Cold Sores: Symptoms, Causes, and Treatments

Written by Ramya Kollipara, MD, Board Certified Dermatologist on March 4, 2020 One Comment

cold sores example

What Are Cold Sores?

Cold sores, sometimes called fever blisters, are small sores that can occur on the lips, within the mouth (along the gums or the mouth’s roof), inside the nostrils, or on the chin and cheeks. They resemble a blister in appearance. Cold sores typically cause pain along with an itchy or burning sensation.

What Causes Cold Sores?

Cold sores are caused by the herpes simplex virus (HSV-1 and HSV-2), which is a highly contagious virus that is transmitted through physical contact. It’s estimated that 50 to 80% of Americans are infected with herpes which may lead to development. The occurrence of cold sores differs greatly form person to person. Some individuals infected with the herpes virus will never develop a cold sore as the virus remains dormant. For others, cold sores can as frequently as 2-3 times per year after the virus is triggered by stress, fatigue, or injury.

How are Cold Sores Diagnosed?

Physicians are often able to properly diagnose cold sores through visual inspection. At times, a doctor may order a blood test or test a sample of the fluid from an active sore to confirm the diagnosis.

Can Cold Sores Be Prevented?

The only way to prevent cold sores is to prevent the transmission of the herpes virus. To prevent HSV transmission, individuals should do the following:

  • Avoiding kissing or touching someone who has an active cold sore
  • Practice safe sex
  • Practicing good hygiene including washing the hands often
  • Avoid the practice of sharing lip stick, straws, cups, utensils, or towels with others

Cold Sores Treatment Options

Unfortunately, there is currently no cure for cold sores. Typically, cold sores clear up on their own after 1-2 weeks. After a period of time the sore will typically break and ooze. A yellow crust develops on top of the sore which scabs away revealing pink skin that heals without causing scarring.

There are, however, a few options that can both shorten the duration of cold sore occurrence and minimize pain and discomfort.

Prescription Medication

Prescription antiviral drugs to address cold sores (and underlying HSV virus) include:

  • Valtrex (Valacyclovir)
  • Denavir (Penciclovir)
  • Famvir (Famciclovir)
  • Xerese, Zovirax (Acyclovir)

Over-The-Counter (OTC) Remedies

There are several non-prescription creams dedicated to shortening the duration of infection. Options include Zovirax or Soothelip, both of which can be purchased without a prescription. These creams are most effective when applied at the onset of a cold sore. Most OTC creams must be applied to the sore multiple times each day in order to be effective.

There are also a few OTC treatments solely dedicated to reducing pain and discomfort caused by the cold sore. Options include Cymex or Blistex. However, its important to note that these options do not contain antiviral medication, so they will not address cold sore duration or speed up the healing process.


Ramya Kollipara, MD

Ramya Kollipara, MD is a board-certified dermatologist and fellowship-trained cosmetic dermatologic surgeon specializing in the practice of both cosmetic and medical dermatology. Dr. Kollipara completed a prestigious laser and cosmetic surgery fellowship program at Cosmetic Laser Dermatology in La Jolla, California. During her fellowship, she was involved in cutting-edge clinical research for novel cosmetic treatments involving fillers, neuromodulators and lasers.


One Response to “Cold Sores: Symptoms, Causes, and Treatments”

  1. Orsdia says:

    I have been looking for such an information about cold sore for along time. Thanks for this.

Leave a Reply