Everything You Should Know About Cold Sores

May 19, 2020

Woman with cold sores on lip

Cold sores are an extremely common skin condition. According to the American Academy of Dermatology, more than 50% of people in the U.S. between the ages of 14 and 49 are carriers of the virus that cause cold sores, and because this condition is so contagious, many children develop cold sores before the age of five. According to Dr. M. David Meyer of U.S. Dermatology Partners affiliate office, Center for Dermatology, in Plano, Texas, “While cold sores are a prevalent condition, the good news is they’re also very easy to treat, and for most people, this condition is not detrimental to overall health.” In this blog, Dr. Meyer explains what cold sores are, the cause, and how your board-certified dermatologist can help you treat and prevent the spread of this condition.

What are Cold Sores?

Cold sores are small blisters that typically appear on the lip or around the mouth. They may also appear on other parts of the face or body. You may hear these blisters referred to as “fever blisters” or “herpes simplex labialis.”

What Causes Cold Sores?

Cold sores are extremely common and are a manifestation of a viral infection of the skin. Almost all cold sores are caused by the herpes simplex virus (HSV).

How Do I Know I Have Cold Sores?

Cold sores are pretty noticeable and usually easy to diagnose, but they are typically the last warning sign of the HSV infection. When you initially contract the viral infection, in its earliest stages, you may notice some of the following symptoms:

  • Burning, tingling or numbness in and around the mouth
  • Sores in the mouth, on the tongue, or on the lips
  • Sore throat, hoarse voice, or difficulty swallowing
  • Swollen lymph nodes
  • Fever and chills
  • Exhaustion
  • Achy muscles
  • Headache or pain in the sinuses and behind the eyes
  • Nausea, diarrhea, vomiting, and other stomach complaints

In some cases, you will develop a cold sore after you originally contract the virus. Some people never develop cold sores, and others will develop cold sores periodically throughout their lives as the HSV (that lives in the nerve tissue after it’s originally contracted) is triggered. Before developing a cold sore, you may notice burning, itching, stinging, tingling, numbness, or throbbing in the area where the sore will develop. In almost all cases, one or more blisters appear on or around the mouth. Some people also develop cold sores on other parts of the face. And in some cases, people will develop cold sores on other areas of the body.

About two days after a cold sore develops, it will break open and drain. Then, the cold sore will dry out and a scab will form. Most people completely heal within two weeks of developing a cold sore. If you have a cold sore that lasts longer than 15 days, you should call your dermatologist.

What Should I Do to Treat Cold Sores?

The majority of people with cold sores can treat them at home with over the counter medications. You can use a topical antiviral medication with ingredients like docosanol or benzyl alcohol. To soothe the burning, pain, and itching, you can apply cold compresses. Many antiviral ointments also contain lidocaine or other medications that will numb or decrease sensation in the area. You can also take over the counter pain relievers like acetaminophen or ibuprofen. To protect the sores as they heal, you can place a small bandage over the affected area. You may also want to use a small amount of petroleum jelly on the cold sores and surrounding area to protect your skin and help retain moisture.

According to Dr. Meyer, “If you need to visit a board-certified dermatologist for cold sore treatment, we’ll provide prescription-strength oral and/or topical antiviral medications. We customize our treatment plan to ensure you recover quickly and comfortably. If you have a weakened immune system, eczema, or other health conditions that may adversely impact you during your recovery, you should let your dermatologist know right away.”

Whether you treat cold sores at home or with the help of your dermatologist, it’s important to protect the area from sun exposure as it heals. You can use a lip balm with sunscreen to cover cold sores without risking the ingestion of topical sunblock. Apply the lip balm with sunscreen using a cotton swab or a makeup brush that can be discarded once your cold sores heal. If you apply the sunscreen lip balm directly to a cold sore, you should discard it once you heal.

How Do I Prevent Cold Sores from Spreading?

Once you get a cold sore for the first time, the herpes simplex virus (HSV) will always live in your body. Everyone responds to HSV differently. Some people have the virus in their body but never develop any symptoms, including cold sores. Others contract the virus and have one or a few cold sores, but they develop antibodies and never have a problem again. In some cases, people will suffer from cold sore flareups throughout their lives. If you fall into the latter category, the odds are you will start to recognize specific triggers that lead to a flareup. By learning your triggers, you may be able to prevent or reduce the number of cold sore flareups you experience each year. Some common triggers to avoid include:

  • Stress and fatigue
  • Illnesses (cold, flu, etc.)
  • Facial injury (even minor cuts or scrapes to the lip)
  • Dental treatments
  • Sun exposure
  • Hormonal fluctuation

In addition to preventing your own cold sore flareups, you should also take steps to prevent the spread of cold sores to others. When you have a cold sore, take these precautions:

  • Don’t kiss people and avoid other intimate contact
  • Don’t come into close contact with those who have weakened immune systems (infants, those with autoimmune diseases, cancer patients under treatment, pregnant women, etc.)
  • Don’t share foods and beverages, cups, or utensils with others
  • Avoid touching the cold sore as you may transfer the virus to other surfaces or people
  • Wash hands frequently during flares

When Should I Visit a Dermatologist for Cold Sore Treatment?

In some cases, you can treat cold sores at home with the use of over the counter topical antiviral medications and other symptom relief measures. Others will need prescription medications. Currently, we can schedule either in-office visits or telehealth appointments to address medical concerns like cold sores, so it’s easier than ever to get in touch with us if you need help.

We recommend you reach out to U.S. Dermatology Partners for treatment if your cold sore is extremely painful, spreads to cover a significant portion of your lip or to other areas of the face, or the cold sore doesn’t completely clear up after 7 to 15 days. Some other circumstances where a board-certified dermatologist should be consulted include:

  • Anyone who has atopic dermatitis (eczema), especially children, should consult a dermatologist about cold sores
  • Anyone with a suppressed immune system
  • Anyone under the age of 13 or over the age of 60
  • Anyone who has cold sores that are close to their eyes
  • Anyone who gets cold sores several times a year

Can I Schedule an Appointment for Cold Sore Treatment?

Absolutely. In response to the coronavirus (COVID-19) pandemic, the U.S. Dermatology Partners team has taken steps to make appointments easily accessible for our patients, no matter your situation. We are happy to offer both in-office appointments and online telehealth visits for medical dermatology conditions.

If you’re interested in making an appointment, you can start the scheduling process by completing our simple online form for either an in-office appointment or a teledermatology appointment. Once our intake team receives your request form, they will be in touch soon to confirm your appointment date and time. We look forward to hearing from you.

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