Cold Sores
HSV-1 is the most common cause of cold sores on the mouth and chin.

Cold sores are called fever blisters, commonly caused by the herpes simplex virus type 1 (HSV-1) and rarely by herpes simplex virus type 2 (HSV-2).

Cold sores are tiny fluid-filled blisters that commonly occur around the mouth and genitals. The fluid-filled blisters are grouped as patches. If the blisters break, they last several days. Cold sores take two to three weeks to heal without leaving a scar.

A cold sore blister may appear around your mouth or lips within 48 hours, but they can appear anywhere on your face, including your chin. As the blister on a cold sore develops, it may cause a swollen chin. The blister could resemble a cluster of small, fluid-filled (pimple-like) bumps surrounded by red, swollen skin.

What are the trigger factors for cold sores?

The herpes simplex virus type 1 lives in the nerve cells, and a few trigger factors may cause its recurrence.

Trigger factors include:

  • Fever
  • Physical or emotional stress
  • Strong sunlight or extreme cold temperature
  • Hormonal changes during pregnancy and menstruation
  • Some foods
  • Dental procedures
  • Injury in the affected area
  • Any other infections

What does a cold sore look like?

Symptoms of cold sores are more severe when they are infected for the first time.

The symptoms appear in the following four stages:

  1. Stage I: Tingling is the first sign before the cold sore develops. There could be burning and itching around the mouth for up to 12 to 24 hours before developing a cold sore.
  2. Stage II: The area becomes red, painful, itchy, and swollen and fluid-filled blisters appear.
  3. Stage III: In the weeping phase, the blisters rupture and ooze yellow fluid. At this stage, the infection is more contagious.
  4. Stage IV: Four to five days after the appearance of cold sores, the area crusts, and scabs. This may crack or bleed as it heals. At this stage, the infection cannot be transmitted. Then, the scabs may shed off, exposing the skin, which is pink or reddish. It takes 7 to 14 days to heal completely.

The first-time infection of cold sores causes:

What are the complications of cold sores?

Cold sores rarely cause complications. Complications most commonly occur with weakened immunity due to an illness or treatment, such as chemotherapy.

A few people have the following complications:

  • High fever: Commonly seen.
  • Dehydration: This occurs when a person has difficulty drinking fluids. Mostly young children are at high risk for dehydration.
  • Skin infections: Herpes infection can spread to other body parts, causing conditions, such as eczema, herpetic whitlow, or whitlow finger (painful sores and blisters are formed around the fingers).
  • Herpetic keratoconjunctivitis: Sores develop in the eye region, especially on the eyelids, and cause swelling and irritation. If keratoconjunctivitis is left untreated, this may infect the cornea (a transparent layer at the front of your eye), gradually leading to loss of vision.

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What are the causes of cold sores and who is at a higher risk of getting them?

The causes of cold sores are:

  • HSV-1 is the most common cause of cold sores. You may get it from contact with the infected person, such as kissing someone or using the utensils used by the infected person.
  • The virus reproduces and damages the skin, leaving cold sores that last a week.
  • In between the outbreaks, HSV-1 is present inside the nerve cells, and there are high chances of recurrence of cold sores, which are never cured completely.

The following people may get cold sores:

  • Infants and young children younger than three years
  • People with low immunity and conditions, such as AIDS
  • People who have undergone chemotherapy
  • People with eczema

How to prevent cold sores

It is not possible to prevent the spread of cold sores, but it can be minimized by taking the following preventive measures:

  • Do not touch cold sores; apply the cold sore cream gently on the sores.
  • Always wash your hands before and after touching the affected area.
  • Do not share items, such as lipsticks, spoons, or straws, that are in contact with the affected area.
  • Do not share cold sore creams or medicines with anyone.
  • Kissing and oral sex should be avoided until the sores are healed completely.
  • Infected people should stay away from newborns, pregnant people, and people with low immunity.
  • If your sores are triggered by extreme sunlight. Apply sunblock and lip balm with a sun protection factor of 15 or higher.

How to treat cold sores

Most of the time, cold sores are not harmful.

The following are the treatment options:

  • Apply ice or a clean cloth soaked in cold water and place it over the affected area. This may give some relief.
  • Aloe vera gel and petroleum jelly may ease the discomfort caused by the sores.
  • Antiviral ointments and creams, such as penciclovir, effectively heal the sores and relieve discomfort.
  • Ointments are more effective when they are applied initially.
  • Antiviral medicines (prescription drugs), such as acyclovir, valacyclovir, and famciclovir.

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Medically Reviewed on 11/10/2022
References
Image Source: iStock image

Cold Sores. https://my.clevelandclinic.org/health/diseases/21136-cold-sores

Cold Sores. https://www.hopkinsmedicine.org/health/conditions-and-diseases/cold-sores

Treating & Preventing Cold Sores. https://www.webmd.com/skin-problems-and-treatments/ss/slideshow-cold-sores

Cold sore. https://www.mayoclinic.org/diseases-conditions/cold-sore/symptoms-causes/syc-20371017