Can Cold Sores Affect Your Ears?

  • Medically reviewed by Emina Ribic (MD) on October 25, 2018. Written by Linda White (MD).

Fever blisters on the ears are a very rare occurrence usually found in population of immunocompromised patients with HSV-1 outbreak.[1] In the other hand, it is quite common that cold sores lead to excruciating ear pain in otherwise healthy individuals. This agony can impact every aspect of your life. It can lead to a throbbing and level of swelling that prevents you from getting sleep.

Your stress level is also likely to increase due to the uncertainty of the medical reason. Is it a side effect of having a cold sore or is there a more worrisome medical explanation?

A cold sore in a different location could be the reason, but there is no guaranteed way to self-diagnose the problem. Unless you seek the opinion of your doctor, you’re unlikely to identify the cause. Also, if you have an infection, you’ll likely need a prescription medication.

We will now explain more about cold sore related ear pain and the other medical possibilities. You will also learn how to reduce your level of discomfort and speed up your recovery.

Medical Reasons for Ear Pain

Although it is unwise to self-diagnose a medical issue, it is only human nature to do so. This is especially true if you have ear pain and an active cold sore. Your initial conclusion might be to connect the cold sore on your lip to the discomfort in your ear. However, numerous other conditions could be the source of your agony.

While most sources of pain are not serious, some, in fact, can be a cause of great concern. This is true if your pain is coupled with fatigue, fever, nausea, etc.

Listed below are potential medical causes for your ear pain that are unrelated to a cold sore outbreak:

  • Ear canal infection
  • Earwax (blockage)
  • Infection within the middle ear
  • Foreign object in the ear canal
  • Swimmer’s ear (Otitis Externa)
  • Ruptured eardrum

While most of the issues noted above can be treated with ease, other issues can be more severe. These problems include, but are not limited to, Crohn’s disease, thyroid cancer, and mouth cancer. Furthermore, if you experience hearing loss or problems with balance during your cold sore outbreak, it is critical to consult a physician. It could be a sign of a vestibular neuritis2, which is a rare but severe complication of HSV-1 infection.

Given the harsh truth about what could be causing the pain, seeking a medical evaluation is critical. While ear pain can be caused by a cold sore, you should never make that blind assumption. It is always better to be safe than sorry when it comes to your health.

Is Earache Related to Cold Sores?

An earache can certainly be related to cold sores if you are in the midst of your primary outbreak. Severe recurring outbreaks can also cause random pains that are seemingly away from the cold sore location.

When the body attempts to fight off HSV-1, many locations of the body can be affected.[3] Similar to most any form of a virus, the body gets worn down. In the same way, the flu can make you weak and fatigued, and a cold sore can do the same thing if the outbreak is severe.

As it relates to an earache, this could be the byproduct of lymph node swelling. Given the lymph nodes relative location to the ear itself, it is not uncommon for ear pain to occur.

Although cold sores and ear pain can be related, so can many other medical issues. This is all the more reason to take medical action if for no other reason than to eliminate other conditions.

Do I have a cold sore or ear infection?

Inner Ear Infection vs. Cold Sore Complications

Complete with general ear pain, fever, nausea, and dizziness, inner ear issues and cold sore complications can be similar. Quite difficult to identify the true culprit, at least initially, severe outbreaks and legitimate ear problems can be hard to discern.

If you are currently dealing with a cold sore, it is important to treat it with an OTC medication. Although stating the obvious, over-the-counter treatment could serve to remove your symptom clutter. As it slowly begins to heal, pay close attention to your ear discomfort. Is it getting better or worse? Is the pain holding steady without relief?

While it is almost impossible to treat the unknown, you can treat your cold sore. This fact alone can help you tell the difference between a cold sore related issue and a serious ear concern. Just because you have a fever blister and are experiencing ear pain does not mean the two are related. It is certainly possible to be a victim of separate issues at the same time.

Aside from seeking immediate medical attention, the best thing you can do is be patient. Work on actively treating your cold sore and then assess your situation. If you discover that your ear pain (and symptoms) are still occurring long after your sore has vanished, you likely have an inner ear problem.

To recap:

  • Inner ear infection symptoms and ear pain caused by a cold sore can be similar. Because many of the same issues occur, it can be hard to understand what is taking place. With both an inner ear infection and a cold sore complication, you can experience dizziness, fever, nausea, and intense ear discomfort.
  • The best way to understand your situation, at least initially, is to treat your cold sore. If you find that your ear pain decreases as your cold sore heals, the two could be connected. However, if your ear pain continues after your sore is gone, you likely have an ear infection.
  • While it is often human nature to connect one issue as a side effect of another, that is not always the case. Having an inner ear infection in addition to a cold sore, while unfortunate, is certainly not impossible. In fact, your cold sore outbreak could have been triggered because your body was dealing with an inner ear issue.

How Do I Reduce the Painful Symptoms of Cold Sores? 

As it relates strictly to cold sores, select an OTC to treat your fever blisters. Abreva, for example, can provide fast relief in a matter of days.[4] Concerning advanced treatment, Virulite is a cold sore removal device that uses light technology. FDA approved, the Virulite machine can remove blisters in 72 hours.[5]

Regarding reducing ear pain, use a proven pain reliever like Advil, Tylenol, etc. Because your ear pain is likely from an unknown source, it is better to focus on general pain relief. Attempting to search for more advanced treatment without knowing what’s wrong could be problematic.

Can cold sores cause ear pain?

To Summarize:

  • While OTC methods can be used to treat a cold sore, ear pain needs to be combated with a basic pain reliever. Without a proper diagnosis, anything more specific (related to the ear) could result in complications.
  • If your cold sore and discomfort are directly related, your pain should begin to diminish after 10-14 days. However, if the pain does not subside, your issue is likely due to an unrelated medical episode.

Conclusion

Although uncertainty, especially as it relates to your health, is never a good feeling cold sores can create that concern. Because they can cause a variety of side effects, some people have to deal with more issues than others. While this matter is worthy in its own right, it can lead to a sense of confusion. For example, if you are unsure whether your ear pain is related to your blister outbreak.

While in a perfect world the answers would be clear, unfortunately, the waters remain muddied. The best you can do, at least in the short term, is treat the pain while treating your sores. Over time, typically within two weeks, you will know if your physical pain is related to your fever blisters.

Seek an OTC remedy for your cold sores and a fast-acting pain reliever for your ear discomfort. These methods should allow you to concentrate, relax, and get the sleep you have likely been missing.

References

  1. Cohen PR. The “Knife-Cut Sign” Revisited: A Distinctive Presentation of Linear Erosive Herpes Simplex Virus Infection in Immunocompromised Patients. The Journal of Clinical and Aesthetic Dermatology. 2015;8(10):38-42.
  2. Cohen BE, Durstenfeld A, Roehm PC. Viral Causes of Hearing Loss: A Review for Hearing Health Professionals. Trends in Hearing. 2014;18:2331216514541361. doi:10.1177/2331216514541361.
  3. https://www.ncbi.nlm.nih.gov/books/NBK482379/
  4. Treister NS, Woo SB. Topical n-docosanol for management of recurrent herpes labialis. Expert Opin Pharmacother. 2010 Apr;11(5):853-60. doi: 10.1517/14656561003691847.
  5. Dougal, G. and Lee, S. Y. Evaluation of the efficacy of low‐level light therapy using 1072 nm infrared light for the treatment of herpes simplex labialis. Clin Exp Dermatol. 2013; 38: 713-718. doi:10.1111/ced.12069

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