What are cold sores?

Cold sores affect around 7 in 10 people in the UK and they're caused by the herpes simplex virus, known as HSV. Most people pick up the virus as a young child through close physical contact with an infected adult. While it stays in your system for life, only 1 in 3 people will get symptoms.

In this article, you’ll find answers to some common questions and concerns, along with helpful information about the HSV-1 virus itself.

Are cold sores the same as herpes?

Technically, the herpes simplex virus (usually type 1, or HSV-1) is what causes cold sores. Genital herpes is typically caused by the HSV-2 virus and it’s important to be aware of this distinction.

While it’s possible to transmit genital herpes from a cold sore if it touches your genitals, this is less common. It’s even less likely if you take precautions, like avoiding oral sex when you or your partner have a cold sore that hasn’t healed fully or is at the early tingling or burning (prodromal) stage.

Cold sore symptoms

The typical cold sore stages include:

A tingling, itching or burning sensation (prodromal stage).
Small, fluid-filled blisters that mostly appear on or around the lips, usually over the course of 48 hours.
These blisters may merge and burst before crusting and healing on their own within 7-10 days.

If you recognise these cold sore symptoms early, it can help with effective treatment.

How are cold sores spread?

Are cold sores contagious? How do you get cold sores? and can you get genital herpes from a cold sore? are questions doctors, clinicians and pharmacists are often asked and yes, the virus is highly contagious – from as soon as you feel the initial tingling, itching or burning symptoms, right up until the cold sore has fully healed.

As the virus is spread via direct skin contact, you can help avoid passing it on by taking some simple precautions. For example:

It’s always good practice to keep your hands clean by washing them with soap and water. If you touch a cold sore for any reason, hand washing is vital. Unless you’re applying a treatment you should try not to touch a cold sore at all.
Avoid kissing during an outbreak, particularly newborn or young babies as they’re susceptible to infection by neonatal herpes. This form of the virus can be extremely harmful to them.
Don't have oral sex until your cold sore is completely healed up. Cold sores can spread from mouth to genitals, and genital herpes can spread to the mouth – it works both ways.

If there’s broken skin or a cut on a hand or finger, it is possible for the virus to enter, and this leads to what’s known as a whitlow.

It’s easy to avoid by following the same precautionary advice and, if you think you have it, see your doctor or pharmacist for diagnosis and treatment.

Alongside the reliable sources of information on the internet, you’ll probably read somewhere that the virus can be passed on if you share a cup, or bottle, use infected cutlery, towels, or make-up.

However, medical experts agree this is very unlikely because the HSV virus dies very quickly outside the body.

Recurring cold sores

As the virus that causes cold sores stays in your body it can reactivate, although if this does happen the symptoms are usually mild.

It’s helpful to know what the triggers can be and the most common are:

Colds, flu or other illnesses that might weaken your immune system.
Feeling tired, run down or stressed.
Exposure to the sun on the affected area.
A physical injury that’s damaged your skin.
Hormonal changes such as menstruation.

Cold sore treatments

Although they can’t be cured, you can get effective cold sore treatment over the counter at pharmacies and, as mentioned earlier, the sooner you start the better.

How to get rid of cold sores

Cold sore remedies include:

Antiviral creams. These include the brands Zovirax and Cymex which are most effective when you apply them as soon as you have symptoms. The active ingredient is an antiviral Aciclovir.
Protective cold sore patches. These are designed to treat a blister that’s already developed and by covering it, the patch protects the cold sore and helps it to heal.
There are antiviral tablets, but these are only used to treat severe cases and can only be prescribed by a doctor.

As strong natural sunlight (and sunbeds) is a trigger, sun blocking products for your face and lips can help with prevention, too.

Pain management

Cold sores can be more irritating and uncomfortable than out-and-out painful, but this obviously varies from person to person.

To help relieve any pain or discomfort, you could take paracetamol or ibuprofen and ask your pharmacist about pain numbing creams. Try to avoid foods or drinks that irritate your blister and if it’s on your lips, perhaps use a straw for drinking.

With the information available, including this article, a cold sore diagnosis is something you may not need from a doctor. You might recognise and be able to treat the symptoms yourself and you can always ask a pharmacist for advice.

If your cold sore (or sores) is causing serious discomfort or not clearing up, you should of course see your GP.