The topic of cold sores can lead to many questions from life-long sufferers and concerned family members. Sometimes the answers that you receive can create further uncertainty about the subject, so we decided to put together an in-depth guide that you can use as a resource.
In This Article:
Although medical topics are complex, it is important to find out the truth about the herpes simplex virus. This will help you to reduce the number of outbreaks each year, identify prevention techniques that work, and keep friends and family safe.b
If you are currently dealing with a cold sore for the first time, or you experience an outbreak once a month, it is likely that you want to know more about the subject. We have provided answers to fifty of the most common queries about fever blisters.
Listed below are answers to HSV-1 questions:
Cold sores, even when not treated, typically last no more than 2-3 weeks. While the virus that causes cold sores cannot be cured, the blisters usually come and go without issue.
Although annoying and embarrassing, cold sores are quite similar to most any other sore on the skin. They will heal naturally. With quality treatment, they can be gone within a matter of days.
While it is not uncommon for fever blisters to return at a later time, the outbreak itself, and what you can expect, will likely be the same. For most sufferers, their primary infection is often the worst in terms of discomfort and duration.
HSV-1, also known as herpes simplex virus type one, is the medical term for what is known as oral herpes. Different from HSV-1, which is classified as genital herpes, HSV-1 produces cold sores. The blisters are the visual byproduct of the virus.
It is impossible to get a cold sore without having HSV-1. Transmitted through saliva and general oral secretions, HSV-1 often enters the body through tiny abrasions on the skin. So tiny in fact that most are not visible.
Once you are infected you will have the virus for the rest of your life. However, for an overwhelming majority of people, the occasional cold sore will be the only issue to ever arise. Unlike many known viruses, HSV-1 is not a crippling ailment for most young people and adults.
Yes. The transmission of HSV-1 through intimate physical contact, such as kissing, is the most frequent form of transmission.
Because HSV-1 is a saliva and oral secretion transfer virus, kissing is essentially ground zero. If you kiss a person with an active cold sore you will likely be infected. In fact, many people still refer to HSV-1 as the “kissing disease” because most people are infected through this activity.
If you have an active cold sore it is important to engage in personal responsibility if you are involved in an intimate relationship. You are encouraged to avoid kissing until your blister has fully healed.
Cold sore triggers are a series of potential irritants that can prompt a cold sore outbreak in those who have HSV-1. Because HSV-1 can lie dormant in the body for potentially long periods of time, negative triggers can serve to awaken the virus.
Specific foods, emotional hardships, common illness, and even weather changes, can all be deemed as cold sore triggers. These various aggressors can impact each person in a different way.
Most people who suffer from HSV-1, especially if they have endured a few outbreaks, are aware of their personal triggers and attempt to steer clear whenever possible.
While understanding the triggers will not completely shield you from ever having an outbreak, this knowledge can reduce the number of outbreaks that you endure during a calendar year.
If you have a cold sore, it will not manifest itself as genital blisters unless you transfer the virus to that part of the body. Viral shedding is always taking place, so you always have to watch out for the warning signs (typically a tingling sensation during the prodrome) that the virus is currently active.
Although HSV-1 has no cure, it will not return as HSV-2. For example, once your outbreak is gone it will not just return 30 days later as genital herpes. If you have HSV-1, any future outbreaks will normally occur in the same region of the lips and mouth as the prior episodes.
The chances of developing HSV-2 are reduced if you currently have HSV-1 and vice versa. Because your body will develop a certain level of resistance to the herpes simplex virus as time passes, it will become harder to contract the other type.
If you receive oral sex from someone with active HSV-1 you can get cold sores on your genitals. Due to the fact that this form of transmission is not genital-to-genital, the sores that develop are still classified as HSV-1.
While the odds of contracting oral HSV-2 from performing oral sex on a partner with active genital herpes are small, genital HSV-1 is on the rise. This is especially the case for men who receive oral sex from an infected partner.
If left completely untreated, cold sores will last 8-14 days. This timeframe could be longer depending on the severity of the outbreak.
Although cold sores are the byproduct of an incurable virus, it is important to remember that cold sores are quite similar to most any other form of blister. In fact, if you resort to natural healing, leaving the sore alone is the best thing you can do.
