COLD SORES

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COLD SORES:
OVERVIEW
WHAT IS A COLD SORE?

A cold sore is a small blister or group of

blisters that usually develop on the lip or
around the mouth. Cold sores are
caused by the herpes simplex virus
(HSV).
Also known as fever blisters or herpes
simplex labialis

If you get these, you’re not alone. More

than half of Americans ages 14 to 49
carry the virus that causes them. The
virus stays in the body after they clear. If
the virus reactivates, or wakes up, you
may get them again.

They are generally not serious. In

healthy people, they tend to clear within
two weeks.

THEY ARE SO CONTAGIOUS THAT MANY

PEOPLE CATCH THE VIRUS THAT
CAUSES THEM BY THE TIME THEY’RE 5
YEARS OLD.

If you have one, you can spread the

virus to others who don’t have the virus.
Even when you treat them, you can still
spread the virus to others. You are
contagious until all the sores have
scabbed over.

By taking the following precautions until

all of the sores have scabs, you can
avoid infecting others:

Don’t kiss people, especially

children
Avoid other intimate contact
Avoid close contact with anyone
who has a weakened immune
system, including newborn babies
Don’t share personal items like lip
balm, towels, or razors
Don’t share beverages or food
Try not to touch your cold sores
If you touch a cold sore or apply
medicine to it, wash your hands
immediately afterward
Wash your hands frequently
throughout the day

These precautions are especially

important if you are around a child who
has eczema or someone who has a
weakened immune system. If that
person catches the virus, it can be very
serious.

SIGNS AND SYMPTOMS

Not everyone who catches the virus has
signs or symptoms. If you do, your signs
and symptoms will depend on whether
you:
Just caught the virus (newly
infected)
Have had the virus for some time

The following explains what signs and

symptoms develop, and when.

NEWLY INFECTED
Most people catch the virus when they
are a child. Not every child who catches
the virus, however, has symptoms. If
symptoms occur, the child usually feels
sick and has one or more of the
following:

A burning sensation in the mouth,

followed by painful mouth sores,
which can form on the tongue,
gums, lips, or throat
Sore throat
Pain when swallowing
Swollen lymph nodes (glands)
Fever
Aches and pains
Headache
Nausea

These symptoms last from one to two

weeks.

It’s rare for adults to catch this virus. It’s

so common and spreads so easily that
most people get it in childhood.

If you catch the virus as an adult, you

may or may not have signs and
symptoms. If you do, you’ll have the
same signs and symptoms as newly
infected children. Adults often say they
feel like they have the flu and have
painful sores inside their mouth.

After you get infected, the virus travels

to your nerves and stay there until it
reawakens. Even if you never have
symptoms, the virus will still travel to
your nerves. Because there is currently
no cure, the virus lives inside your body
permanently.

Even with the virus inside your body, you

may never get a breakout. Some people,
however, get them occasionally, which
tends to be less severe. The signs and
symptoms also differ.

1. Warnings symptoms begin. A day

or two before an outbreak, you may
feel one or more of the following
where the breakout is going to
appear:

Burning
Itching
Stinging
Tingling and the skin feels a little
numb
Throbbing

Some people who have these warning

symptoms never get a fully broken out
cold sore.

MEDICINE, WHICH YOU CAN BUY

WITHOUT A PRESCRIPTION, CAN
SHORTEN HOW LONG THEY LAST. YOU
NEED TO APPLY IT AT THE FIRST SIGN
OF AN OUTBREAK.
1. An outbreak appears. One or
more painful, !uid-"lled blisters
appear. These usually form on your
lips or around your mouth. They
can also appear elsewhere on your
face.If you have a sore near an eye,
you should see an eye doctor
immediately. The virus can spread
to the eyes. Warning signs that this
has happened include your eyes
becoming sensitive to light or
feeling painful. Your eyes may also
feel gritty or runny.If any of these
symptoms develop, you need
immediate medical treatment.
Without treatment, your eyesight
could be a#ected. Sometimes,
blisters appear elsewhere. They can
appear on a hand or in the genital
area. This can happen when you
spread the virus from your mouth
to other areas by touching a sore
and then touching another part of
your body. You can avoid spreading
the virus to other parts of your
body by not touching the sores.
Washing your hands after touching
a sore accidentally can also help
prevent spreading the virus to
other parts of your body.
2. Sores crust over. Within 48 hours
of the warning symptoms, sores
usually break open. They will ooze
!uid and then crust over (form
scabs).In healthy people, most
sores will disappear then within 5 to
15 days. They often heal without
leaving a scar.

If you have cold sores for longer than 15

days, you should see your primary care
doctor or dermatologist. Some people
need treatment to get rid of cold sores.

VERY CONTAGIOUS
The virus that causes cold sores is very
contagious, so many people get cold
sores.

In the United States, people usually get

this virus when they are a child. Getting
kissed by someone who has a cold sore
is often how a child catches the virus.

A child can also get the virus by eating

from the same fork or spoon as
someone who has a cold sore or sharing
a towel with a person who has a cold
sore.

