Oral Herpes & Cold Sores: Prevention and Treatments

Oral herpes and cold sores: what they are, causes, symptoms, prevention and treatments. Cold sores are fluid filled blisters caused by a virus that develop on the lips and around the mouth… They usually start off as a red patch and can develop in groups. Over a few days, the blister usually erupts and crusts over, leaving a scab which then slowly heals. They are common in the UK, and up to 7 out of 10 people carry the virus.

What causes cold sores?

Cold sores are caused by the Herpes Simplex virus. Oral herpes is the medical term for cold sores due to it being caused by this virus. There are two types, known as HSV-1 and HSV-2.

The majority of oral cold sores are produced by HSV-1; HSV-2 are more commonly associated with genital herpes but either type can affect any part of the body. Cold sores are caught via direct skin contact and most commonly this is thought to be due to kissing or having oral sex with a person who has an active infection of the virus.

The virus enters the body through a broken area of skin or inside the mouth. The virus then continues to travel from the skin to a nearby nerve, where it eventually becomes inactive.

Many people who have been infected with the virus often do not show any signs until they become ill and their immune system (cells of the body that fight infection) is weakened which gives an opportunity for the virus to become active. This is known as ‘re-activation’. Around 20% of people with the virus will have recurrent cold sores throughout their life.

Cold Sore Symptoms

An active infection may present as unpleasant tingling, burning or itching of the skin before blisters appear. Until the blisters scab over, the viral infection is highly contagious. Often cracks appear within the scabs that have formed and cause discomfort or pain, particularly when trying to eat or drink. Usually, cold sores clear up without treatment within 7 to 10 days.


Take steps in order to minimize the spread of infection:

  • Avoid intimate contact such as kissing a person when they have an active cold sore or contact with active genital herpes. This should not affect everyday contact with people at work or travelling.
  • Avoid sharing personal care items with a person with a cold sore such as toothbrushes, razors or towels.
  • Avoid touching and picking the sore as this can increase the chance of the virus spreading. Wash your hands before and after if you do touch the cold sore.

Some people may get a cold sore following a trigger. This can vary from person to person and if known, avoiding triggers can help. Triggers can even include injury, stress, menstruation, excess alcohol or ultra-violet (UV) rays from the sun or sunbeds.

Reducing your chances of a recurrence

You can reduce the chance of re-activation of the virus by following a healthy lifestyle to maximise the strength of your immune system, as well as avoiding any triggers if known. As part of keeping healthy we encourage getting enough sleep, minimising stress where possible, eating healthy and exercising regularly.

What treatments are available?

Normally, cold sores clear up without treatment within 7 to 10 days. However, anti-viral treatments are useful in relieving symptoms and shorten their duration, so they heal faster. The most common anti-viral treatment is Aciclovir, which comes in the form of a topical cream or tablets.

The cream can be purchased from a high street pharmacy or Chemist.net and they are most effective when used when you first notice symptoms (tingling). Tablets can be prescribed by a health professional or by consultation with TheDoctorService.co.uk when cold sores are recurrent and problematic.

Topical anaesthetic (numbing) creams may be used to numb the area of the skin and may help prevent blisters developing. For example, Lidocaine 5% ointment may be purchased from a pharmacy or Chemist.net.

Edited by Dr Kiran Sodha & The Doctor Service

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