Cold sore
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Cold sores, often called fever blisters, are clustered, small, fluid-filled blisters. You may feel a tingling on your lip before a small, hard, painful spot appears (top). In a day or two, blisters form, which later break and ooze (bottom). Healing usually occurs in two to four weeks without scarring.
Cold sores — also called fever blisters — are a common viral infection. They are tiny, fluid-filled blisters on and around your lips. These blisters are often grouped together in patches. After the blisters break, a crust forms over the resulting sore. Cold sores usually heal in two to four weeks without leaving a scar.
Cold sores spread from person to person by close contact, such as kissing. They’re caused by a herpes simplex virus (HSV-1) closely related to the one that causes genital herpes (HSV-2). Both of these viruses can affect your mouth or genitals and can be spread by oral sex. Cold sores are contagious even if you don’t see the sores.
There’s no cure for HSV infection, and the blisters may return. Antiviral medications can help cold sores heal more quickly and may reduce how often they return.
A cold sore usually passes through several stages:
Signs and symptoms vary, depending on whether this is your first outbreak or a recurrence. They can last several days, and the blisters can take two to four weeks to heal completely. Recurrences typically appear at the same spot each time and tend to be less severe than the first outbreak.
During first-time outbreaks, some people also experience:
Children under 5 years old may have cold sores inside their mouths and the lesions are commonly mistaken for canker sores. Canker sores involve only the mucous membrane and aren’t caused by the herpes simplex virus.
Cold sores generally clear up without treatment. See your doctor if:
Cold sores are caused by certain strains of the herpes simplex virus (HSV). HSV-1 usually causes cold sores. HSV-2 is usually responsible for genital herpes. However, either type can cause sores in the facial area or on the genitals. Most people who are infected with the virus that causes cold sores never develop signs and symptoms.
Cold sores are most contagious when oozing blisters are present. But you can transmit the virus to others even if you don’t have blisters. Shared eating utensils, razors and towels, as well as kissing, may spread HSV-1. Oral sex can spread HSV-1 to the genitals and HSV-2 to the lips.
Once you’ve had an episode of herpes infection, the virus lies dormant in nerve cells in your skin and may emerge as another cold sore at the same place as before. Recurrence may be triggered by:
Cold sores on the lips can be embarrassing and tough to hide. But, turns out, you might not have a reason to be embarrassed.
“About 70-plus percent of the U.S. population has been infected with herpes simplex 1. Now, a very small percentage of those people will actually develop cold sores.”
Dr. Pritish Tosh, an infectious diseases specialist at Mayo Clinic, says, genetics determines whether a person will develop cold sores.
“A proportion of the population, they don’t quite have the right immunologic genes and things like that and so they’re not able to handle the virus as well as other people in the population.”
The problem is people can spread the herpes virus whether they develop cold sores or not. Herpes virus spreads through physical contact like kissing, sharing a toothbrush — even sharing a drinking glass — or through sexual contact.
“Since the number of people who are infected but don’t have symptoms vastly outnumber the people who are infected and have symptoms, most new transmissions occur from people who have no idea that they are infected.”
For the Mayo Clinic News Network, I’m Ian Roth.
About 90 percent of adults worldwide — even those who’ve never had symptoms of an infection — test positive for evidence of the virus that causes cold sores.
People who have weakened immune systems are at higher risk of complications from the virus. Medical conditions and treatments that increase your risk of complications include:
In some people, the virus that causes cold sores can cause problems in other areas of the body, including:
Your doctor may prescribe an antiviral medication for you to take on a regular basis, if you develop cold sores frequently or if you’re at high risk of serious complications. If sunlight seems to trigger your recurrences, apply sunblock to the spot where the cold sore tends to erupt.
To help avoid spreading cold sores to other people or to other parts of your body, you might try some of the following precautions:
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Cold sore
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