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Cold Sores

What is a cold sore?

Cold sores are blisters that appear on your lips and around your mouth. They are caused by a virus called herpes simplex..

There are two types of herpes simplex virus:1 and 2. Type 1 mostly causes cold sores. Both types can cause sores or warts on the genitals. The information on this page applies to sores on the mouth.

You can catch herpes simplex from other people, through their saliva. Most people are first infected as children.

Some children get very ill when they are first infected. They may get ulcers inside their mouth and may find swallowing painful. They may also have a fever, swollen glands, bad breath, poor appetite, and decreased energy levels. If your child has these symptoms, you should take them to see a doctor. There are many treatment options.

Once you are infected with the virus, it stays in the nerves in your face. It can cause further cold sores at any time. Some things such as throat infections, stress, tiredness, periods in women, exposure to sunlight, and some medications, including steroids can trigger a cold sore to develop.

You can pass the virus to other people when you have cold sores through your saliva. To reduce the risk of passing the virus, you should avoid kissing, sharing cutlery and towels. You should avoid oral sex when you have cold sores.

What are they symptoms?

Cold sores start as red patches and become small blisters. When the blisters burst, the skin becomes an open sore. Some people may get a fever. Your skin will return to normal in a week to ten days.

What are the treatment options?

Cold sores usually clear up without any treatment in seven to ten days. There are some things you can to do help prevent and to treat attacks.

If sunlight triggers your cold sores, it is helpful to try using sunscreen to protect your lips and mouth from the sun. There is some evidence that using sunscreens on your lips and mouth can reduce the chance of new cold sores.

You can by antiviral creams from the chemist, such as acyclovir (Zovirax). Generally these work best if started as early as possible when a cold sore is developing (when the tingling sensation first happens). These creams can make your skin red in itchy.

Doctors sometimes prescribe antiviral tablets for babies and children if they get very bad cold sores. Antiviral tablets may be prescribed for adults with weak immune systems, such as people with HIV and cancer. However, most people do not need antiviral tablets because the cold sores usually go away without treatment.

Other treatments options include tablet forms of the antiviral medications – acyclovir (Zovirax), famciclovir (Famvir) or valaciclovir (Valtrex). There is strong research to indicate that antiviral tablets can help treat cold sores as well as reduce pain and speed up healing. Taking these antiviral tables before symptoms appear or shorty after symptoms appear may speed up recovery.

What happens if I do not treat it?

Cold sores clear up without treatment in about seven to ten days. They do not leave a scar. Most people who are infected with the herpes simplex virus get cold sores every year. 1 in 10 people get cold sores six or more times a year.

People with a weak immune system may get more serious illnesses from herpes simplex.


Who should I ask for more help?

Dr Roth recommends discussing problems with cold sores with your GP. If first-line treatments are not adequate your GP may refer you to an infectious diseases specialist or an immunologist.

Please note Dr Roth does not offer consultations or treatments for cold sores.

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