What Actually Are Cold Sores? Facts, Symptoms, and Treatments

The SMSNA periodically receives and publishes ‘guest editorials.’ The current article was submitted by Mia Barnes, a freelance writer and researcher who specializes in women's health, wellness, and healthy living. She is the Founder and Editor-in-Chief of Body+Mind Magazine.

You can likely tell a cold sore is forming when you feel a tingling or sharp pain around your lips and mouth. Although not dangerous, they are common but bothersome blisters. Here is an overview of cold sores, the most typical symptoms, and how to prevent them from reoccurring.

What Are Cold Sores?

Herpes simplex virus (HSV) is the root cause of cold sores — a typical symptom of type HSV-1. Conversely, most people are familiar with HSV-2 as genital herpes.

Over 50% of Americans 14-49 years old carry HSV-1 — which most get as a child — making them more susceptible to cold sores. Unfortunately, HSV-1 is a lifelong condition, settling in the nerves on the side of your face until something triggers it. However, most people over 35 tend to have fewer cold sores.

The virus spreads through the fluid in the blisters, especially in people with weakened immune systems. You can get the virus from kissing someone infected, or sharing drinks and utensils with someone with cold sore flare-ups. Common triggers include chronic stress, fatigue, the common cold or influenza, hormonal fluctuations, aggravating foods, or dental procedures.

Symptoms of Cold Sores

There are several stages of a cold sore. However, most start with an itchy or burning sensation around the lips. Typically, this is followed by a cluster of small, painful blisters around the lips, cheeks or inside your mouth. The blisters contain fluid, which may ooze if they burst, causing crusting — a sign they are starting a 2-3-week healing process.

Other common symptoms include the following:

• Pain around the gums
• Blisters on the throat or tongue
• Fever
• Headache and muscle tension
• Lymph node swelling
• Swollen lips

Although cold sores are uncomfortable, they usually fully heal after a few days when the crust falls off without leaving a scar. If they don’t go away within a few weeks or return shortly after, consider scheduling an appointment to see your doctor. Nearly 64% of patients visit their dentist annually or biannually, where their specialist may have a solution for pain relief.

Treatments and At-Home Remedies

Cold sores usually don't require treatment, but you may opt for over-the-counter creams and gels to ease discomfort and aid healing. For example, lidocaine won't eliminate the cold sore but could alleviate some burning sensations. Other solutions may even prevent blisters from forming. Although, if you’re prone to cold sores, your doctor may prescribe a more potent antiviral ointment.

You can prevent spreading HSV-1 and subsequent cold sores by avoiding kissing people until your sores are healed, practicing good hygiene like handwashing, staying away from sports requiring a mouth guard and avoiding oral sex. Other tips include gargling with salt water, changing your toothbrush after a flare-up and avoiding spicy foods.

Boost Your Defenses Against Cold Sores

You might not be able to prevent a cold sore from forming, but there are several ways to soothe them and stop new ones from appearing. Take care of your oral health to make life with cold sores easier.

References:

American Academy of Dermatology. (2020, January 21). Cold sores: Who gets and causes. https://www.aad.org/public/diseases/a-z/cold-sores-causes 

MayoClinic. (2024, January 5). Cold sore. https://www.mayoclinic.org/diseases-conditions/cold-sore/symptoms-causes/syc-20371017 

National Library of Biotechnology Information. (2022, March 23). Overview: Cold sores. National Library of Health. https://www.ncbi.nlm.nih.gov/books/NBK525782/ 

ProDent USA. (2022, October 27). How to Help Your Patients Practice Good Oral Health. https://prodentusa.com/help-your-patients-practice-good-oral-health/