Cold sores

Overview

After the first infection, the virus stays in the nerves for life. Stress, sun, illness, or hormone changes can wake it up and cause a new cold sore in the same area.

Many people first notice tingling or burning before blisters appear.

Symptoms

Symptoms follow a pattern:

• A cold sore or blister on the lip
• Tingling or burning before blisters
• Crusting as it heals

Less common

• Fever and swollen glands with the first infection
• Sores in the mouth in young children

When to get medical care

Causes

Herpes simplex virus spreads through skin contact, like kissing, even when no sore is visible.

Does it spread or run in families?

• Yes, it can spread from person to person.
• How it spreads: touch or sex.
• Condoms lower the risk. Sex partners should be tested and treated too.

Who is more likely to get it

• Stress, sun, or illness can trigger outbreaks
• Weak immune system

Possible complications

• Eye infection: Can harm vision

Diagnosis

Usually diagnosed by how it looks.

Questions you may be asked

• Past cold sores

The exam

They'll look at the sore.

Tests

Rarely needed:

• Swab test: Confirms the virus.

Treatment

Cold sores heal on their own. Medicine can speed healing if started early.

Self-care

• Use a cold compress
• Don't pick or squeeze
• Use lip balm with sunscreen
• Don't kiss or share cups until healed

Medicines

Options:

OwieClear doesn't give doses: follow the label or your healthcare professional. Medicine names here are examples, not a full list.

Antiviral pills work best when started at the first tingle. People with frequent outbreaks may take them daily.

Prevention

To prevent spread:

• Don't kiss babies when you have a cold sore
• Wash hands after touching it
• Use sunscreen on lips

Which doctor treats this

• Start with your primary care provider (family doctor or internist).

Back to school, work, or sports

• You usually don't need to miss school or work. Wash hands often.

Children, pregnancy, and older adults

• Newborns: Herpes can be very dangerous for babies. Don't kiss a newborn with a cold sore.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Some infections can pass to the baby during pregnancy or birth. Tell your provider if you've been exposed.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

Outlook

Cold sores are harmless for most people and heal without scars.

Myths and facts

Getting ready for your visit

Bring a list of your symptoms and medicines.

What to bring

• A list of your medicines

Questions to ask

• Should I keep antiviral pills on hand?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Cold sores