With responsible actions, coupled with a little bit of patience, cold sores can come and go without incident. Especially if you are a teenager or adult who is in good general health.
The most common way to treat a cold sore is with OTC medication. While prices will obviously vary, finding a cold sore treatment that works for you should be relatively simple.
The HSV-1 market is larger than ever. More competition amongst companies results in more choices for you.
While cold sores will naturally heal on their own in a fairly short period of time, proper treatment can reduce healing time in a dramatic fashion. Quite often people find their sores clearing up within a matter of 72 hours.
As is often the case with most OTC selections, regardless of illness or condition, people tend to stick with what works. Finding a quality OTC cold sore treatment during your first outbreak could prove to be a good thing moving forward. You can return to that specific treatment in the future at the first sign of trouble.
They are considered to be contagious from the initial symptom until fully healed.
While various stages of the cold sore lifecycle can be more contagious than others, the possibility of transmission exists at all stages. Contrary to some popular belief, you can be in the midst of an active cold sore outbreak without a visible blister. What can be seen or not seen has no bearing on transmission and the contagious stage.
All of the above is why understanding HSV-1 is so important. Not only understanding what it is but also how it operates. While foolish behavior is to blame in some cases, HSV-1 transmission is largely due to the infected individuals simply lacking critical information.
While not common, cold sores can bleed. More times than not, bleeding occurs during some portion of the scab stage. This is especially true if the scab has been manipulated in any way. Either through accidental or intentional means. Because scabs are so delicate, generally speaking, even the slightest trauma can cause the surface to crack and peel.
While bleeding does not pose a major threat to the area in terms of halting the natural healing process, it can introduce a potential issue as it relates to viral spreading and transmission. If you notice that your sore is bleeding you are encouraged to act immediately.
Applying ice to the compromised sore will stop the bleeding and also dull the pain. Once the area has been properly cleaned your OTC treatment of choice can be applied to the area.
In fact, cold sores can be anywhere the virus enters the body via saliva transfer. Regarding the mouth, if HSV-1 transmission occurs through a tiny abrasion on your cheek, for example, a blister will appear in that area.
They develop at or near the original location of transmission. This is why viral transfer through kissing typically manifests itself through blisters on the lips.
Although more difficult to treat, for the most obvious reasons, cold sores in the mouth can be remedied with OTC medications.
Cold sores have the ability to spread to essentially any location on the body where the virus has compromised the skin. However, this spreading is not natural and can only occur through irresponsible or accidental dealings with an active cold sore.
For example, if you touch an active cold sore blister with your fingers and then rub your mouth or other areas of your lips you could potentially spread the virus. Due to the fact that your fingers have been contaminated, the virus could enter the skin through any cut or abrasion on the skin. This is why it is so important to simply leave cold sores alone unless a treatment application is in progress.
In terms of spreading avoidance, just being mindful of your situation can go a long way. If you touch your cold sore, for any reason, be sure to wash your hands thoroughly before touching any part of your skin, especially your mouth, nose, or eyes.
Whenever you have a cold sore, the objective is to not only treat the area but to quarantine the virus.
While it is rather difficult to prevent an outbreak once you have contracted HSV-1, there are a few things you can do to improve your situation.
One of the most critical things you can do is to understand cold sores triggers. Not only the known list of triggers but your personal triggers. While this will likely come with time it will be important information to have.
Another way to potentially prevent cold sores is to take care of your lips. Especially if the lip region was the transmission point and how you acquired the virus. By keeping your lips moisturized and free of dryness you will have a better chance at fending off an outbreak.
Taking responsible preventative measures can be the difference between having cold sores once a year and having blisters once a month.
While cold sores are often deemed as a skin-to-skin virus as it relates to contraction, most transmission occurs through the passing and sharing of contaminated saliva.
This is why acts such as kissing, sharing of beverages, sharing of utensils, and risky intimate behaviors, such as oral sex, can transfer the virus.
While adults need to be mindful of their actions in order to avoid potential infection, a great number of HSV-1 carriers acquired the virus during their youth. It is not uncommon for well-meaning parents to give cold sores to their children through basic acts of affection.
Cold sores and HSV-1 (herpes simplex virus type one) are the same. Cold sores and HSV-2 are not the same.
