There is no cure for cold sores, but there are several ways you can speed up recovery and reduce pain.
The fastest way to get rid of cold sores is by taking anti-viral pills and ensuring that you keep the infected area clean. Avoiding the trigger when the outbreak is related to stress will also help the sores clear up. Cold sores also react badly to exposure to wind and sun; protecting yourself from those will speed up the healing process.
Read on to learn more about the potential triggers that can cause a cold sore breakout and the accompanying symptoms. Yow will also find helpful information on pain management and home remedies.
What are cold sores?
Cold sores1 are tiny, painful blisters caused by the herpes simplex virus that usually occur on and around your lips. A breakout starts with a tingling, burning sensation. The blisters get filled up with fluid and group into small patches. They will burst and form a scab within a few days. Cold sores usually clear up within one to two weeks when untreated and heal without leaving a scar.
Cold sores are highly contagious1 and spread from person to person through close contacts, such as kissing and touching. They are most commonly caused by the herpes simplex virus type 1 (HSV-1) and, less typically, type 2 (HSV-2), which causes genital herpes. However, both types of viruses can affect the mouth and genitals even with no visible sores.
Sometimes there are no signs of infection when first encountering the virus, and outbreaks only happen later.Some treatments help manage cold sores, but there is no cure. Antiviral pills and creams can help the sores heal faster and reduce the outbreaks' severity, length, and frequency.
Symptoms
When you first contract the virus, it is called the primary infection. Most people usually don’t show any symptoms for about 20 days. The first time you have an outbreak is the most severe one, and you might experience several symptoms,1,2 such as:
- High fever
- Painful gums
- Sore throat
- Swollen glands
- Muscle aches
- Headaches
The symptoms are the worst at the first occurrence; the blisters take 2 to 3 weeks to heal. Every new outbreak gets better; the only symptom that stays will be the blistery sores.
After the initial episode, a cold sore will typically occur without the symptoms mentioned above and heal within one to two weeks. It usually passes through three stages:2
- Tingling and itching: a tingling, burning sensation around the lips a day or so before the blisters show
- Blistering: tiny, fluid-filled blisters erupt around the lips, nose, or cheeks and sometimes inside the mouth
- Oozing and crusting: after a few days, the blisters burst, leaving the sores open and oozing and crusting over
Causes of cold sores
Cold sores are caused by a virus called HSV-1. HSV-2 usually causes genital herpes. However, either type of herpes can be spread into areas on the face or genitals via close contact or shared utensils, razors, and towels.2
Cold sores are highly contagious, especially in the oozing phase when the virus spreads through bodily fluids. The virus is also infectious in the absence of symptoms. Many people never develop the symptoms but can give the disease to others.
It’s common for people to get this infection early on in childhood through being kissed by a person with the virus.2
Once infected, the virus will lie dormant in your nerve cells. An episode of blister breakout will usually occur when the following triggers1,2 are present:
- Having another viral infection
- Fever
- Stress: emotional or psychological
- Tiredness and fatigue
- Strong sunlight or wind exposure
- Hormonal changes, like menstruation
- Injuries to the skin
- Changes in the immune system
Getting rid of cold sores and treatment
Medical prescriptions
Several anti-viral treatments1,2 help speed up the healing process and reduce pain. They are typically in the form of creams and tablets. When the infection is severe, antiviral injections are given.
Popular medications:
- Acyclovir (Zovirax)
- Valacyclovir (Valtrex)
- Famciclovir
- Penciclovir (Denavir)
- Docosanol (Abreva)
- Zilactin (Cream that numbs the sores)
- Ibuprofen (Relieves pain and reduces inflammation)
- Cold sore patches (They contain acyclovir: they protect the infected area and help with the healing)
Home remedies
There are ways to relieve the discomfort without the use of prescription medications1,2. They don’t contain anti-viral agents but help with the pain caused by the virus.
You can try the following:
- Rubbing alcohol: it is an astringent that dries out the sores. It helps clean the area and speeds up the healing
- Using lip balms and cream: Protects your lips from wind and sun exposure and keeps them moisturised
- Applying compress: cold compress helps remove the crusting and promotes healing. A warm compress helps ease the pain
- Rest and pain relievers: Creams that contain lidocaine or benzocaine offer some pain relief
Some alternative treatments have shown some good results in treating cold sores1,2. You may try some of the following:
Lysine: may prevent or shorten the length of the outbreak
Rhubarb and sage cream: according to a 2001 study3, a topical cream made of these ingredients is as effective as some anti-viral medications
Stress reduction: meditation and breathing exercises help reduce stress, a common trigger for cold sores.
Propolis: a material made by bees and is used to treat cold sores; it helps with the healing process.
When to seek medical attention
Cold sores tend to go away on their own within a couple of weeks. If the sores linger beyond two weeks, you might want to visit your doctor. Another reason to see a healthcare professional is if you have cold sores several times a year or feel like you are constantly dealing with breakouts.
It would be best if you also considered visiting your doctor when you:
- Experience severe pain
- Have many cold sores at the same time
- Have sores near your eyes
- Have sores that are spreading to other parts of your body
- Have eczema, as the virus might spread into the cracked openings of your skin
- Have a weakened immune system. Some illnesses and their treatments, such as cancer and HIV, weaken the immune system and increase the risk of complications for people with cold sores
Summary
Cold sores are a recurring condition with many triggers. Once the herpes virus is in your body, it can be activated by them any time. Avoiding the triggers can help reduce the number of breakouts. When you feel a tingling sensation, you may start taking anti-viral medication to shorten the healing period. You should also keep the area clean and ensure you do not infect others via touch or bodily fluids. You can take pain medication or use home remedies to ease the discomfort and speed up healing.
References
- Cold sores symptoms and treatments [Internet]. www.nhsinform.scot. [cited 2022 Oct 15]. Available from: https://www.nhsinform.scot/illnesses-and-conditions/mouth/cold-sore#about-cold-sores
- Cold sore - Symptoms and causes [Internet]. Mayo Clinic. 2018. Available from: https://www.mayoclinic.org/diseases-conditions/cold-sore/symptoms-causes/syc-20371017
- Nelson EO, Ruiz GG, Kozin AF, Turner TC, Langland EV, Langland JO. Resolution of Recurrent Oro-facial Herpes Simplex Using a Topical Botanical Gel: A Case Report. The Yale Journal of Biology and Medicine [Internet]. 2020 Jun 29 [cited 2022 Oct 15];93(2):277–81. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7309665/