You know the warning signs—a tingling or burning sensation…a bit of itching…perhaps some redness on or around your lips. It is the start of a cold sore—a small painful fluid-filled blister caused by the herpes simplex virus (HSV-1).

You may think that all you can do is suffer through days with an unsightly sore on your face…but there are some things that will shorten the duration of a cold sore, says board-certified dermatologist Angela J. Lamb, MD.

Reality: Most people have been infected by HSV-1, the virus that causes cold sores, through close contact with someone who has a cold sore, and about 20% to 40% of those infected will get one or more cold sores over their lifetime. Cold sores are most common between ages 14 and 49.

What causes cold sores?

Cold sores, also known as fever blisters, are caused by HSV-1, which is among the most common recurring viral infections. The virus stays dormant in the body but reactivates under certain conditions. Cold sores can be triggered by stress, fatigue, illness, sun exposure, hormonal changes and a weakened immune system. Without treatment, they usually clear up on their own in 10 to 14 days.

Canker sore vs. cold sore

Cold sores are contagious blisters that appear around the lips and sometimes down to the chin. They often are confused with canker sores, or aphthous ulcers, non-contagious ulcers located inside the mouth and often caused by irritation, stress or certain foods.

Cold sore treatment

Prescription antivirals such as valacyclovir (Valtrex) and acyclovir (Zovirax) can shorten a cold sore’s healing time, especially if taken at the first sign. These medications can be given in pill or cream form…and in some cases, your doctor may prescribe both forms. You also can try the over-the-counter (OTC) cold sore cream docosanol (Abreva), which can slightly reduce healing time if applied early, but it’s less effective than prescription antivirals. If the cold sore is painful, you can also use an OTC numbing pain reliever such as topical lidocaine or benzocaine. Other steps…

  • Keep the cold sore area clean.
  • Avoid touching a cold sore to prevent irritation or infection…and to prevent the virus from spreading to other parts of your body or to other people.
  • Use a cold compress for pain relief.
  • Keep your lips moisturized to prevent cracking.
  • Try to avoid stress.
  • Wash your hands frequently.
  • Avoid close contact with others until the cold sore has cleared.
    •As a preventive measure, use sunscreen on your lips when you don’t have a cold sore

To prevent cold sores

If you experience frequent or severe cold sore outbreaks, daily antiviral therapy can help reduce recurrence and lower transmission risk. Call your doctor if…

  • Cold sores are frequent (five or more times a year), severe or last longer than two weeks.
  • A cold sore spreads to your eyes—signs would be blisters and irritation on your eyelids.
  • You have a weakened immune system and get a cold sore.
  • You have eczema and get a cold sore (cold sores can spread to breaks in the skin).

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