The reason why it is more common to see “cold sores” written and verbally discussed is simply a byproduct of what HSV-1 produces. The primary visual sign of the virus is a cold sore. Therefore, the virus itself is often discarded (in the discussion) in favor of what the virus actually produces. This is often the case on non-medical sites and casual message board forums.
This question is certainly a good one considering a small percentage cold sore sufferers are unaware they have herpes. Or any form of virus for that matter.
Cold sores are serious in newborns. Potentially fatal. In these unfortunate cases, emergency action should be taken immediately at the first sign of symptoms.
However, as it relates to most everyone over the age of 3, cold sores are nothing more than an annoyance and potential source of embarrassment. While the word “serious” can be viewed as subjective, HSV-1 is nothing more than a glorified skin blemish for the vast majority of virus carriers. Especially for teens and adults.
If you are 21, for example, and are in generally good health, the only “serious” issue related to a cold sore will likely be how the blister effects your appearance.
While cold sores and impetigo do share a few similarities, the conditions are not the same. Therefore, it would be irresponsible to use the same treatment methods. Especially when specific treatments for impetigo do exist.
If you have been diagnosed with impetigo, your doctor will likely provide you with antibiotic treatment. Most notably in the form of an ointment or cream. In severe cases, antibiotic tablets can be prescribed.
Because impetigo, like cold sores, can be healed in a relatively short period of time it is not wise to “get cute” with your treatment plan. It is our advice that you follow the treatment that your doctor has given you. It is simply the responsible course of action. Especially if you want to be healed and avoid potential complications.
Cold sores appear at the location of initial transmission. The area where the infection entered your body is typically where a blister will form. This is why kissing is the most common form of transmission and blisters on the mouth are the most common location for an outbreak.
Unlike chicken pox, for example, cold sores do not appear in random places. It is impossible to contract HSV-1 through oral kissing and then produce a blister on your elbow. Cold sores are relegated to the site of transmission unless spread after the fact.
While cold sores will not leave a scar after every outbreak, scarring is possible. Manipulation of active sores, either intentional or accidental, and the severity of the outbreak can both contribute to scarring.
The good news is that scarring, in a majority of cases, can be treated. Various OTC treatments do exist to diminish the skin blemishes left by aggressive cold sores.
In terms of a visual, cold sore scars are typically quite small and red. Potentially leaving behind a small ring around where the problematic blister once existed.
If you have a blister on your lip, for example, and it is not the herpes simplex virus, then you do not have a cold sore.
Quite a common assumption, especially by those who are unfamiliar with their origin, cold sores do not simply appear. They are a byproduct of HSV-1. Without the virus, there can be no cold sore development.
While it is possible for some blisters and even some conditions to mimic cold sores in various ways, impetigo being one, the presence of a lip blister does not make it a cold sore.
Additionally, cold sores have nothing to do with a bad cold or common cold. While that school of thought has decreased in recent years, it still does exist.
Typically referred to as the ulcer stage, cold sores will naturally burst and ooze as part of the healing process. While the ulcer stage is quite often the most painful, the “popping” of a cold sore is natural and normal.
Understanding that cold sores will pop on their own is critical as it relates to blister manipulation. Because this is a natural process it is paramount that you do not attempt to pop a cold sore. Manipulating a blister in this fashion, especially when the sore is not ready to be exposed, can halt the healing process.
While cold sores can be potentially fatal in newborn and infants, HSV-1 is overwhelming regarded as just a minor inconvenience for the rest of the general population.
Given the fact that cold sores will heal naturally within an 8-14 window (in most cases), blisters of this nature are more of a beauty dilemma than anything else. Seeking ways to heal and cover the blisters are usually the only concerns that HSV-1 suffers have.
Although it is human nature to think the worst, for the majority of HSV-1 carriers the only symptom of the virus is the blisters.
It is estimated that roughly 70% of general population is infected with HSV-1. An estimated 1 in 4 of all HSV-1 carriers will have recurring cold sore outbreaks. This information is courtesy of Abreva, one of the world leaders as it relates to cold sore OTC medications.
While those numbers are quite staggering, the positive aspect is also found in those same numbers. Because cold sores and the transmission of HSV-1 is so common, treatment options are more extensive than ever before. Abreva, for example, is just one of an endless number of companies who have joined the OTC market.
