FAQs about Cold Sores: Causes, Treatments, Symptoms, HSV-1

Questions about cold sores? You’re not alone. Check out these frequently asked questions about cold sores and HSV-1, and head to this page for more details on cold sores and potential treatments like light therapy.

What is a cold sore?

A cold sore is a fluid-filled blister on the lips and around the mouth. It’s caused by the common and contagious HSV-1 virus.

Are cold sores contagious? Can cold sores spread?

Yes, cold sores are caused by HSV-1 and are contagious, but they usually aren’t serious.

How common are cold sores?

Very common. Over 50% of the United States has been infected with the virus that causes cold sores, though many people never develop symptoms.

How long do cold sores last?

Cold sores usually take 4-5 days to scab over and 1-2 weeks to heal completely. More severe or frequent cold sore outbreaks may warrant medical attention.

How often do cold sores occur? How frequent are cold sore outbreaks?

It depends. Some people get them several times a year, while others may only get them a few times in their life. It’s not clear why cold sore frequency varies so widely from person to person.

Who gets cold sores?

Anyone can become infected with the virus that causes cold sores. The majority of people seem to get it during childhood, but anyone is susceptible to cold sores. Outbreaks tend to decrease into middle-age.

What are the symptoms of cold sores?

Cold sore outbreaks usually begin with a tingling or itching feeling around the lips. Over the next 24 hours, the area becomes redder and swells as a painful sore develops. For several days, the cold sore may break and ooze yellowish fluid. Within 4-5 days, a cold sore usually scabs over and stops oozing fluid, though it may crack or bleed as it’s healing. The sore is typically healed and gone in 1-2 weeks. Usually, cold sore outbreaks and symptoms are worse the first time they happen. [CC]

What causes cold sores?

Cold sores are caused by the herpes simplex virus type 1 (HSV-1), which is common and highly contagious.

How do cold sores spread?

HSV-1 causes cold sores, and it spreads by saliva or close contact, often through kissing or sharing foods, drinks, or oral products like lip balm. Many people are exposed to HSV-1 over the course of their childhood, but symptoms are often mild, so not everyone is aware they have the virus.

Does everyone with herpes (HSV-1) get cold sores?

No. Some people experience outbreaks fairly regularly, while others may only have a few through their adulthood. Others with HSV-1 may never experience symptoms, and never know they have the virus.

What triggers a cold sore? Why do cold sore outbreaks happen?

When HSV-1 is activated, it travels through the nerves to the lips, where a sore develops. Different people experience very different outbreak triggers. These are some of the more commonly reported reasons or triggers for cold sore outbreaks:

• Stress or anxiety
• Fatigue
• Illness (cold, flu, fever)
• Hormonal changes (like menstruation and pregnancy)
• Exposure to extreme hot or cold temperatures
• Sunburn
• Dry, cracked lips

Can you spread cold sores from kissing?

Yes, the virus that causes cold sores can be spread by oral contact like kissing and sharing food.

Are cold sores herpes?

Cold sores are caused by the herpes simplex virus, type one, known as HSV-1. It’s a common condition that affects roughly half the population.

How do cold sore outbreaks start?

Cold sore outbreaks usually begin with a tingling or itching feeling around the lips. Over the next 24 hours, the area becomes redder and swells as a painful sore develops.

Do cold sores go away?

Most cold sores heal on their own within 1-2 weeks, but the virus that causes cold sores, HSV-1, remains in the body for a person’s entire life.

Does HSV-1 go away?

No, HSV-1 remains dormant in a person’s nerve cells for their entire life, and may cause cold sore outbreaks periodically.

How are cold sores treated?

There is no cure for HSV-1 or cold sores, but people use ointments, medications, home remedies, and light therapy to lessen pain and manage outbreaks.

What are natural, at-home, DIY methods for cold sores?

