’re usually flat lesions. They’re not contagious and are not caused by the herpes simplex virus.

Cold sores are usually found on the lips and outside the mouth. They’re highly contagious. Cold sores are raised and have a “bubbly” appearance.

To prevent spreading cold sores to other people, you should wash your hands often and avoid skin contact with others. Make sure you don’t share items that touch your mouth, such as lip balm and food utensils, with other people during an outbreak.

You can help prevent the reactivation of the cold sore virus by learning your triggers and taking steps to prevent them. Some prevention tips include:

• If you get cold sores when you’re in the sun, apply a zinc oxide lip balm before soaking up some rays.
• If a cold sore pops up each time you’re stressed, practice stress management techniques such as meditation and journaling.
• Avoid kissing anyone who has a cold sore, and do not perform oral sex on anyone who has active genital herpes.