Studies have shown that those who suffer from HSV, especially HSV-1, are less likely to contract HSV-2. This is due in large measure because HSV-1 exposure is so high.
Thanks to what is known as an acquired immune response, those who carry HSV-1 often have enough immunity against the virus in their system to potentially fend off additional HSV infection. This is especially true for those who are now adults who contracted HSV-1 as a child.
If you have been an HSV-1 carrier for many years, perhaps decades, the odds of contracting HSV-2 are even more unlikely.
Usually commencing in a very subtle fashion, HSV-1 symptoms often begin with a slight burning or tingling sensation at the transmission point.
Using the lower lip as an example, a small portion of the lip may start to tingle and itch. This symptom can last up to 48 hours before a blister begins to form.
While slight fatigue, fever, and headache can also be early symptoms of HSV-1, these occurrences typically occur in during an initial outbreak only. For the vast majority of all HSV-1 carriers, the symptoms of a forming cold sore involve a slight tingle sensation at the transmission site and nothing more.
Understanding the earlier symptoms of HSV-1 is critical. This is especially true as it relates to future outbreaks. If you can detect the initial symptom (initial tingle), you have a better chance of treating the area even before an actual blister forms. An early start can likely result in quicker healing.
While a physician can diagnose the presence of HSV-1 after the initial symptoms have occurred, more times than not HSV-1 is never diagnosed by a professional. The presence of a blister is typically deemed as proof enough in terms of identifying the virus.
In a vast majority of HSV-1 cases, most notably cold sore outbreaks, a trip to the doctor is not needed. Thanks to OTC medications, cold sores can be wiped out in days.
However, as it relates to the question, newborns and infants are a different matter. Because HSV-1 can pose a deadly threat to babies, it is critical to get a proper diagnosis and immediate care.
Unless you are lucky enough (through treatment) to heal the area before the blister stage, which is extremely rare, HSV-1 will form a blister.
While blister formation is normal and natural and is a positive sign towards healing, you should never attempt to compromise this stage. Being fortunate enough to prevent a sore from forming is rare. However, you should not take dangerous means to prevent this occurrence.
It should be noted that the act of treating a cold sore does not mean that natural stages will be excluded. Treatment simply means that natural stages will occur at a faster pace thus ensuring a quicker healing time.
They will not be present when the virus is dormant. When HSV-1 is in a dormant state, you will not have an outbreak, and you will not be able to transmit the virus.
Cold sores only occur when HSV-1 has been activated by a trigger. For many people, although the range is different for everyone, HSV-1 can remain dormant for a very long period of time. It is certainly not out of the question to go a full year or longer without a single issue.
If you are an HSV-1 carrier or have a close relationship with someone who is, just know that the dormant stage is the safe stage. The virus, although still existing within the body, is not able to spread unless active.
While many cold sore creams exist on the market, and some certainly have better reviews than others, deciding which one is best is a personal decision.
One of the most forgotten areas of cold sore treatment is the treatment selection. If you can find an OTC cream that works for you, it can prove to be a positive as times goes on. The ability to have a go-to treatment at the first sign of an outbreak can give you a leg up in many ways.
If you have recently had your first outbreak and were left uncertain as to which cream to try, the best advice we can offer is to continue to test the waters. What works for one person is not guaranteed to work for you.
We recommend trying the more common and highly regarded brands first and then moving on from there if necessary.
If you do not know what a cold sore feels like then you are doing something right. It is our advice never to touch an active sore.
Because cold sores are indeed contagious from the initial symptom through the duration of complete healing, touching a cold sore is not wise. With that obvious exception of a treatment session, cold sores should never be touched or rubbed. This can introduce the potential for both infection and viral spreading.
While cold sores are essentially like any other skin blister regarding how they heal, cold sores demand greater care. This is the most obvious and critical difference.
Although there is no foolproof way to prevent a recurrence, understanding what can potentially “set off” your outbreak is very important. Not everyone will react adversely to every trigger, so understanding your own triggers is wise.
As it relates to recurring outbreaks, it is also important to note that additional outbreaks will likely not be as severe as your initial episode. As a general rule, the worst cold sore outbreak you will have is typically your first.
The lifecycle for most cold sores is 8-14 days if left untreated. That window can expand during severe outbreaks, infection, or manipulation of the sore itself.