People have reported anecdotal relief with hundreds of natural, at-home, and over-the-counter methods over the years. To ease pain, many people with cold sores apply ice or a wet washcloth, and use lip balm, Vaseline, or petroleum jelly. Lysine supplements and aloe vera are popular DIY solutions. Other methods include tea tree oil, essential oils, lemon extract or lemon balm, oregano, zinc, camphor, and witch hazel. Some people use honey, hydrogen peroxide, coconut oil, turmeric, apple cider vinegar, baking soda, Vitamin C, and Vitamin E.

One example of a home use light therapy device for cold sores is the Luminance RED Cold Sore Treatment Device.

Are there ointments for cold sores?

Antiviral ointments like penciclovir (Denavir) are sometimes used to control pain. Ointments work better the sooner they’re applied during a new outbreak, and typically need to be re-applied several times daily. Docosanol (Abreva) is a leading over-the-counter cream.

Are there antibiotics or drugs for cold sores?

Some people choose to treat cold sores with oral antiviral drugs like acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex). Doctors may prescribe these medications if outbreaks are frequent and severe. Consult with a trusted physician.

Can you use light therapy for cold sores?

Yes, light therapy is used for cold sores. Numerous peer-reviewed clinical trials have shown light therapy treatments can improve healing results and limit outbreaks of herpes labialis. Check out this post on cold sores and light therapy to learn more.

At what ages are cold sores most common?

It is possible to develop a cold sore at any age, though the chance of having a cold sore outbreak decreases after the age of 35. It is common in children and teens.

Are cold sore outbreaks worse the first time?

Yes, often people report cold sores are worse or more painful the first time they experience an outbreak.

How serious are cold sore outbreaks? Should I see a doctor for severe cold sores?

For the majority of people with cold sores, outbreaks are an occasional annoyance that can be managed and overcome in a few weeks. However, cold sores can be a far more serious medical concern for young babies, immunocompromised people, and those with eczema. Seek medical care for cold sores if you have eczema, HIV, cancer, or a compromised immune system. You should also consult a doctor if you’re experiencing frequent and painful outbreaks, or if your outbreaks aren’t healing within a few weeks.

What are the symptoms of cold sores?

Cold sore outbreaks begin with a tingling or itching feeling around the lips. Over the next 24 hours, the area becomes redder and swells as a painful sore develops. For several days, the cold sore may break and ooze yellowish fluid. Within 4-5 days, a cold sore usually scabs over and stops oozing fluid, though it may crack or bleed as it’s healing. The sore is typically healed and gone in 1-2 weeks.

Does stress or anxiety cause cold sores?

Many people report experiencing cold sores in times of high stress or anxiety. Responses to HSV-1 vary widely from person to person, so while stress may trigger cold sores in one person, it may not in another person.

Do kids and toddlers get cold sores?

Yes, it’s common for kids and toddlers to get HSV-1 and experience cold sore symptoms.

Do babies get cold sores?

If young babies are experiencing cold sore symptoms, consult with a trusted medical professional.

Cold sore or canker sore?

Cold sores appear on and around the lips. Canker sores only occur inside of the mouth, and they aren’t contagious or caused by the herpes simplex virus. If an ulcer is inside your mouth, it is not a cold sore.

Cold Sore or Pimple? Cold Sore or Acne?

Cold sores usually appear in the same areas of the lip each time, while acne may appear anywhere on the face. Cold sores often appear in small clusters, while pimples and blackheads appear one at a time. Cold sores may hurt, but acne is more acutely painful to the touch and feels more pressure-filled.

Cold Sore or Chapped Lips?

A cluster of cold sores usually only occurs on one or two spots around the lips, while chapped lips tend to affect much of the lips at the same time, top and bottom. Cold sores are found on the edges of the lips, where chapped lips cause vertical cracks through the whole lip.

Does ice work for cold sores?

Ice may relieve acute pain from cold sores and make outbreaks more manageable.

Does COVID-19 / coronavirus cause cold sores?

No.

Sources and References:

[1]  Cleveland Clinic. Cold Sores.
[2]  WebMD. Cold Sores.
[3]  Healthline. Cold Sores.