Helping You Say Goodbye to Cold Sores

Cold sores are tiny, fluid-filled blisters that form on and around your lips, often grouped in patches. After the blisters break, a crust forms over the resulting sore, which typically heals in about two to four weeks without leaving a scar. They’re typically spread from person to person by close contact and are caused by a herpes simplex virus (HSV-1) closely related to the one that causes genital herpes (HSV-2). Both viruses can affect your mouth or genitals and can be spread by oral sex. Cold sores are contagious even if you don’t see the sores, and there is no cure for HSV infection, so the blisters may return. Here at Certified Dermatology, we can recommend antiviral medications that will help your cold sores heal more quickly and even reduce how often they return. To learn more, visit our locations page and reach out to the office that’s most convenient for you to set up your initial appointment.

The Signs and Symptoms

A cold sore usually passes through several stages.

Tingling and Itching

Many people feel an itching, burning, or tingling sensation around their lips for a day or so before a small, hard, painful spot appears and blisters erupt.


Small fluid-filled blisters typically break out along the border where the outside edge of the lips meets the skin of the face. Cold sores can also occur around the nose or on the cheeks.

Oozing and Crusting

The small blisters may merge and then burst, leaving shallow open sores that will ooze fluid and then crust over.

Your specific signs and symptoms may vary, depending on whether this is your first outbreak or a recurrence. Symptoms can last for several days, and the blisters can take two to four weeks to heal completely. Recurrences typically appear at the same spot each time and tend to be less severe than the first outbreak.

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Additional Cold Sore Symptoms

Children under five years old may have cold sores inside their mouths, and the lesions are commonly mistaken for canker sores. Canker sores involve only the mucous membrane and aren’t caused by the herpes simplex virus.

During first-time outbreaks, some people also experience:

  • Fever
  • Painful eroded gums
  • Sore throat
  • Headache
  • Muscle aches
  • Swollen lymph nodes

When to Visit Certified Dermatology

Cold sores generally clear up without treatment. We recommend that you visit Certified Dermatology for your cold sores if:

  • You have a weakened immune system
  • The cold sores don’t heal within two weeks
  • Symptoms are severe
  • You have frequent recurrences of cold sores
  • You experience irritation in your eyes

Causes of Cold Sores

Cold sores are caused by certain strains of the herpes simplex virus (HSV). HSV-1 usually causes cold sores, while HSV-2 is usually responsible for genital herpes. Either type can cause sores in the facial area or on the genitals. Most people who are infected with the virus that causes cold sores never develop signs or symptoms.

Cold sores are most contagious when oozing blisters are present, but anyone can transmit the virus to others even if they do not currently have blisters. Shared eating utensils, razors and towels, and activities like kissing may spread HSV-1. Oral sex can also spread HSV-1 to the genitals and HSV-2 to the lips.

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Cold Sore Recurrence

Once you’ve had an episode of herpes infection, the virus lies dormant in nerve cells in your skin and may emerge as another cold sore at the same place as before. 

Recurrence may be triggered by:

  • Viral infection or fever
  • Hormonal changes, such as those related to menstruation
  • Stress
  • Fatigue
  • Exposure to sunlight and wind
  • Changes in the immune system

Potential Complications

In some people, the virus that causes cold sores can cause problems in other areas.


Both HSV-1 and HSV-2 can be spread to the fingers, a type of infection that is often referred to as herpes whitlow. Children who suck their thumbs may transfer the infection.


The herpes virus can sometimes cause eye infection. Repeated infections can cause scarring and injury, which may lead to vision problems or blindness.


People who have a skin condition called eczema are at higher risk of cold sores spreading all across their bodies. This can become a medical emergency.

Other Organs

In people with weakened immune systems, the virus can also affect organs such as the spinal cord and brain.

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