While the vast majority of people seek treatment methods to achieve faster healing, cold sores will heal on their own. This is why unproven treatment practices can prove detrimental. Why would you want to potentially harm the problem area when naturally healing will occur in two weeks or less? Patience is often the best medicine when dealing with an active blister.
It is important not to get caught up in labels. This is especially true as it relates to herpes.
From a traditional standpoint, simply based on where the infections primarily occur, HSV-1 is not an STD, while HSV-2 is often classified as such. However, in the big picture, it does not matter. This is critical to understand because cold sores, regardless of type, can appear in your mouth and your genitals. The actual STD classification holds no merit.
If transmission of HSV occurs due to a sexual act it is deemed an STD. However, you can also acquire HSV through a standard (non-sexual) kiss. This is why labels, especially a label such an STD, is not critical in this regard.
Cold sores scab because of blisters, especially blisters that ooze, naturally heal in this fashion.
It is important always to remember that on its face cold sores are quite similar to any other type of blister or skin blemish. Blisters scab over for the same reason that bloody cuts and abrasions also scab. If blood gets underneath, a cold sore scab can turn black.
Although the scab stage is perhaps the most noticeable stage from a visual standpoint, a scab is a positive sign. If your cold sore has formed a scab it typically means that you are only hours away from complete healing.
This is why it is so critical to avoid any form of manipulation. Most notably forced removal to complete the healing process. If a scab is not ready to be peeled away you could be in for a reboot of the healing process. Not to mention some sharp and stinging pain.
In the case of most fever blisters, a scab will form over the problem area and then slowly flake away. Typically in small pieces. Once again, it is important to let this process happen naturally.
Although a cold sore can be infected for a variety of reasons, blisters of this nature typically become compromised due to lack of treatment, poor general hygiene, or trauma to the blister itself. While this trauma can certainly be accidental it is usually due to excessive touching, pressing, or picking of the sore. In this regard, curiosity can cause an infection.
To avoid this unwelcome pitfall, it is important to adopt a hands-off approach. Unless you are currently treating your sore, and need a finger or two to apply the cream, you should never touch your blister. As long as you can see it there is no reason to touch it.
While an infected cold sore is certainly not the end of the world, it will likely halt the healing process by a few days.
Although the stages of a cold sore can be given many names, the basic concept is quite simple.
Listed below are the primary stages of a fever blister and what each stage details.
Once a cold sore (blister) completes its formation it will fill with fluid and then pop. While not exactly the most pleasant stage or pleasant picture, fluid (or pus) is the hallmark of cold sore development.
From blister formation to blister eruption, the entire duration is typically 24-48 hours. If there is a positive to be had it is the knowledge that the entire process will not last long.
And, logically speaking, the larger the sore, the more fluid will the blister will contain.
If you have contracted HSV-1 on your genitals, your pregnancy could be severely compromised without proper treatment and care.
Impacting roughly 1 in 3,500 babies, neonatal herpes is the result of a newborn contracting herpes while passing through the birth canal. This typically fatal condition is the product of HSV-1 (or HSV-2) being active in the genital region during the time of birth.
If you have cold sores on your genitals is it paramount that you notify your physician as soon as possible. This is especially true if you are on the brink of delivery.
Not long. Typically 60 minutes at the most. This is why contracting herpes from non-physical contact is almost impossible.
Because HSV thrives in an active body, the virus suffers when removed from that element. HSV on a plastic table, for example, would struggle to survive.
Additionally, it is important to note the difference between HSV simply existing on a surface and the ability for transmission. Simply coming in contact with HSV, on that rare occurrence, does not equal infection.
The odds of acquiring HSV through a pillow, for example, is incredibly rare.
No, they are the byproduct of a direct contact virus. You will not get HSV-1 by simply being in the same room with someone who has an active blister.
From a basic logic standpoint, if cold sores were contagious through the air then everyone would have HSV-1. In fact, everyone would have contracted the virus within the first couple of years of school.
HSV-1 will produce blisters at the physical location where the virus originally entered the body. Beyond that, nothing more will take place as it relates to HSV-1. Certainly not cancer.
The only major pitfall associated with HSV 1 or 2 is the increased potential for developing HIV if you have genital herpes.
Primary cold sores refer to your initial outbreak. Your initial blisters that prompted you to realize that you had HSV-1.
