Cold sores are proof that life can be unfair -- some people get them, others don't. Besides being itchy and painful, cold sores (fever blisters) make you feel self-conscious. Certain treatments can help shorten the duration of symptoms of cold sores, when used at the first sign of an outbreak. Other treatments can relieve symptoms. Use this pictorial guide to learn how to recognize cold sores and how to prevent and treat them.
Cold sores aren't caused by the common cold. They're caused by the herpes simplex virus (HSV), passed on through contact with infected skin or body fluid. There are two types of HSV, type 1 and type 2. Cold sores are usually caused by type 1. HSV-1 damages the skin as it reproduces itself, creating cold sores that last about a week. Between outbreaks, HSV-1 hides out inside nerve cells, so it's never completely cured.
Who Gets Cold Sores and Why
More than half of us have been infected with the HSV-1 virus, usually from well-meaning kisses from relatives or romantic partners. So why do only an unlucky few get cold sores? The answer may be in your genes. A 2008 study identified six genes that many people who get cold sores share. Three of those genes may relate to how HSV-1 reactivates itself, causing outbreaks.
Stress Can Trigger a Cold Sore
HSV-1 spends most of its time inactive, hiding in nerves. Many people have familiar triggers that tend to bring HSV-1 out of seclusion, causing cold sores. Sunlight, fever, stress, and menstruation are common triggers. Some people get cold sores twice a year; for others, it's a frustrating, stressful, monthly ritual.
When You're Contagious
A cold sore is caused by skin damage as the herpes virus reproduces itself within infected cells. From the time skin turns itchy or red, HSV-1 is likely present and can be spread. Cold sores are most contagious when blisters are present and just after they rupture, until the skin is completely healed and looks normal again. However, some people can transmit the virus through their saliva at any time -- even if they never get cold sores.
How Is the Cold Sore Virus Spread?
HSV spreads through body fluids. The cold sore virus is usually present on an infected person's lip, even if there's no obvious sore. So the main way it is transmitted is by kissing. Because HSV-1 can also live in saliva, sharing kitchen utensils or drinking glasses can also allow infection. Oral sex can lead to HSV-1 infection of the partner's genitals.
How to Avoid Spreading the Virus
Use caution while a sore is present: No kissing, no sharing of toothbrushes, tableware, or glasses; and no oral sex. That will reduce most spread of HSV-1, although you may not be able to entirely reduce the possibility of spread.
Easing Cold Sore Pain
While the initial outbreak can last up to two weeks, recurrent outbreaks usually last about one week. Some people may find relief with hot or cold compresses. There is no cure for cold sores, but some over-the-counter creams and gels can provide symptomatic relief of burning and pain.
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