Cold Sores

What are cold sores?

Cold sores are very common and affect around 7 in 10 people in the UK. They’re caused by the herpes simplex virus type 1 (HSV-1). Many people catch the virus in childhood through close contact, such as a kiss from an adult.

Once you have HSV-1, the virus stays in your body for life. However, only about 1 in 3 people ever develop visible cold sores.

Are cold sores the same as herpes?

Cold sores are caused by the herpes simplex virus, usually HSV-1. This is different from genital herpes, which is more commonly caused by HSV-2.

It’s possible, but uncommon, for a cold sore to spread herpes to the genitals through oral-genital contact. The risk is higher during an active cold sore, especially at the early tingling or blister stage. Avoiding oral sex until the cold sore has fully healed helps reduce the risk.

Cold sore symptoms

Cold sores usually develop in stages.

Many people first notice a tingling, itching, or burning sensation around the lips or mouth. Within a day or two, small fluid-filled blisters appear, most often on or around the lips. These blisters can burst, crust over, and then heal naturally within 7 to 10 days.

Recognising symptoms early is important, as early cold sore treatment is usually more effective.

How are cold sores spread?

Cold sores are contagious from the first tingling sensation until the skin has fully healed. The virus spreads through direct skin-to-skin contact.

You can reduce the risk of spreading cold sores by washing your hands regularly, especially if you touch the affected area, and by avoiding kissing during an outbreak. Extra care is needed around babies, as neonatal herpes can be serious.

Avoid oral sex while a cold sore is present, as the virus can spread from the mouth to the genitals and vice versa. If the virus enters broken skin on the fingers, it can cause a painful infection known as herpetic whitlow.

Sharing cups, cutlery, towels, or makeup is very unlikely to spread the virus, as HSV doesn’t survive long outside the body.

Recurring cold sores

Cold sores can come back because the virus remains dormant in the body. Recurrences are often milder and triggered by things such as colds or flu, stress, tiredness, sun exposure, skin injury, or hormonal changes like periods.

Understanding your personal triggers can help reduce flare-ups.

Cold sore treatments

Cold sores can’t be cured, but treatment can help shorten outbreaks and reduce discomfort, especially when started early.

Antiviral creams, such as those containing aciclovir, are most effective when applied at the first tingling stage. Cold sore patches can protect the blister once it forms and support healing.

For more severe or frequent cold sores, antiviral tablets may be prescribed following a clinical assessment.

Using lip balm with sun protection can also help prevent sun-triggered cold sores.

Managing pain and discomfort

Cold sores can feel sore or irritating. Paracetamol or ibuprofen may help ease discomfort. Avoid foods and drinks that irritate the sore, and consider using a straw if the cold sore is on your lip.

Getting advice and treatment at Nashi Pharmacy

Many people recognise cold sore symptoms themselves and don’t need a formal diagnosis. If you’re unsure, or if outbreaks are frequent or severe, help is available.

If symptoms don’t improve, or if you’re concerned, you should speak to your GP or pharmacist for further advice.