Cold sores, also known as fever blisters, are small, fluid-filled lesions that usually appear on or around the lips. They are caused by herpes simplex virus type 1 (HSV-1), one of the most widespread viruses in the world.

According to the World Health Organization (WHO), about 67% of people under age 50 are infected with HSV-1. Many never show visible symptoms, while others may experience recurring outbreaks several times a year, often triggered by physical or environmental factors.

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What Causes Cold Sores?

Cold sores result from HSV-1 infection, usually transmitted through direct oral contact. Once the virus enters the body, it remains dormant in nerve cells and may reactivate under certain conditions, including:

• Stress

• Fatigue

• Illness or fever

• Hormonal changes

• Prolonged sun exposure

• Dental procedures

When reactivated, the virus travels along nerves to the skin, leading to blister formation. While they most often appear near the lips, sores can also occur on the chin, cheeks, nostrils, or inside the mouth.

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Recognizing the Symptoms

Cold sores usually follow a pattern of stages:

1. Tingling and itching – A burning or tingling sensation around the lips appears 1–2 days before blisters.

2. Blistering – Small, fluid-filled bumps form near the lip line or face.

3. Oozing and crusting – Blisters burst and leave shallow sores that develop a yellowish crust before healing.

The healing process typically takes 7–10 days, and outbreaks may become less frequent with time.

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Treatment Options

There is no permanent cure for HSV-1, but several treatments can help shorten outbreaks and ease discomfort.

Prescription Antivirals

Best taken at the first sign of symptoms, these medications can reduce healing time and pain:

• Acyclovir (Zovirax)

• Valacyclovir (Valtrex)

• Famciclovir (Famvir)

Over-the-Counter Remedies

For milder outbreaks, topical products can help:

• Docosanol 10% (Abreva) – May reduce healing time if used early.

• Lidocaine or benzocaine gels – Provide temporary pain relief.

Supportive Home Remedies

These do not cure cold sores but may offer comfort:

• Aloe vera gel – Soothes irritation.

• Lemon balm (Melissa officinalis) – May shorten outbreak duration.

• Cold compresses – Reduce swelling and discomfort.

• Petroleum jelly – Prevents cracking and helps healing.

Always use clean hands or applicators to avoid spreading the virus.

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Preventing Outbreaks

To lower the risk of recurrence, experts recommend:

• Managing triggers – Track stress, sleep quality, sun exposure, and illness in a journal.

• Supporting immunity – Eat a balanced diet, exercise, stay hydrated, and get enough rest.

• Sun protection – Use SPF lip balm outdoors.

• L-lysine supplements – May help some individuals, though more research is needed.

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Preventing Transmission

HSV-1 is contagious even without visible sores. To reduce spread:

• Avoid kissing and oral contact during outbreaks.

• Do not share utensils, towels, razors, or lip balm.

• Wash hands often, especially after touching your face.

• Refrain from oral sex during outbreaks to avoid genital infection.

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When to See a Doctor

Seek medical attention if:

• Sores last longer than 10–14 days

• Outbreaks are frequent or severe

• The virus spreads to the eyes or other body areas

• You have eczema or a weakened immune system

Doctors may recommend episodic antiviral therapy (taken at outbreak onset) or suppressive therapy (daily medication to prevent recurrences).

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Final Thoughts

Cold sores are extremely common and manageable. While HSV-1 has no cure, early treatment, preventive care, and lifestyle adjustments can greatly reduce symptoms and outbreak frequency. By understanding your triggers, practicing good hygiene, and seeking medical advice when needed, you can successfully control cold sores and minimize their impact on daily life.