Recurrent cold sores are defined by cold sores that appear after your initial outbreak. If you had your first blisters in March, for example, and then had a second episode in November, the second outbreak would be deemed as recurrent.
While some people are fortunate enough to have a fever blister outbreak and never have another one, that occurrence is not likely for most HSV-1 carriers.
It is estimated that 1 in 4 of all HSV-1 carriers will have recurrent cold sores.
Specially designed OTC cold sore patches as well as various makeup techniques can enable you to conceal a cold sore.
While we recommend an OTC patch simply because most work to conceal and treat, makeup is a quality method if beauty is your main objective. Example: Looking your best for a job interview or it’s your wedding day.
In terms of hiding blisters, there are better times than others. These times are directly related to the cold sore stage. While you can use a medicated patch to conceal your sore at any stage, makeup, used at the wrong time, can potentially introduce infection.
If you are in the midst of the blister or ulcer stage it is not wise to use makeup. On the other hand, if your sore has fully scabbed over, makeup can be used if you are careful and delicate with the application.
As it specifically relates to winter weather, cold temperatures and especially cold wind can steal the moisture from your lips. Lips that are rough, dry, and severely chapped, are danger zones for HSV-1 carriers.
Additionally, artificial heat from winter weather can prove to introduce similar effects. Artificial heat, primarily from a heater, can dry the air. This dryness can work on your lips the same way that cold wind does. More drying, chapping, and lack of moisture.
If you have HSV-1 it is important to protect your lips during the winter months. Whether it is through various articles of clothing or moisturizing lip balm, it is important to be mindful of weather conditions as it relates to your condition.
For all of the reasons noted above, it should come as no surprise that winter months produce more cold sore flare-ups.
Knowing what to eat and which foods to avoid can potentially go a long way when it comes to winning or losing the battle against cold sores.
While everyone is different, and certain foods will produce more negative effects than others, and there is a common link between some foods and cold sores.
Noted below are select foods that can potentially trigger cold sores:
Herpes simplex encephalitis, also known as HSE, is a rare condition that causes inflammation of the brain. Caused by HSV-1, the condition is the result of HSV being activated but going to the brain rather than the original transmission point(s) on the face.
The most common symptoms include headaches, fevers, hyper tendencies, and fatigue. Stiff neck, confusion, and slurred speech issues can also occur. HSE is considered a critical condition with a dire outcome.
It is estimated that one-third of all victims will succumb to HSE while only 2% of survivors will regain normal brain function.
HSV-1 affects the skin and mucous membranes. The virus, either type 1 or type 2, is not found in blood or bodily fluids. While HSV can certainly infect the skin around your genitals, infection of the genital region is not a product of contaminated semen, sperm, etc.
HSV, when active, lives on the surface rather than inside the body. Unlike HIV, for example, an HSV carrier does not have contaminated blood. The same way that a person who once had chicken pox, which is also a form of herpes, does not have contaminated blood.
The main takeaway is that you can contract HSV-1 (or 2) through sexual activity but the transmission will not the result of ejaculation. Genital to genital contact will be the cause of infection.
Having a “family history” of cold sores only implies that your family has experienced some bad luck regarding HSV-1. Nothing more. Nothing less.
Because HSV-1 is a virus that can only be contracting through contact with another person, it does not naturally exist in the body simply due to heredity.
Unless your mother was infected when genital herpes, you will not be born with the virus. Therefore, having a family history of cold sores is mere coincidence.
Cold sores are born from a virus. Canker sores are not.
Canker sores are primarily the byproduct of some form of gum or mouth irritation. Have you ever bitten the inside of your cheek and a sore formed? Have you ever consumed food or beverage that irritated your gums and produced an ulcer? These are both examples of irritants causing the development of cankers sores.
Because the inside of your mouth is quite delicate, ulcers and sores can often form due to the slightest forms of manipulation.
As you can see, cold sores can present a rather complex discussion. While easy to explain on the surface, every question opens a new window.
We hope that you found this guide useful. HSV-1 is a fairly simple virus to treat when you are armed with knowledge.
So much that tends to go wrong in the fight against cold sores comes from mistakes. Learning how to treat your sores while also leaving them alone can be easier said than done.
Here are some top rated cold sore treatments that work really well.
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