What Are Cold Sores, and How Can You Get Rid of Them?

Your lips start to tingle or itch. Soon, you notice that a blister has formed in that area. You’re quite sure at this point that you have a cold sore. Cold sores are common, and they affect more than half of all people worldwide.

In this post, we’ll talk more about where they come from, how to know if you have one, and what you can do to prevent them.

What are cold sores?

Cold sores are small blisters caused by the herpes simplex virus (HSV). Some also refer to them as fever blisters or oral herpes.

There are two types of HSV: HSV-1 and HSV-2. HSV-1 is the one that tends to cause sores in and around the mouth. It can lead to sores located:

• On or around your lips

• Inside your mouth

• Inside your nostrils

• On your cornea (the clear surface layer of your eye), although this is more rare

On the other hand, HSV-2 tends to cause genital sores (also known as genital herpes). But this is not a hard and fast rule. Both HSV types can cause herpes sores in or around your mouth, facial, genital, or groin area.

How do cold sores spread?

HSV is spread through direct physical contact with someone who has the virus. This can happen through kissing, oral sex, or sharing items such as drinkware or bath towels.

And although the virus is most often transmitted when sores are visible, you can also spread it when no cold sores or symptoms are present.

What are cold sore outbreaks?

Once infected, the HSV virus tends to live inside someone’s body for their whole life. It can lie dormant for years and never cause symptoms, or it can cause periodic cold sore outbreaks.

How often these outbreaks occur can vary from person to person. Some may not have an outbreak for years. Others may get cold sores at least once a month. These outbreaks tend to occur less often after age 35.

How and why do cold sore outbreaks occur?

It isn’t always clear why an outbreak happens. But they tend to occur during times when you have a weakened immune system. This is because your immune system tends to keep the virus in check most of the time.

Cold sores may occur when your immune system is busy fighting off another illness, such as the common cold or flu. Health conditions that cause more long-term changes to your immune system, like HIV, can also cause sores. This is also true for treatments that suppress your immune system, such as medications for people who have had organ transplants.

Cold sore triggers

Other triggers may include:

• Physical or emotional stress

• Fatigue

• Food allergies

• Extreme hot or cold temperatures

• UV rays

• Hormone changes, such as those that occur during menses or pregnancy

• Trauma to the mouth, such as that caused by dental work or sunburnt or cracked lips

What are the symptoms of a cold sore?

When HSV gets inside the body, not everyone develops cold sores or symptoms. But when they do occur, the primary or first infection tends to be the worst.

During this initial infection, cold sores may be accompanied by signs and symptoms that mimic the flu, such as:

• Fever

• Headache

• Body aches

• Sore throat

You may also notice that your lymph nodes become swollen. These are small, circular organs that have immune cells that attack and kill viruses and other foreign invaders. They are found in areas such as your neck, under your chin, and in your armpits and groin.

You may first notice that the site where the sore will appear feels swollen or it tingles, burns, or itches. Within a day or two, you will see small but painful fluid-filled blisters on your lips, under your nose, or on other parts of your face. These tend to erupt in clusters.

During its final stage, clusters near each other merge, and the blisters burst open. These leave painful, open sores that ooze fluid.

After a few days, scabs or crusts form over the open sores as they start to dry out. These will likely fall off and fully heal within a week or two after the cold sores first surfaced. You are less likely to infect others once this cold sore crust forms.

Cold sores that come back tend to be at or near their previous spot. Other symptoms tend to be milder after the initial outbreak.

How are cold sores treated?

Most cold sores heal on their own within a week or two without treatment. Cold sore treatments can expedite healing and relieve pain.

Oral herpes medications prescribed by your healthcare provider can shorten how long sores last. They work best when you take them within 72 hours of an outbreak. They may also be prescribed to prevent cold sores that come back often. Examples include:

• Valacyclovir (Valtrex)

• Acyclovir (Zovirax)

• Famciclovir (Famvir)

Antiviral creams, ointments, patches, and gels can also help you heal quicker by about a day. They contain the medications acyclovir or penciclovir, and you can buy them over the counter (OTC). These work best when you start them within 24 hours of your first cold sore symptom.

OTC pain medications may help ease cold sore pain and swelling. These include oral medicines such as ibuprofen and acetaminophen. Applying a liquid or gel with benzocaine or lidocaine, such as Orajel or Anbesol, may also help numb the pain.