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Cold sores are small, watery blisters around the mouth caused by the herpes simplex virus type 1 (HSV-1). They are also referred to as fever blisters or oral herpes.
HSV-1 infection is common. The majority of the world’s population is thought to have HSV-1.1
HSV-1 infection never actually goes away. Instead, it remains dormant in the body. It also doesn’t usually cause any symptoms.2 Sometimes, though, people experience outbreaks, which generally include cold sores.
Once you’ve been infected with HSV-1, you may never have any symptoms, but it’s possible for you to have an outbreak.
Outbreaks may be brought on by:2, 3, 4
Cold sores can also be spread from person to person through close contact, such as kissing, oral sex, or sharing personal items.
Cold sores often start with itching, tingling, or burning around your lips. A visible rash may accompany these symptoms.
Soon after symptoms onset, the sores break out. They usually appear along the lips but sometimes surface on other parts of your face or inside your mouth.
When a sore oozes, it is considered the most contagious period. Wash your hands frequently, refrain from touching your face, and avoid sharing food or straws with other people.
Cold sores are generally shallow and watery. They leak fluid before they crust over and heal. If this is your first outbreak, you may also have a fever, sore throat, and body aches and pains.
Cold sores generally heal within a week and a half, even without treatment.5 Certain over-the-counter (OTC) and home remedies might help speed up the healing process.
Keep in mind that these remedies are more likely to be effective if you begin applying them as soon as your symptoms begin.
They include:
Docosanol is the active ingredient in the over-the-counter ointment Abreva. It acts as an antiviral agent, possibly by preventing your cells from fusing with the herpes simplex virus.6
If used as directed on the onset of a break out, it may shorten your healing time. One study found that it shortens healing by an average of 17.5 hours.7
Note: You may get a headache or experience some stinging where you applied the ointment.6
Zinc oxide is often available in a topical cream, like docosanol. It’s known to help soothe the pain and discomfort of cold sore outbreaks. It may even shorten healing time.3, 5
Certain over-the-counter cold sore gels dry after they’re applied. They may contain alcohol, which can heal cold sores by keeping them dry.3
Cold sore patches are available over-the-counter. They offer the double benefit of keeping your cold sores dry while also keeping them covered. Covering your cold sores also prevents you from touching them.
One study found these patches to be as effective as acyclovir, a common antiviral medication.8
Applying a damp towel or cloth to the area around your cold sore will keep the area clean. It may also reduce oozing and crusting and relieve pain.3
Rhubarb-and-sage creams are available in stores and online. Like cold sore patches, they’ve shown similar results to acyclovir in speeding up cold sore recovery.9
Propolis, or bee glue, is a mixture bees make from saliva, beeswax, and tree resin. It may help cold sores heal faster due to its antimicrobial properties.3, 10 Propolis isn’t always available in its purest form, but it does come as an over-the-counter ointment.3
Honey, like propolis, has antimicrobial properties. Medical-grade honey has been used in research against cold sores.11 Other kinds of honey may also have healing benefits due to the presence of antimicrobial compounds.10, 12
Aloe vera, which is often used to soothe sunburns and other skin conditions, can also promote healing in cold sores.13, 14 The aloe vera plant grows in many parts of the world, but gel extracts are available over the counter.
There are other home remedies you may want to try, such as:
These remedies may promote healing for cold sores, but research is either limited or shows modest efficacy.13
If you experience a cold sore outbreak, avoid spreading them to other people.
Take the following precautions:
Cold sores often go away on their own without professional treatment. But if your cold sores are severe, long-lasting, or recur frequently, see a doctor.
You should also notify your doctor if your cold sores cause eye discomfort. This may signal a potentially serious eye infection.3
Your doctor will likely be able to diagnose a cold sore by visual inspection alone. But it’s possible they’ll take a sample from an open sore and test it for other health problems.
Your doctor can prescribe antiviral medications to reduce the healing time and symptom severity. They are typically more effective than OTC treatments.
These medications may include:2, 3
These come in the form of pills, topical creams, and/or injections.
It’s best to avoid kissing, oral sex, and other close contact with someone who has a cold sore. Refrain from sharing personal items that may have touched their lips.
It’s possible that someone may be spreading the herpes simplex virus despite not having any visible cold sores. But if someone does have a visible outbreak, you’ll want to avoid close contact, especially if the sores are still leaking and haven’t crusted over.
Be proactive if you are aware of cold sore triggers. For example, if you frequently get cold sores after prolonged time in the sun, consider using sunscreen or sun-blocking lip balm. If stress causes your outbreaks, explore meditation or other relaxation techniques.
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