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Cold sore – Pictures, Symptoms, Causes, Treatment

Updated on October 3, 2013

Cold sores are fluid-filled, small lesions that develop on or around the lips. They are also known as fever blisters. The lesions mostly occur in clusters or patches. A sore forms after the rupture of the blister and eventually crusts over. Most cases of cold sores heal within 14 days.

Cold sores migrate from one individual to another via close personal contact like kissing. It is caused by an HSV-1 or a herpes simplex virus that is closely linked to the genital herpes causing HSV-2. Both these types of viruses can affect the genitals and the mouth and can transfer through oral sex.

HSV infection or cold sores does not have any cure. The lesions may occur periodically or at random, generally as a response to a compromised immune system or stress. Intake of antivirals can result in a faster healing process as well as help in reducing the incidences of recurrence.

Cold sore symptoms

A majority of individuals infected with cold sore causing virus usually remain asymptomatic. They are however contagious and can pass on the infection, even without the presence of lesions.

There are a few stages to a cold sore development. Affected individuals may show the below listed signs and symptoms:

  • Itchiness and tingling: Lots of patients experience tingling or burning sensations, or itchiness around the lip area for a couple of days before the eruption of sore lesions.
  • Blister formation: Tiny blisters filled with fluid erupt along the borders of the lips. Such blisters may also form on the cheeks or around the nose.
  • Discharge and crusting: The tiny lesions may combine together and later break open to develop into open shallow sores. These sores will release fluids and then experience crusting.

The symptoms that occur during the first outbreak of a cold sore may differ from those experienced during a recurrence. Patients may also elicit the below listed symptoms during the initial outbreak:

  • Sore throat
  • Fever
  • Headache
  • Swollen lymph nodes
  • Muscle aches

Affected children under the age of five years may develop cold sores inside the oral cavity. The blisters may be erroneously identified as canker sores. Younger children are also at greater risk to spread the virus to other parts of the body like around the eyes or to their fingers.

Causes of cold sore

Some types of HSV or herpes simplex virus strains are responsible for causing cold sores. The main culprit is HSV-1. The other type, i.e. HSV-2, usually causes genital herpes. It may however be noted that both types of herpes viruses can cause sores on the genitals as well as on the face.

The first instance of cold sore virus infection is passed on from an individual who is infected by the herpes virus and has an active blister. HSV-1 may spread via shared use of razors, utensils, towers, and close contact like kissing. Oral sex can aid the transfer of HSV-2 to the lips and HSV-1 to the genitalia.

Cold sores are most contagious when the blisters are discharging fluids. However, the infection can also migrate to others when an affected individual does not show any symptoms.

After the initial infection by the herpes virus, it remains inactive in the skin nerve cells, only to later come out as an active infection at the original location or around it. The below listed factors can trigger a recurrence:

  • Menstruation
  • Fever
  • Stress
  • Exposure to excess sunshine
  • Fatigue

It is important to note that nearly 90 percent of the global adult population test positive for presence of the cold sore causing herpes virus, even if they have never experienced the symptoms of the infection.

Individuals with compromised immune system may be at greater susceptibility to developing health complications of the viral infection. Certain types of treatment and diseases that can increase the risk to complications are listed below:

  • Eczema
  • Serious burns
  • Intake of anti-rejection medications during organ transplants
  • Chemotherapy for cancers

Treatment of cold sore

  • Cold sores generally tend to disappear on their own within a couple of weeks. Certain kinds of antiviral prescription medications such as Valacyclovir, Acyclovir, Penciclovir, and Famciclovir can help speed up the healing process.
  • Some of the above listed antivirals are available in the topical form, while some others need to be taken orally as pills. The latter has a greater effect on the healing process than creams. Extreme cases of cold sores may require intravenous administration of the drugs.
  • Patients may also use docosanol cream available over the counter to alleviate cold sores. You may also use topical medications that have a drying agent. Application of cold water or ice is an effective home remedy for easing cold sore symptoms.
  • Patients also need to ensure that they do not spread the infection to other parts of their body, or to others. Hence, avoid sharing personal items, do not make skin contact when the lesions are active, regularly wash the hands and keep them clean, and avoid touching other parts of your body, particularly the genitals or the eyes.

Cold Sore Pictures


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