What you need to know about cold sores

What causes cold sores?
There are two viruses that cause cold sores: HSV-1 and HSV-2. Typically, HSV-1 causes sores in and around the mouth and nostrils. Both are highly contagious and transmit easily during close contact. Once the virus enters your body, you may experience the following:
- Sores in/around the mouth or in nostrils
- Flu-like symptoms
What are the symptoms of cold sores?
The initial symptoms of HSV-1 typically appear 2 to 20 days after exposure and include the following:
- Lesions on mouth, tongue, cheeks, chin or in the nostrils
- Swollen lymph nodes
- Mouth/tongue pain
- High temperature
- Nausea
- Difficulty swallowing/sore throat
- Dehydration
- Lip swelling
- Headache
Cold Sore Stages
There are several stages to cold sore development:
- Tingling, burning, itching sensation around the mouth
- Appearance of painful, fluid-filled sores
- Sores burst, releasing fluid
- Yellow crust forms over sores
- Crust comes off, leaving behind pink skin which heals in 3 to 4 days
Diagnosing Cold Sores
If you have recurring outbreaks, you can manage them at home by recognizing the symptoms and using medication. However, you should consult a medical provider if:
- The symptoms are severe
- The cold sore does not begin healing within 10 days
- Your gums swell
- You have a compromised immune system
- Your other symptoms are causing concern
Treating Cold Sores
In most cases, a cold sore outbreak will resolve on its own in 1 to 2 weeks without treatment, but some prescription and OTC treatments can shorter the duration of the outbreak, as well as reduce your pain/discomfort. However, they will not remove the virus from your body. Ideally, you should start treatment at the first signs of an outbreak. Some of the most common cold sore treatments include:
- Antiviral creams: these can shorten the duration of the outbreak. The cream should be applied every 2 to 3 hours.
- Oral antiviral medications: if you have frequent outbreaks or a compromised immune system, your medical provider may prescribe you an oral medication that should be taken 1 to 2 times a day. These can shorten the duration of the outbreak and may prevent it from coming back.
- Pain relievers: OTC pain relievers do not shorten the duration of the outbreak but can make you more comfortable. The cream/gel/ointment should be applied with a cotton swab and should never be shared.
- Home remedies: there are some home remedies that people use, but there’s no scientific proof that they work:
- Apply cold, soaked tea bags every hour
- Dabbing affected area with diluted tea tree, geranium, or lavender essential oil
- Applying petroleum jelly to keep the skin moist
Potential Complications of Cold Sores
In some rare instances, cold sores can lead to complications, especially in individuals with a compromised immune system. Some of these complications include:
- Dehydration
- Herpetic whitlow
- Herpetic keratoconjunctivitis, which is an infection that affects the eyes
- Encephalitis, which is a condition characterized by swelling of the brain and can be life-threatening
Preventing Cold Sores
When you have a cold sore, you can prevent the spread by:
- Avoiding kissing/skin-to-skin contact involving the affected area
- Don’t share personal items
- Wash your hands regularly
- Don’t touch areas where sores may develop
- If you must touch the sores, wash hands with soap and water after