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Cold Sore on Lips

Updated on November 4, 2013

Cold sores are small, fluid-filled lesions that develop on the lips and around it. Cold sores on lips are also known as fever blisters. In most cases, the blisters occur in clusters or patches. Rupture of a blister results in formation of a sore which eventually crusts over. A cold sore on lip typically resolves in around 2 weeks.

Cold sores are caused by the HSV-1, aherpes simplex virus that has close links to the HSV-2 or genital herpes causing virus. Cold sores transmit from one individual to another via close personal contact like kissing. Both types of herpes simplex viruses can affect the genitals or the mouth and can get transmitted via oral sex.

As HSV infections have no cure, cold sore blisters may recur periodically, mostly as a reaction to an enfeebled immune system or elevated stress levels. Treatment of cold sores on lip with antivirals can help speed up the healing process and may also decrease the incidences of a relapse.

Symptoms of cold sore on lips

Most individuals who are carriers of the viral infection responsible for formation of cold sores on lip, never actually experience the symptoms. They may however be still contagious and spread the infection to others, even without the occurrence of blisters.

People with visible cold sores on lip may elicit the below listed signs and symptoms during the different stages of cold sore development:

  • Tingling and itchiness: Several affected individuals feel a burning, tingling, or itchy sensation around the lips for 1 to 2 days before the eruption of cold sore blisters.
  • Blister formation: Tiny blisters that are filled with fluids usually develop on the outer borders of the lip. It is also possible for the blisters to appear on the cheeks or around the nose.
  • Discharge and crusting: The tiny blisters may join together and then rupture, leaving superficial open sores in its wake. Such sores will discharge fluids and later crust over.

Depending on whether or not it is a first episode of cold sores on lip, or a recurrence, the symptoms may differ. Some patients may elicit the below listed additional symptoms during the initial outbreak:

  • Sore throat
  • Fever
  • Muscle ache
  • Headaches
  • Swelling of lymph nodes

Children younger than five years may develop cold sore lesions inside the mouth. They are often erroneously thought to be canker sores. Younger children are also at greater risk to spreading the infection to other areas of the body such as around the eyes or the fingers.

Causes of cold sore on lips

Cold sores on lip are caused due to infection by some strains of the HSV or herpes simplex virus. The most common cause of cold sores is HSV-1. In most cases, HSV-2 causes genital herpes. It may however be noted that either of the virus strains can cause sores on the face or the genitals.

An individual will suffer from the first bout of herpes infection after close contact with another individual who has an active blister. Kissing and sharing of razors, utensils, towels, etc., may help transmit HSV-1. Oral sex can transfer HSV-2 to the lips and HSV-1 to the genitals.

A cold sore on lip is most contagious when it is leaking fluids. However, the virus can spread to others even in the absence of blisters.

After the initial bout of herpes infection, the virus remains inactive in the skin’s nerve cells. It may arise later as an active infection at or next to the original location. Such recurrences can be activated by:

  • Menstruation
  • Fever
  • Fatigue
  • Stress
  • Elevated exposure to the sun

Treatment of cold sore on lips

A cold sore on lip will typically disappear on its own within a couple of weeks, without any treatment.

  • The intake of different prescription medications such as penciclovir, famciclovir, valacyclovir, and acyclovir can help fasten the healing process.Some of these drugs are available in the topical form while others may need to be taken orally. Pills generally tend to yield better and faster results than creams.
  • Severe infections may require intravenous administration of antiviral medicines.
  • Individuals who are prone to frequent recurrences of cold sores on lip, or those with a greater risk to developing severe complications from the infection are generally prescribed a regular dosage of antiviral drugs by the doctor.

The varied symptoms of cold sore on lip can be alleviated by following the below listed steps:

  • Application of ice cold compresses on the blisters and around the affected area.
  • Use of certain OTC preparations containing a drying agent, like alcohol, can also aid the healing process
  • Frequent use of an FDA approved non-prescription cream called docosanol can also help curtail an outbreak of cold sores on lip.

Patients with active blisters can help prevent the spread of infection to other body parts or to other persons by washing their hands on a regular basis, not sharing personal items, and avoiding skin contact with others.


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