Adults also catch the virus. That’s why

it’s so important for everyone who has a
cold sore not to kiss people or have
intimate contact until the cold sore forms
a scab. To prevent infecting others, it’s
also important to stop sharing personal
items like towels and razors until the
cold sores form scabs.

OUTBREAK TRIGGERS
Some people have triggers that cause
outbreaks of cold sore. A serious
sunburn triggered this teen’s cold sores.

A virus causes cold sores. Most cold

sores are caused by the herpes simplex
virus (HSV). More than half of
Americans ages 14 to 49 carry this virus.

Once you get the virus that causes cold

sores, you have it for life. After the sores
clear, the virus travels to your nerves,
where it stays unless it reawakens.

After getting infected, some people

never get a cold sore. Others see some
cold sores, but then develop antibodies
to the virus and never get another cold
sore. It’s also possible to get cold sores
throughout your life.

Outbreaks tend to occur less often after

35 years of age.

If you get cold sores, it’s likely that

something triggers the virus to wake up.
The following can be a trigger:

Stress
Fatigue
Illness, such as a cold, fever, or !u
Injury, such as a cut, to the area
where you have had cold sores
Dental work
Cosmetic surgery or laser treatment
Strong sunlight
Certain foods
Hormonal changes, such as getting
your period

What triggers cold sores in one person

may not trigger them in another person.

HOW DO DERMATOLOGISTS
DIAGNOSE COLD SORES?
A dermatologist can often diagnose a
cold sore by looking at it.

Your dermatologist may also swab a

cold sore. Fluid from the sore can be
examined to find out if you have a
herpes virus called the herpes simplex
virus (HSV). This is the virus that causes
cold sores.

HOW DO DERMATOLOGISTS
TREAT COLD SORES?
To treat cold sores, a dermatologist may
prescribe:

Antiviral medication: Cold sores are

caused by a virus, so antiviral
medications are used to treat them. Your
dermatologist may prescribe medication
that you:

Apply directly to the sores, such as

docosanol cream or acyclovir cream
Take by mouth, such as acyclovir,
valacyclovir, or famciclovir

For someone who has a serious

outbreak and cannot get relief from the
above, a dermatologist may prescribe an
antiviral medication that you receive
through an IV, such as foscarnet or
cidofovir. You’ll be closely watched if
one of these medications is necessary.

If you get cold sores often and have a

weak immune system, your
dermatologist may prescribe a
prescription cream called penciclovir. It
can reduce the time that you have an
outbreak. To work, you need to apply it
to the skin with the first symptoms, such
as burning or tingling.

TREATMENT TIP
When applying medicine, dermatologists
recommend gently dabbing the medicine
on with a clean cotton-tipped swab.

Pain medication: If you have a lot of

pain, your dermatologist may prescribe a
medication that you apply to the sores,
such as lidocaine.
Sunscreen: While the sores are healing,
it’s important to protect them from the
sun. A lip balm with an SPF of 30 or
higher and broad-spectrum protection
can help protect your lips. Worn year
round, this lip balm may help prevent
new outbreaks.

Treatment can shorten your outbreak. It

may even prevent you from getting a
cold sore if you start treatment at the
first sign of one (a tingling or burning
sensation on your skin).

Treatment can also reduce your risk of

spreading the virus to others. Treatment
is highly recommended if you get a cold
sore and have:

Atopic dermatitis (usually begins in

childhood and is often called
eczema)
Sores near your eyes
A lot of cold sores
A lot of pain
Sores that spread to another part of
your body, such as your hands or
genitals
HIV, AIDS, cancer, or another
disease that weakens your immune
system
Cancer and are getting
chemotherapy
To take medication that suppresses
your immune system, such as
medicine to control severe psoriasis
or prevent organ rejection
Outbreaks frequently
An outbreak that lasts more than
two weeks

It’s important to treat cold sores if you

have any of the above because they
may not go away without treatment. Left
untreated, the virus can spread to other
parts of your body. Some people
develop another illness and become
very sick.

If you’re healthy, you can treat them on

your own. Find out what dermatologists
recommend at, Cold sores: Self-care.

OUTCOME
Cold sores cannot be cured. Some
people get the virus and have just one
outbreak. Others continue to get
outbreaks over their lifespan.

If you get cold sores several times a

year, tell your dermatologist. A
prescription antiviral medicine may help.
Taking this medicine at the start of an
outbreak can shorten the duration. Some
people who get cold sores frequently
take this medicine every day. Taken
daily, it can help prevent outbreaks.

TIPS FOR MANAGING

How to treat cold sores

WHEN TO SEE A
DERMATOLOGIST
Some people need help to clear cold
sores. You should make an appointment
to see a dermatologist if you have:

Atopic dermatitis
A weakened immune system
because you take a medicine that
suppresses your immune system or
have a disease that weakens your
immune system
Close to your eyes
Happen several times a year
Lasting longer than 15 days

Treatment can help you feel better and

prevent complications.

SCHEDULE APPOINTMENT

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