(Fever Blisters; Herpes Labialis; Herpes Stomatitis; Herpes Simplex)
DefinitionCold sores are small, painful, fluid-filled blisters. They are usually found at the border of the lip.
|Herpes Simplex on the Lips|
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CausesCold sores are caused by 2 types of herpes simplex viruses. Cold sores are common. In most cases, people contract the virus as young children.You may get the virus from:
- Contact with the fluid from a cold sore of another person, or genital herpes sores
- Contact with the eating utensils, razors, towels, or other personal items of a person with active cold sores
- Sharing food or drink with a person with active cold sores
- Contact with the saliva of a person who has the herpes virus even if no sores are present
Risk FactorsFactors that can reactivate the virus and lead to an outbreak of cold sores include:
- Infection, fever, cold, or other illness
- Exposure to sun
- Physical or emotional stress
- Certain drugs
- Weakened immune system
- Physical injury or trauma
- Dental or other oral surgery
SymptomsA cold sore occurs most often on the lips, but can occur in the mouth or other areas of the skin. They are small, painful sores that are fluid filled and red-rimmed blisters.You may notice some itching, tingling, or burning the day before a cold sore appears. The sores will dry up with a crust and shallow sore after a few days.
DiagnosisYou will be asked about your symptoms and medical history. The blisters will be examined.A cold sore can usually be diagnosed with a visual exam. In rare cases, a sample of the blister may be taken. The sample will be sent to a lab to be tested.A blood sample may also be taken for testing.
TreatmentCold sores will usually heal within 2 weeks even without treatment. However, certain treatments may help decrease symptoms. They may also shorten the time that you have a cold sore. Treatment options include:To help reduce pain consider:
- Over-the-counter cold sore cremes and ointments
- Cold compresses on the blister
- Rinsing with mouthwash that contains lidocaine
PreventionTo reduce your chance of catching a virus, take these steps:
- Be careful around people who have active cold sores. Avoid skin contact and kissing. Do not share food, drink, or personal items.
- Avoid performing oral sex on a person with genital herpes. The virus spreads more easily when active sores are present.
- Avoid long periods of time in the sun.
- Use sun block on your lips and face when in the sun.
- Get enough rest. Try to minimize stress.
- If you have outbreaks often, talk to your doctor about taking antiviral medications.
American Academy of Dermatology
Family Doctor—American Academy of Family Physicians
The College of Family Physicians of Canada
Skin Care Guide Canadian Edition
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Herpes simplex. American Academy of Dermatology website. Available at: http://www.aad.org/dermatology-a-to-z/diseases-and-treatments/e---h/herpes-simplex. Accessed January 14, 2015.
Herpes. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/herpes.html. Updated May 2014. Accessed January 14, 2015.
Herpes simplex. DermNet NZ website. Available at: http://dermnetnz.org/viral/herpes-simplex.html. Updated December 7, 2014. Accessed January 14, 2015.
Oral herpes. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 8, 2014. Accessed January 14, 2015.
Schmid-Wendtner MH, Korting HC. Penciclovir cream—improved topical treatment for herpes simplex infections. Skin Pharmacol Physiol. 2004;17:214-8.
Spruance S, Bodsworth N, Resnick H, et al. Single-dose, patient-initiated famciclovir: a randomized, double-blind, placebo-controlled trial for episodic treatment of herpetic labialis. J Am Acad Dermatol. 2006;55:47-53.
Spruance SL, Jones TM, Blatter MM, Vargas-Cortes M, et al. High-dose, short-duration, early valacyclovir therapy for episodic treatment of cold sores: results of two randomized, placebo-controlled, multicenter studies. Antimicrobial Agent Chem. 2003;1072-1080.
- Reviewer: David L. Horn, MD
- Review Date: 01/2015
- Update Date: 05/02/2014
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