Understanding Cold Sores

A Patient's Guide to Herpes Simplex Virus Type 1 (HSV-1) Infections

Dermatology

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Last updated: Mar 24, 2025

What Are Cold Sores?

Cold sores, also known as fever blisters, are small fluid-filled blisters that typically appear around the lips and mouth. They're caused by the herpes simplex virus type 1 (HSV-1).

Key Facts

  • Highly contagious viral infection
  • Affects up to 67% of people globally
  • Usually heals within 1-2 weeks
  • Can recur throughout life

Symptoms

Early Warning Signs

  • Tingling or burning sensation
  • Itching around the lips
  • Redness in the affected area

Active Outbreak

  • Small fluid-filled blisters
  • Painful sores
  • Crusting and scabbing

Triggers

  • Stress
  • Illness or fever
  • Sun exposure
  • Hormonal changes
  • Weakened immune system

Treatment Options

Over-the-Counter Treatments

  • Antiviral creams (docosanol)
  • Pain-relieving creams
  • Cold sore patches

Prescription Medications

  • Oral antiviral medications (acyclovir, valacyclovir)
  • Prescription-strength creams

Prevention

  1. Avoid touching active sores
  2. Use sun protection on lips
  3. Manage stress levels
  4. Maintain good overall health
  5. Avoid sharing personal items

When to See a Doctor

  • Severe or frequent outbreaks
  • Symptoms lasting longer than 2 weeks
  • Eye involvement
  • Weakened immune system

Complications

Rarely, cold sores can lead to:

  • Bacterial skin infections
  • Eye infections
  • Spread to other body areas

Living with Cold Sores

While there's no cure for HSV-1, understanding triggers and maintaining good health can help reduce outbreak frequency and severity.

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