Medical Review by Jennie Stanford, MD, FAAFP, DipABOM
Summary:
- The herpes simplex virus (HSV) can be spread unknowingly
,since symptoms do not always appear right away. - Learning to recognize the early signs of a cold sore can help you manage your symptoms effectively. Early signs include tingling, itching, and blisters.
- Knowing how cold sores are transmitted and practicing good hygiene can help prevent them from spreading. They normally spread through direct contact, contact with contaminated items, or saliva.
- Cold sores normally clear up on their own, but you can also use antiviral medications to help speed up the process.
- If you have cold sores, communicating honestly with people around you is important for preventing their spread.
Learn more about cold sores to minimize their impact
Did you know that cold sores are caused by the herpes simplex virus (HSV)? Not everyone does, but that’s the truth. Despite being common, this condition is still plagued by myths and misunderstandings.
But don’t worry—we’re here to help you understand how cold sores manifest and the factors that can lead to outbreaks. With this knowledge and support from our medical team, you can make informed choices for your health that help keep cold sores at bay.
Why cold sores are so common
Many people carry HSV without showing any symptoms, which means it’s possible to spread the virus without knowing it. However, learning more about when infection is most likely and how to spot the early signs can help you increase awareness and prevent HSV from being transmitted.
The virus that causes cold sores
There are many different strains of HSV, but only two kinds that affect humans:
- HSV-1 is the main cause of cold sores (herpes labialis).
- HSV-2 is more likely to cause genital herpes (herpes genitalis).
Both strains of the virus require close or intimate contact to spread. We’ll explain more about how exactly cold sores spread later on in this article.
When cold sores show up
Most people catch the virus that causes cold sores in early childhood, although symptoms don’t typically appear right away. They tend to be more severe at this age since your body isn’t used to the virus yet and hasn’t produced any antibodies.
Unfortunately, HSV stays in your body forever once you have it. The good news is that it usually lies dormant, meaning it doesn’t have obvious effects. It can come back later in life under certain circumstances, but it’s usually less severe because you’ve built up antibodies by then.
When cold sores reappear
As an adult, cold sores tend to appear more often when your immune system is weakened or when your body is fighting off an infection. Physically exerting yourself, being under stress, or experiencing hormonal changes may also play a role—but science doesn’t know exactly why some people get cold sores more often than others.
What cold sores look and feel like
Cold sores cause blisters to appear on a patch of skin that forms near your mouth. The skin in this area is usually tight and red, and it can also be itchy. Cold sores can also spread to nearby areas of skin.
The blisters normally break open within several hours. When this happens, they will leak fluid and then scab over. In most cases, they will go away in 5-15 days and will not leave behind a scar.
Other symptoms of cold sores
Sometimes, cold sores can come with other symptoms. These normally occur when you are first infected, as your body is not effective at fighting the virus yet. They can include fever, body aches, a sore throat, headache, and swollen lymph nodes near the location of the infection.
How cold sores spread
Knowing how cold sores are transmitted is essential to preventing their spread. They can be passed through any of the following ways:
- Direct contact with the affected area
- Indirect contact with contaminated items
- Saliva
To protect yourself and others, practice good hygiene, avoid close contact with infected individuals, and don’t share personal items.
Asymptomatic viral shedding
Cold sores are transmitted most easily when the sores are visible, but the virus can still spread when you don’t see or feel any symptoms. This is called asymptomatic viral shedding.
Identifying cold sores
Having an accurate diagnosis is vital for managing any herpes infection, and cold sores are no different. If you suspect you might have HSV-1, you should consult your healthcare provider for an assessment as soon as possible.
Having a cold sore diagnosed usually involves seeing a doctor, who can often tell if you have a cold sore by performing a visual inspection in a clinical setting. They may also perform a simple test using a swab to confirm that you have HSV-1.
Treating & managing cold sores
Cold sore medications
Antiviral medications are widely used to treat cold sores, and applying them quickly after an outbreak may reduce the severity and duration of your symptoms. These usually contain medications like acyclovir or penciclovir, which are available as oral tablets or topical creams and ointments. In tablet form, these medications usually require a prescription—whereas they can often be purchased over the counter in topical forms.
Holistic ways to treat cold sores
The main way to minimize cold sore outbreaks if you have HSV-1 is to avoid events that can trigger an outbreak. Here are some tips based on the known triggers for cold sores:
- Try to avoid getting sick or developing a fever
- Limit the time you spend in direct sunlight
- Try to avoid injuries and stressful situations
- Prepare for the possibility of cold sores if you are menstruating or going for surgery
- If you do get a cold sore, try having a cold drink or sucking on a popsicle to reduce discomfort
Preventing the spread of cold sores
Because the virus that causes cold sores can spread even when you don’t see or feel them, preventing the spread presents challenges. But there are several steps you can take to make transmission less likely:
- Talking to your partner(s) about whether either of you have cold sores before sex
- Not having sex when you have symptoms
- Wearing a condom
- Not sharing items that have saliva on them (like food or a toothbrush)
These methods may not make it impossible to transmit the virus that causes cold sores, but they can help lower the risk.
Finding support while managing HSV-1 & cold sores
Remember, cold sores are extremely common—billions of people worldwide have HSV-1. That makes it important to learn the symptoms of this condition and seek help quickly if you notice any signs so you can confirm whether or not you have it and take steps to prevent spreading it if you do.
Working with a qualified healthcare provider can help you identify cold sores and create a plan for managing them. Lemonaid Health can put you in touch with a US-based medical professional for an online consultation and provide cold sore medication if clinically indicated.
