Cold sores — BIMC Hospital Bali

Cold sores

Posted on : June 7, 2011

Up to 30% of adult people in US had a history of having blisters around the lip.  80-90% of people under 50 years old actually carry the HSV 1.  These blisters are known as cold sores or fever blisters.  This is actually a virus infection caused by herpes simplex virus type 1, which becomes reactivated when someone’s immunity is down, like when they get sick.  In medical terms , the diagnosis is herpes labialis.

What is HSV ?

HSV or herpes simplex virus is a virus that infects humans, most commonly giving skin symptoms of multiple blisters.  There are 2 strains of the virus.  HSV type 1 causes blisters on the lip and around the mouth, while the type 2 strain causes blisters on the genital.  However, due to oral-genital contact, the typical symptoms have changed and either HSV type 1 or 2 can infect both the oral or genital area.

This is not the same as the chicken pox virus, ie. herpes-zoster virus, but has similar characteristics.  One similarity is that the virus is dormant in one’s body and can recur at any time, especially when someone’s immunity is compromised.

Transmission and Symptoms

Direct contact with an active lesion, ie. when the blisters break and ooze may cause transmission.  Other contact such as sharing eating utensils, razors and towels are also possible modes of transmission.

Cold sores most commonly appear on your lips.  Occasionally, they occur on your nostrils, chin or fingers.   Although it’s unusual, they may occur inside your mouth — more often on your gums or the roof of your mouth.  Typically the blisters appear within 1 week of exposure and clears up about 2 weeks.  The blisters form, break and ooze, then a yellow crust forms and finally sloughs off to uncover pinkish skin that heals without a scar.  After a crust develops, it is usually not contagious anymore.  There is a possibility of spreading the virus for some time even after the skin has healed.

Once you’ve had an episode of herpes infection, the virus lies dormant in the nerve cells in your skin and may emerge again as an active infection at or near the original site.  You may experience an itch or heightened sensitivity at the site preceding each attack.  Fever, menstruation, stress, fatigue and exposure to the sun may trigger a recurrence.


Your doctor will diagnose herpes labialis based on clinical symptoms.  Tests are not routinely performed since it only shows positive for the virus in your body but doesn’t show if it’s active or not.


Cold sores generally clear up without treatment.  In the meantime, the following steps may provide relief:

  • Use OTC ointments or pain reliever. Over-the-counter (OTC) ointments, such as topical lidocaine or benzocaine, can help ease discomfort.  Pain relievers include aspirin, acetaminophen  and ibuprofen.  Always follow the instructions and recommendations in the package.  If in any doubt contact your doctor.
  • Use cold or heat. Try applying ice or warm compresses to the blisters to ease the pain.
  • Let it heal. Avoid squeezing, pinching or picking at any blister.

Don’t let it spread

If you have a cold sore, avoid close contact with infants, anyone who has eczema (atopic dermatitis) or people with a suppressed immune system, such as people with cancer, AIDS or an organ transplant.  These people are at higher risk of more severe infection.


You can take steps to guard against cold sores, to prevent spreading them to other parts of your body or to avoid passing them along to another person.  Cold sore prevention involves the following:

  • Avoid kissing and skin contact with people while blisters are present. The virus can spread easily as long as there are moist secretions from your blisters.
  • Avoid sharing items. Utensils, towels, lip balm and other items can spread the virus when blisters are present.
  • Keep your hands clean. Wash your hands carefully before touching another person when you have a cold sore.
  • Be careful about touching other parts of your body. Your eyes and genital area may be particularly susceptible to spread of the virus.
  • Avoid triggers. If possible try to avoid or prevent conditions that stress your body, such as getting a cold or the flu, not getting enough sleep, or staying in the sun for long periods of time without applying sunblock.
  • Use sunblock. Apply sunblock to your lips and face before prolonged exposure to the sun — during both the winter and the summer — to help prevent cold sores.


–          webmd

–          mayoclinic

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