Cold Sores (Nongenital Herpes Simplex Infections)

  • Medical Author: MaryAnn Tran, MD
  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Cold Sores Slideshow

What does recurrent herpes look like?

By far the most common manifestation of herpes infections -- what people usually mean when they speak of "herpes" or "cold sores" -- is a recurrence of the virus when it is reactivated from its latent state in the nerves below the skin. What this looks like depends on where the virus has been hibernating. Although the mouth is the most common site of infection, other areas of the body may be involved:

  • Labial herpes: This is the familiar cold sore that appears on the lip margins (labial refers to the lip). When labial herpes reappears, it usually occurs at the same location each time or a few millimeters away.
  • Herpetic whitlow: Sometimes, the herpes virus shows up on the fingertip. This is especially common in dental and medical workers who have to put their fingers inside people's mouths, despite the use of gloves. In herpetic whitlow, the virus has entered the finger. Occasionally, the virus re-emerges and causes blister-like sores on the fingertip.
  • Wrestlers' herpes: This has the picturesque name "herpes gladiatorum." Gladiators, or nowadays just plain wrestlers, can contract herpes from an opponent who is shedding the virus. This form of herpes can appear anywhere over the body. The face, neck, and arms are common locations. Unlike most other types of infection, lesions may occur at multiple sites.

How long do cold sores last?

In recurrent herpes, sores start as inflamed red bumps that swell and become fluid-filled forming blisters. The blisters eventually collapse and form an ulcer. This will take two to three days. It often takes seven to 10 days before these ulcers completely disappear and the skin returns to normal.

In primary herpes, the healing process usually takes two to three weeks, but skin pain can last for one to six weeks.

Medically Reviewed by a Doctor on 2/18/2015
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