Cold Sores

Cold sores are caused by the herpes simplex virus (HSV). Once a person is infected, the virus stays in the body for life and may remain dormant for long periods.

Cold sores most often appear as painful, fluid-filled blisters on or around the lips, but they can also develop on other areas of the face. In healthy individuals, cold sores usually heal on their own within 5 to 15 days.

Many people experience early warning signs before a cold sore appears. These symptoms may begin 1–2 days before the blister forms and can include:

• Burning
• Itching
• Tingling
• Stinging
• Throbbing
• Mild numbness

Within about 48 hours, a blister typically forms, breaks open, releases fluid, and then scabs over.

Cold sores are caused by HSV, which is commonly acquired during childhood. Once infected, outbreaks can be triggered by certain factors, including:

• Sun exposure
• Cold or windy weather
• Illness (such as a cold or flu)
• Stress
• Fatigue
• A weakened immune system

Cold sores usually develop in three stages, though not everyone experiences every stage:

1. Warning stage – Tingling, itching, burning, or numbness where the sore may form
2. Blister stage – Painful, fluid-filled blister(s) appear
3. Healing stage – Blister breaks open, scabs over, and heals

For most healthy individuals, healing occurs within 5 to 15 days.

Cold sores and genital herpes are caused by the herpes simplex virus, but they usually involve different strains:

• HSV-1 commonly causes oral cold sores
• HSV-2 more commonly causes genital herpes

Both are contagious and lifelong infections.

Cold sores typically develop on:

• Lips
• Around the mouth
• Cheeks
• Chin
• Nose

Sores inside the mouth are usually canker sores, which are not caused by HSV.
In rare cases, HSV can spread to the eyes, fingers, or other areas of skin.

In individuals with healthy immune systems, cold sores usually heal within 5 to 15 days without complications.

Yes. Cold sores are highly contagious, especially when blisters are present or oozing. HSV can spread through:

• Direct skin-to-skin contact
• Kissing
• Sharing items like lip balm, utensils, or towels

Yes. Once infected, HSV remains in the body for life. Some people never experience outbreaks, while others may have recurring cold sores triggered by stress, illness, or environmental factors.

• Cold sores occur outside the mouth and are caused by HSV
• Canker sores occur inside the mouth and are caused by irritation, stress, vitamin deficiencies, or immune-related conditions

There is no cure for HSV. However, treatment can:

• Reduce symptom severity
• Shorten healing time
• Lower the risk of spreading the virus
• Help prevent future outbreaks

Cold sores often heal on their own, but treatment can help speed recovery. Options include:

• Over-the-counter (OTC) treatments – Creams with anesthetics or anti-inflammatory ingredients
• Topical prescription antivirals – Such as acyclovir or penciclovir
• Oral prescription antivirals – Including acyclovir, famciclovir, and valacyclovir

Prescription antivirals are most effective when started at the first sign of symptoms.

Yes. Mild outbreaks can be managed at home with:

• Moisturizing lip balms or creams
• Cold or warm compresses
• Nonprescription pain relievers

Telehealth services make it easy to get prescription treatment without an in-person visit.

Most cold sores heal on their own within one to two weeks. If a sore lasts longer than 15 days, worsens, or spreads, you should consult a medical provider.

Cold sores are contagious until the blister has completely healed and the scab is gone. Avoid close contact during this time.

Yes. Telehealth providers allow you to connect with a licensed medical professional online. If approved, your prescription can be shipped discreetly to your home or sent to a local pharmacy.