Understanding Cold Sores

You have an important work meeting coming up, or perhaps you have a big date night, and you feel that familiar sensation on your lip. If you’ve ever experienced pesky cold sores, you know how irritating and uncomfortable it can be. When you understand how they occur and simple remedies to treat them, it will be a great source of comfort if one ever pops up.

What are cold sores?

A cold sore is also known as a fever blister and is caused by the herpes simplex virus (HSV). It presents as one or multiple small, red blisters around the mouth. They can occur around the lips or they can also develop on the inside of the mouth. HSV is actually very common, over two-thirds of the population carry the virus and it remains latent in people until a trigger (stress, fever, etc.) causes an outbreak.

Common symptoms that an outbreak of a cold sore is starting include:

  • tingling sensation
  • itching
  • localized swelling
  • reddened area

Cold sores can be managed, but unfortunately cannot be cured. Once you have a cold sore, there is always a possibility of developing another, but there are treatments and management that shorten the duration of the outbreak.

How does one get cold sores?

The virus that causes cold sores can be caught multiple ways including kissing a partner with a cold sore, or sharing things like food or make-up if they are contaminated with HSV. Direct contact with a towel can also pass on the virus if there is a break of skin.

Stages of Cold Sores

Stage 1 (Tingling)

This is the pre-blister phase when you may experience tingling or itchiness indicating that a cold sore is developing. This is the stage you want to start treatment to limit the duration and severity of your outbreak.

Stage 2 (Blister)

A localized swelling or fluid-filled blister will develop a few days after Stage 1. It may appear reddened and you may still feel tingling.

Stage 3 (Ulcer)

A few days later, the cold sore will break open oozing liquid. This is a painful and contagious period. Avoid touching the lesion and wash your hands regularly to avoid spreading the virus. You can use a warm compress for pain relief.

Stage 4 (Crusting)

Your cold sore will dry out and crust over in a brown or yellowish color to form a scab.

Stage 5 (Healing)

Healing takes approximately two weeks from the onset of your cold sore outbreak to the healing phase. Your crusting stage will heal over and flake away leaving new skin.

Cold Sores vs. Canker Sores

It is easy to confuse a cold sore and a canker sore as they are both irritating. Many people interchange the lesions, but there are actually major differences between them.

A canker sore, also known as an aphthous ulcer appears inside the mouth on the gum tissue, roof of mouth, and cheek. They can vary in size and they tend to be painful and sensitive to spicy and acidic foods. A few notable ways to determine the difference between them include:

  1. Cold sores are caused by HSV, while canker sores are caused by stress or injury.
  2. Canker sores are not contagious while cold sores are transmittable.
  3. A cold sore can appear in multiple parts of the body, while a canker sore remains in the mouth.
  4. A canker sore is white or yellowish with a reddened border.

Do I need to tell my dentist about having a cold sore?

You should notify your dentist if you have an upcoming appointment because cold sores tend to be contagious. It only takes touching a door knob, a sink, etc. to transmit the virus, therefore it is safer to reschedule your appointment for a few weeks once your lesion heals.

Cold Sore Triggers

Cold sore outbreaks can be triggered by:

HSV is typically triggered by environmental factors rather than food or medicine. Since HSV remains dormant in our nerves, some people are more likely to experience outbreaks from certain triggers and may notice a pattern of when they develop one (seasonal, during illness, etc.)

Possible Complications of Cold Sores

Cold sore complications are rare but possible. Most of the time complications arise when there is an interference with the healing process. A majority of people will see their oral cold sores resolve within two weeks, but if you have a weakened immune system or develop an infection, complications can result. These include:

  • Ocular herpes—this occurs when there is a transfer of the virus to the eyes. It can cause swelling or irritation and be treated with antiviral medication. Left untreated, it can lead to blindness.
  • Herpetic whitlow—you can transfer the virus from your mouth to your hand and fingers if there is a break in the skin.
  • Dehydration—it is possible to become dehydrated if you are avoiding liquids because of your painful lesions.
  • Encephalitis—this is a rare but serious condition when the virus can cause brain swelling and possibly death.
  • Eczema complications—if you suffer from eczema, it is possible to cause irritation of your skin if HSV gets transmitted to the area of eczema. You can develop serious lesions and require oral or intravenous antiviral medication.

Treating Cold Sores

Some people will swear by certain remedies because each person’s healing period is different and each person responds to treatment differently. Many remedies will help provide pain relief, reduce symptoms, and speed up the healing process. There are several strategies for how to cure cold sores and sometimes it takes some time and experimenting to find what works best for you.

  • Cold sore patch—a hydrocolloid gel patch is a good way to help conceal your cold sore. It prevents scabbing and encourages healing because it is designed to help heal wounds.
  • Make-up—make-up can help conceal your unsightly cold sore until it is ready to heal. Remember to wash your face well before bed.
  • Over-the-counter cream—several companies sell creams that promise a shortening of your cold sore outbreak.
  • Sunscreen—always protect your lips from the sun with sunscreen. Sun can actually trigger a cold sore.
  • Compress—a warm or cold compress may reduce redness and help relieve pain.
  • Pain relievers—an over-the-counter pain medication may be beneficial if your cold sore is extremely sensitive and you are having difficulty eating or drinking.
  • Lysine—this is recommended as a supplement and presents as a cream or oral treatment.
  • Tea-tree oil—some studies show that this oil helps heal cold sore lesions quickly.
  • Stress reduction—a major cause of cold sore outbreaks is stress. Try to use breathing exercises, yoga, and other meditating strategies to reduce your stress levels.
  • Antiviral medication—cold sores almost always self-resolve within two weeks with no treatment. If you have complications or want to speed the process up, speak with your doctor about antiviral medications like Acyclovir or Valacyclovir.