Cold sores, also known as fever blisters, are small, fluid-filled ulcers that appear on the lips and around the mouth. They may last for a week or more, causing discomfort as well as embarrassment due to their crusty appearance.
For years, most cold sores simply had to run their course, causing pain for days or weeks. Today, however, there are safe and effective ways to help stop them or shorten the time they appear on a person's face.
The best approach to treating a cold sore is to attack it early before it can even be seen. This involves having the right medications on hand so they can be used at the earliest sign of a sore.
People who are prone to cold sores should also get to know what triggers them to help reduce the number of outbreaks. Finally, because cold sores are highly contagious, it is crucial to know how to avoid spreading them to others.
Though cold sores cannot be avoided all the time, people should always try to treat them as soon as they can.
Treating a cold sore in its earliest stage can result in a smaller sore that heals quickly.
Ideally, the cold sore may be stopped in its tracks, so it never appears at all.
The following steps can help stop a cold sore early or minimize the outbreak.
Know the early signs of a cold sore
Most people who get cold sores report that they can feel one coming before it appears on their skin. So, people who have them should watch for signs that a cold sore may be developing.
Tingling, burning, or itching may be felt around the lips for several hours or a day before the cold sore appears. This is the best time to begin treating the cold sore.
Keep antiviral medications on hand
People who frequently get cold sores may want to have the appropriate medications on hand so that they can begin using them at the earliest possible stage.
The medicines that have been proven to work on cold sores are called antivirals, and they work to stop a virus from replicating. This, in turn, can stop the cold sore from developing or may reduce its size and healing time.
Antiviral medications are only available with a prescription. Cold sore antivirals come in two different forms:
- topical medication (cream) that is applied directly to the area
- oral medications (pills) that are taken by mouth
Antivirals are well-tolerated by most people. However, not everyone can or should take antivirals. The benefits and risks must be discussed with a doctor.
People may wish to have a prescription filled out and ready rather than wait for the next cold sore to appear before they ask for one. This way, the medication can be taken or applied as soon as the tingling or other symptoms begin.
Antivirals work best when used as early as possible before the cold sore can even be seen.
Get to know cold sore triggers
Due to their potentially embarrassing nature, many people look to get rid of cold sores overnight.
However, preventing a cold sore is quicker and safer approach than treating an outbreak. People can try to avoid triggers that cause cold sores, keeping the sores on their skin from appearing in the first place.
Preventing a cold sore may also help reduce the risk of spreading the virus to other people.
Not all cold sores can be prevented, but knowing what triggers them is an important step in cold sore management. Common cold sore triggers include:
- certain foods
- an illness or surgery
- lack of sleep
- sun exposure or wind
- injury to the skin
- hormonal changes, especially from menstruation or taking birth control pills
- a weakened immune system
Keeping a diary or log may help a person work out what triggers their cold sores. Writing down things, such as diet, activities, illnesses, and life events can help narrow down what has preceded the outbreak.
An added benefit of knowing cold sore triggers is the ability to be even more proactive in taking medications. Consequently, if a person knows they were exposed to a cold sore trigger, they can be especially watchful for early signs and get started on medications right away, if needed.
Consider home remedies and over-the-counter products
Antiviral medications may only be prescribed for those who have recurrent cold sores. For an occasional sore that does not need a prescription medication, over-the-counter products or natural remedies may help with healing and appearance.
Some steps that people can take to treat cold sores early include the following:
- Docosanol (Abreva) is an over-the-counter treatment that may shorten a cold sore's duration. Like prescription medicines, it works best when taken at the earliest stage. Abreva can also be purchased online.
- Other over-the-counter cold sore products that contain tea tree oil, menthol, and antibacterial agents may also be helpful in managing the pain. Various products are available to purchase online.
- Rubbing alcohol and hydrogen peroxide may help dry out the sore and speed up healing. People should stop using it, however, if it causes more pain or irritation.
- Topical or oral numbing medicines, which can be purchased in stores, can help with discomfort. These may be safe for children, but caregivers should ask a pediatric doctor before using them on a child.
- Cold packs, ice, or cold foods and drinks may help soothe the area. They may also help with the healing process by fighting inflammation.
Cold sores are caused by the herpes simplex virus (HSV). Though HSV can be spread through sexual contact, the HSV that causes cold sores is not usually spread this way.
HSV type 1, which most often causes cold sores, can be spread through casual kissing, sharing utensils or drinks, and by touching the face.
Many children and babies are exposed to HSV type 1 through adults who unknowingly give them the virus by kissing them or touching their face.
The American Academy of Pediatrics (AAP) say that more than half of Americans have the virus in their body by the time they are adults, most of them having been exposed to it before age 5 years.
Once a person gets HSV, they will have it for life as the virus stays in the body and has no cure.
HSV may remain inactive for months or even years, causing no symptoms. However, certain triggers can cause it to become active again, resulting in a cold sore.
Cold sores spread easily from person to person. They can spread even when someone does not have an active sore.
To help avoid spreading the HSV virus, people can do the following:
- Avoid touching, scratching, or picking at cold sores. Touching them transfers the virus to the hands, allowing it to spread to the fingers, eyes, and to other people.
- Wash their hands frequently. This can help keep the virus off the hands, and so from being spread.
- Avoid sharing drinks, utensils, lip products, toothpaste, towels, or any items that might touch the mouth, especially when a sore is present.
- Avoid skin-to-skin contact with others when cold sores are present. This includes kissing, sexual contact, and contact sports.
Cold sores are rarely dangerous. In some cases, however, they can cause serious problems.
The HSV virus can spread to the eyes, causing scarring of the cornea or blindness. This is known as HSV keratitis, which is a major cause of blindness worldwide, according to the AAP.
Cold sores in babies can be dangerous, as their immune systems have not fully developed. Babies who are exposed to cold sores can become very ill.
Eczema herpeticum is a dangerous complication of cold sores that can occur in people with eczema. If the HSV virus comes into contact with eczema on a person's skin, it can spread throughout the body, causing long-term scarring, blindness, and sometimes organ failure or death.
People with weakened immune systems may also get a widespread herpes infection if they are exposed to a cold sore. This can affect vital organs such as the spinal cord and brain.
Most people recover completely from a cold sore outbreak without treatment.
Despite this, the herpes simplex virus never goes away and cannot be cured. For this reason, people who have frequent outbreaks may wish to look into antiviral therapy to help reduce the number of outbreaks and the risk of spreading the HSV to others.
Anyone who gets cold sores should be careful to avoid them spreading, especially to babies, children, and those who have weakened immune systems.