Health & Wellness

1 Feb 2021 admin


Cold sores, also known as fever blisters, are caused when a person gets infected with the Herpes Simplex Virus (HSV), resulting most often in oral or genital herpes. Cold sores can occur on and around your lips as painful tiny fluid-filled blisters that can break open into sores and crust over. These blisters appear grouped in patches or clusters and can sometimes appear in your mouth or on other parts of your face like your nose and cheeks.

Cold sores are usually caused by the Herpes Simplex Virus 1 (HSV-1), although they may also appear as symptoms of HSV-2. These viral strains are highly contagious, and people who have cold sores most likely got infected through close contact activities. While you can get infected with HSV-1 -the strain that usually causes oral herpes- through sexual activities, it is often transmitted through other means like kissing, sharing cutlery, razor, or towel with an infected person. Oral herpes is very common. According to the World Health Organization, 65% of the global population under age 50 have HSV-1. After infection with HSV-1, the virus travels to a group of nerve cells called a ganglion, where they stay dormant or inactive. Sometimes, the virus may remain dormant permanently, and you may never have symptoms. If you do have symptoms, it may take as long as 10 to 20 days after the initial infection before your first outbreak, and outbreaks may be recurrent. Cold Sore

How does a cold sore form?

A cold sore outbreak occurs in different stages:


The HSV-1 reactivates from its state of dormancy and travels through nerve endings towards the origin area of infection, like a person’s lips or mouth.

Tingling and Itching

The area under the skin’s surface at the site of infection starts to tingle, itch, or burn. This happens for a day or two before tiny, hard, and painful red or flesh-colored spots appear.


These spots erupt into painful, fluid-filled blisters.


These blisters may combine and burst into open sores that dry up and crust over. The crust then falls off, healing the skin, and the virus goes back to dormancy. Most cold sores do not scar after healing. The first cold sores outbreak is usually the most severe and long-lasting, taking up to two to three weeks for the blisters to heal completely. With recurrent outbreaks, recovery is shorter, and the blisters are a little less severe. On average, most recurrent cold sore outbreaks last between seven to ten days before healing on their own. There is currently no known cure for cold sores. However, there are many ways to treat and manage oral herpes by shortening the healing period and preventing recurrent outbreaks.

How to prevent cold Sore outbreaks

 Some people never have outbreaks, while others may experience an outbreak only once, still, at least 25% of people living with oral herpes experience recurrent cold sore outbreaks. To prevent outbreaks, you have to identify your triggers and avoid them or manage them as much as possible. You could have a diary where you record when you have outbreaks and the possible things that could have triggered the outbreak. These include things like food, illnesses, activities, or major life events.

Below are a few common triggers and ways you can prevent outbreaks.


Many people have recorded a cold sore outbreak when under stress. A possible reason for this is that your immunity is compromised when you go through a stressful situation or fall ill. With your immunity down, it becomes easier for the virus to reactivate and harder for your body to fight it. Stressors could also include significant life changes like losing a loved one, a breakup, or a new role at your job. Not getting enough sleep can also lead to stress and weaken your immunity. To prevent an outbreak, you should try to identify stressful situations and manage them before they break you down. Try to take as many breaks as you may need, practice relaxation techniques, meditation, and get enough sleep.

Avoid excessive sunlight

Excessive exposure to sunlight could also trigger a cold sore outbreak in some people. If sunlight is a trigger for you, apply sunscreen to the area on your face where cold sores appear. You can also use lip balms containing sunblock when you want to leave your house.

Use antiretroviral medication

To avoid frequent recurrences of cold sores, a doctor can prescribe antiviral medications that you can use every day. These oral antiviral medications include Valacyclovir (Valtrex) Acyclovir (Zovirax) Famciclovir (Famvir) These medications work by reducing the herpes virus’s ability to replicate in your body, thereby lowering your viral load. This leads to fewer outbreaks, reduced symptoms, and shortened duration of outbreaks. These medications have been proven to reduce recurrent outbreaks by about one-third. Depending on the frequency or severity of your outbreaks, your doctor may prescribe a once-a-day or twice-a-day dose.

These medications can also be prescribed as topical creams for people who do not like oral medication for treatment.


How to avoid spreading cold sores to others

If you have oral herpes, it is important that you try to prevent spreading it to others. The HSV-1 virus spreads through direct contact, and the chance of spread is higher when you have cold sores. To avoid spreading it to others:

  • Avoid kissing, oral sex, and other sexual activities when you have an outbreak.
  • Do not share items that may have touched your sores during an outbreak, like cutlery, toothbrushes, or lipstick.
  • Avoid contact between your sores and broken or open skin membranes.
  • Wash your hands regularly.


Cold sores are relatively common and are nothing to be ashamed of. With the right treatment, you can continue to enjoy your life without transmitting it to others. Do you need to talk to an online dermatologist about the right cold sore treatment for you? Book an appointment with a Canadian licensed physician on Winston.

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