My Cold Sore Scab Fell Off Early: What Will Happen Now?

Disruptions to the natural cold sore healing process can potentially cause healing and cosmetic issues. Early scab removal is, unfortunately, one of the most common disruptions.

Potentially leading to an extended healing process, scabs that fall off prematurely can also introduce infection. This can lead to other issues that require professional medical treatment.

While scabbing is a positive stage regarding natural healing, it is also a critical stage of recovery. So much can go wrong that can negatively impact the cold sore as well as the recovery time.

We will discuss how to treat early cold sore scab removal, prevent potential transmission, and better understand the signs of infection.

Understanding the Cold Sore Scab Stage

Typically regarded as the second-to-last stage of the cold sore cycle, the scab stage is critical. Not only is this stage a likely prelude to complete healing, but also a sign that extreme caution should be used.

Because scabs are very sensitive and fragile, it is important to protect them. Natural and normal flaking off of your cold sore scab is the objective. This is required for uninterrupted healing. Intentionally pulling off or picking at the scab is not advised under any circumstance.

Navigating the scab stage requires just hours of patience. Many times the scab stage only lasts 24-48 hours. Depending on OTC treatment the wait can be much shorter. This is yet another reason while having respect for the scab stage is important. When you are only hours away from total healing the last thing you want is any harm.

To summarize:

• The natural flaking away of the scab is the last major hurdle in the cold sore cycle. After the scab has deteriorated, the area in question gives way to your new and fresh skin.
• Do not manipulate the scab. Do not peel the edges or attempt to remove the scab. This is arguably one of the most important “rules” when it comes to proper cold sore healing.

What Happens if a Cold Sore Scab Comes Off Early?

Excluding the obvious burning and stinging pain, having a cold sore scab come off before it’s ready can be problematic. As it relates to the healing process, premature scab removal essentially reboots the entire healing cycle.

Because scabbing protects fresh skin, manipulating this process is detrimental. Either by accident or forced removal, the absence of a scab can leave fresh skin susceptible to infection. In essence, a new wound is created when a scab comes off before the area has healed.

Regarding your next step(s), the first thing you need to do is clean the area and stop any bleeding. Once the area has been quarantined to some degree, OTC treatment can resume. If the wound continues to burn or sting a simple ice application can numb the pain and reduce swelling.

While the accidental (or intentional) removal of a scab can cause a brief setback, serious issues can also arise.^[1] The last thing you want is an infection. This can extend the healing process by as much as 2-3 weeks in some cases. Being vigilant is very important once the natural healing process has been disturbed in this fashion.

Is a Cold Sore Still Contagious After the Scab Comes Off?

Whether the scab removal was natural, accidental, or intentional, scabbed cold sores are contagious until they are fully healed. However, premature removal increases the likelihood of virus transmission. This is because natural healing was disturbed.

Regarding precautionary measures, simply treat your cold sore as problematic at all time. This is truly the safest route to travel. Avoiding oral sex, sharing of beverages, and any other form of saliva exchange is the responsible course of action. This is a smart plan to adopt at any stage in the cold sore lifecycle.

While looking out for others is paramount when it comes to HSV-1 transmission, viral spreading is also a concern. It is possible, especially after a scab has been prematurely removed, to infect yourself with HSV-1 further. This is why it is important to check your skin for even the slightest abrasion. The herpes simplex virus can attack the mouth, nose, and other areas of the face if not properly treated.^[2]

To summarize:

• Cold sores are contagious from the first symptom until the start of the healing process. Whether a scab falls off naturally or prematurely, the area is still problematic and transmission can still occur.
• Common sense action can protect others from the potential transmission. No mouth-to-mouth intimate acts should be performed if you have a cold sore.^[3] The same applies to sharing drinks, utensils, etc.
• Treating your cold sore, especially after scab removal, can prevent you from spreading HSV-1. Many OTC methods not only treat the sore but block the replication of cells. This is vital because HSV-1 can spread to other areas of the face.

What Are the Signs of a Cold Sore Infection?

Although marginal bleeding, redness, and minor swelling can occur after a scab has been removed, prolonged symptoms can indicate a larger problem. While cold sores can be infected at any stage, exposing fresh skin too soon can introduce bacteria.

If you notice that your sore has become oddly discolored or simply will not go away, you could have an infection. While not serious on a grand scale, an infection can lead to more blisters, swelling, and severe redness.

If OTC methods are not working, we encourage you to visit your physician. If your doctor diagnoses you with bacterial infection of an existing cold sore, antibiotics will be given to treat it.

To recap:

• Strange discoloration, bleeding, redness, swelling, and the formation of new blisters are all potential signs of infection. The inability to calm these symptoms is also another sign of a greater issue.
• If OTC methods no longer work, your doctor can give you antibiotics to treat the problem area. We encourage you to consult your physician if you begin to notice unusual changes at the blister site.

How to Treat a Cold Sore After the Scab Falls Off

Although the concept of continued treatment has been noted throughout, let’s take a look at specifics.

In most cases, barring infection, scab removal simply serves as a healing reboot. This means that whatever OTC measures you were using beforehand will still work. Various creams and ointments will heal the fresh skin and provide a barrier from germs and bacteria. Not to mention calming the skin and soothing any pain caused by the abrupt scab removal.

Noted below are just a few ways to treat a fever blister after the scab falls off…

• If a scab is ripped off, the first treatment should be ice. Just a small piece of ice, wrapped in a paper towel, will stop the pain and reduce swelling. Your first objective should be to make yourself comfortable and not make the situation worse.
• Once the cold sore wound has settled down, you can resume your normal OTC cold sore treatment selection like cream, ointment, etc. This will advance the healing of the premature skin while also protecting the area from bacteria and potential viral spreading.
• While medicated cold sore patches are popular during the blister stage, we do not recommend patches after scab removal. This could actually harm the skin due to the fact that natural healing was disrupted. Any sort of material that sticks to the region could actually damage the area. Especially when the patch is removed. The last thing you want is a tape-like substance on prematurely exposed skin.
• Avoidance is treatment. Protect the exposed area from certain environmental irritants. While this is good practice at any cold sore stage, avoiding certain foods, beverages, and weather climates are important. If you are dealing with an exposed wound it is critical to avoid items that can harm the skin. Acidic foods and beverages, for example, can cause tremendous pain to the wound and halt the healing process. Never underestimate the treatment measure of basic avoidance.

Conclusion

While seeking treatment for your cold sore is wise, protecting your scab is paramount. Essentially serving as the difference between fast healing and a potential setback, the scab stage is critical. There are, of course, things that you can to do heal a cold sore scab faster.

Although unfortunate things can happen and scabs can flake away prematurely, deliberate removal is what should always be avoided. While this can be an act of willpower, it is vital to avoid temptation. This is especially true if you are in the midst of your first cold sore outbreak.

Understanding the scab stage and the importance it holds in the healing process can make a world of difference.

References

1. https://medicinetoday.com.au/2003/december/regular-series/uncontrollable-cutaneous-herpes-simplex-infection
2. Arora R, Chattopadhyay S, Agrawal S, Chatterjee S. Self-inflicted herpetic whitlow. BMJ Case Reports. 2014;2014:bcr2013201817. doi:10.1136/bcr-2013-201817.
3. https://www.nhs.uk/conditions/cold-sores/