Long Logo

Main Line Pediatrics

Are You Sick?

Cold Sores

Is this your symptom?

  • Painful blisters on the lips, nose or face
  • Also called fever blisters

Causes of Cold Sores

  • Colds sores, also called fever blisters, are caused by the Herpes simplex virus. They are spread from person-to-person by close contact, such as touching or kissing.
  • Many people get cold sores more than once.
  • After the first outbreak, cold sores can return when your immune system is weak. Factors are stress, being over-tired, viruses/illness, sun and wind exposure or hormone changes (menstrual periods).
  • The cold sore will get better in 7-10 days.

Treatment

  • There is no cure for cold sores, but there are medicines that can help with outbreaks.
  • Docosanol cream (brand name Abreva) helps decrease the pain and duration of cold sores. No prescription is needed.
  • There are also prescription creams and pills which may help relieve symptoms and/or make the sores heal faster.

When to Call for Cold Sores

When to Call for Cold Sores

Call Doctor or Seek Care Now

  • Sore or sores close to the eyes
  • Spreading redness around the sores
  • You feel weak or very sick

Contact Doctor Within 24 Hours

  • Weak immune system. Examples are: sickle cell disease, HIV, cancer, organ transplant, taking oral steroids, diabetes, kidney problems.
  • Sores in other places besides lips (inside the mouth, on the gums or inside the nose)
  • Getting worse in spite of treatment
  • You think you need to be seen

Contact Doctor During Office Hours

  • Cold sores happen often
  • You are worried you might have an STI (sexually transmitted infection)
  • Sore lasts more than 10 days
  • You have other questions or concerns

Self Care at Home

  • Mild cold sores

Call Doctor or Seek Care Now

  • Sore or sores close to the eyes
  • Spreading redness around the sores
  • You feel weak or very sick

Contact Doctor Within 24 Hours

  • Weak immune system. Examples are: sickle cell disease, HIV, cancer, organ transplant, taking oral steroids, diabetes, kidney problems.
  • Sores in other places besides lips (inside the mouth, on the gums or inside the nose)
  • Getting worse in spite of treatment
  • You think you need to be seen

Contact Doctor During Office Hours

  • Cold sores happen often
  • You are worried you might have an STI (sexually transmitted infection)
  • Sore lasts more than 10 days
  • You have other questions or concerns

Self Care at Home

  • Mild cold sores

Care Advice for Cold Sores

  1. What You Should Know about Cold Sores:
    • Cold sores are an infection in the skin caused by the herpes simplex virus. Early symptoms are tingling or pain.
    • An outbreak may be triggered by another illness, sunshine, stress or even menstrual periods.
    • Cold sores are contagious from when the tingling starts until they are fully healed.
    • Here is some care advice that should help.
  2. General Advice:
    • Avoid contact with babies or people with weak immune systems. It could cause a life-threatening infection.
    • Do not touch the cold sore except to put cream on it. Wash your hands before and afterwards. Do not lick the sores.
    • Do not share anything that comes into contact with the cold sore, such as towels, lip balm, eating utensils, or cold sore cream.
    • Do not have oral sex until the cold sore is fully healed. This could give your partner genital herpes.
    • If you wear contact lenses, do not touch the lens or your eye without washing your hands first. You could spread the virus to your eye.
    • Use a sunblock lip balm (SPF greater than 15) when outdoors.
    • Drink plenty of fluids to avoid dehydration.
  3. Pain Medicine:
    • To help with the pain, take an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil). Ibuprofen works well for this type of pain.
    • Use as needed but do not take more than the maximum recommended dosage as stated on the package.
    • If you are not sure what to take, ask a pharmacist.
  4. Other Medicines:
    • Docosanol cream (brand name Abreva) is an over-the-counter anti-viral cream. It may shorten the episode. Start the cream as soon as the tingling starts.
    • Your doctor may prescribe antiviral meds if your cold sores are severe.
  5. Work and Other Activities:
    • Cold sores are spread to others by contact with the sores or from your hands if you have touched the sore.
    • Wash the hands often. Try not to touch the sores.
    • For mild cold sores, you can continue work and other activities.
    • For severe cold sores, it may be better to stay at home.
  6. What to Expect:
    • Starts with tingling of the skin.
    • Fluid-filled blister(s) follow. These burst and become open sores which crust over and scab.
    • The skin often heals in 10 days.
  7. Call Your Doctor If:
    • Sores are near the eye or eyelid
    • Sores last more than 10 days
    • You think you need to be seen
    • Your symptoms get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2023 Schmitt Decision Logic LLC.

Share by: