Cold sores are characteristic lesions caused by the herpes simplex virus that occur on the lips. They are often confused with canker sores, but they are very different. Canker sores occur inside the soft tissues of mouth, and are not caused by herpes simplex.

What Are The Symptoms of Cold Sores?

Before the appearance of cold sores, there is often what’s called a prodromal stage, where there is pain or tingling in a localized area. Cold sores are painful, red, fluid-filled blisters that typically occur on the lips, although they may also occur on the nostrils, chin, gums, or hard palate. You may also have soreness in the mouth, fever, and swollen lymph nodes.

What Causes Cold Sores?

Cold Sores are caused by Herpes Simplex Virus Type 1 (HSV1), which is distinguished from Herpes Simplex Type 2, which causes genital herpes. However, it is possible for either virus to cause cold sores; for example, lip-to-genital contact may result in an HSV-2-caused cold sore. Likewise, HSV-1 may cause genital herpes via this mode of transmission.

Who Is Likely To Get Cold Sores?

The great majority of the population has already been exposed to HSV1 in childhood, but most don’t know it. In most people, the virus lies dormant. It is only when the virus is activated (the virus enters what is called the “lytic phase”) that symptoms occur (a breakout). These factors may cause breakouts:

• Stress
• Menstruation
• Other infections
• Sunlight/sunburn
• Fever
• Local skin trauma
• Immunocompromise due to:
  • Long-term corticosteroid treatment
  • HIV
  • Immunosuppressive drug treatment

What Does Treatment for Cold Sores Involve?

Topical treatment with acyclovir cream may be helpful; a new regimen of one-day treatment with oral valacyclovir has demonstrated good results. However, it is important to treat the condition as early as possible.

What Are The Advantages Of Treatment?

The outbreak is relieved.

How Long Does It Take?

Treatment with topical creams should be five days. For oral preparations, the standard used to be 2-3 days, but a new protocol (mentioned above) uses only 1 day of treatment.

How Many Treatments Are Required?

One full course of antivirals should suffice, but you should be alert for any signs of recurrence.

When Will I See Results?

Cold sores may take as long as 14 days to completely resolve, although often, especially with oral antivirals, there is a response in 7 days or less.

What Are My Alternatives to Treat Cold Sores?

Docosanol – a nonprescription topical preparation sold under the trade name Abreva.

Will I Have Pain?

Cold sores can be painful, but the pain often subsides within a couple of days of treatment.

When Can I Go Back To Work Or School?

Unless you have high fever and other complications, cold sores should not prevent you from going to work or school.

Who Will Perform My Treatment?

One of our board-certified dermatologists will prescribe the appropriate treatment.

How Much Does It Cost?

Please call TopSurgeons at 800-506-8084 for more information.

Will My Insurance Cover Cold Sore Treatment?

Insurance should cover this condition and any approved treatments.