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Cold Sore inside Mouth – Symptoms, Causes, Treatment

Updated on November 4, 2013

Cold sores are reddish, tiny, fluid-filled lesions that are often painful and also slightly raised as compared to the surrounding skin. Cold sores commonly occur inside and around the mouth, and on the lips. Cold sores inside mouth typically develop on the roof of the mouth and the gums. They generally begin with a burning or tingling sensation that persists for around one to two days.

Cold sores inside mouth are caused due to infection by the herpes simplex virus or HSV. In already infected persons, the virus remains in an inactive state in the nerve cells. It will often get reactivated by stress or a weakened immune system. It is important to take varied precautions to avoid infection by HSV. However, once you have been infected, maintaining a strong immune system will help prevent reactivation of the virus and recurrence of cold sores inside mouth.

Symptoms of cold sore inside mouth

Some individuals infected by HSV may not elicit any symptoms, including the formation of cold sores inside mouth. They can however be still contagious and pass on the infection to others.

The development of cold sores inside mouth occurs in three stages along with the below listed signs and symptoms:

  • Itching and tingling: Many affected people feel itchy, burning, or tingling sensations on the lip, and/or in and around the mouth for one to two days before the onset of cold sores.
  • Formation of blisters: Tiny, reddish, fluid-filled lesions appear inside mouth, and/or on the lip borders. Such blisters may also occur on the cheeks, or in the area surrounding the nose.
  • Oozing and scabbing: The blisters may come together and form patches which later rupture and ooze fluids. An open sore forms at the spot which then scabs over.

Individuals affected by cold sores inside mouth for the first time may also sometimes experience the below mentioned additional symptoms:

  • Swollen lymph nodes
  • Headache
  • Achy muscles
  • Fever
  • Sore throat

It is important to note that occurrence of cold sores inside mouth in children is often mistakenly recognized as canker sores. Parents need to consult a doctor whenever they notice blister formation inside the mouths of their children for correct diagnosis and treatment.

Causes of cold sore inside mouth

Cold sores inside mouth are caused due to infection by two types of herpes simplex virus, i.e. HSV type 1 and HSV type 2. The former typically affects the oral area, while the latter causes genital herpes. However, most cases of cold sores inside mouth are caused by HSV-2, which can get transmitted to the mouth during oral sex.

The virus can transfer from an infected person to another via direct personal contact such as kissing, or indirect contact with the virus through shared razors, cooking utensils or drinking cups, towels, etc. Once contracted, the virus remains dormant in the body’s nerve cells for the remainder of the patient’s life. It tends to get activated and form cold sores when the conditions are favorable for replication and growth.

People may not develop cold sores inside mouth immediately after getting infected by the virus. Cold sore development is generally triggered when the below listed conditions are present:

  • A weakened immune system
  • Fever
  • A higher level of arginine as compared to lysine
  • Elevated levels of stress
  • Exposure to prolonged sunshine
  • Somewhat acidic body
  • Menstruation
  • Fatigue

Treatment of cold sore inside mouth

Cold sores inside mouth typically fade away on their without treatment after a couple of weeks. Medical treatment of cold sores can however help speed up the healing process and limit the risk to recurrences.

  • Medical treatment involves intake of different antiviral drugs as prescribed by the doctor. Pain killers may be given for easing pain. Severe instances of cold sores inside mouth may require intravenous drug administration. People who are prone to recurrences are often prescribed antivirals and other medications that have to be taken on a regular basis.

There are several home remedies which patients can use to alleviate the many symptoms of cold sores inside mouth. The home remedies are:

  • Application of moist, cold compresses. If it is not possible, then rub ice cubes against the sores. When this done during the first ‘tingling sensation’ stage of cold sore development, then it can help inhibit the further growth of the sores.
  • Use a toothpaste with zinc content. It can also be directly applied on the cold sores inside mouth.
  • Take a glass of Aloe Vera juice and rinse the mouth with it, at least once a day. Let the effect of the juice stay for at least an hour before washing the mouth with water.
  • Garlic also helps in quicker healing of cold sores inside mouth. Include it in the daily diet. Apply garlic paste on the sores on a daily basis.
  • Engage in meditation and/or yoga to reduce the stress levels. Take adequate rest, eat a healthy diet, and exercise regularly. This will boost the immune system and prevent the number of recurrences.


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