In this article
Cold sores are a common problem, causing discomfort and sometimes embarrassment. Understanding the different stages of a cold sore can help you manage the symptoms, prevent complications, and minimize the risk of spreading the virus.
In this article, we’ll discuss the five stages of a cold sore and explore what to expect at each phase.
Cold sores are tiny, fluid-filled blisters that usually form on the lips. They are also called fever blisters or oral herpes.
There are 5 distinct stages of a cold sore. However, not everyone experiences the same set of symptoms in the same order.
A cold sore is contagious from the time you first experience symptoms until it’s completely healed. Typical cold sore stages include:
During this stage, you may feel an odd sensation. A cold sore develops 12 to 24 hours before it’s noticeable. As blisters form, the skin often becomes red, inflamed, and painful. It can also become dry and itchy.
During the first outbreaks, it can take up to 20 days for symptoms to develop after being exposed to the cold sore virus.
Other symptoms include:
People who experience these early symptoms of cold sores may never actually have a cold sore outbreak. Applying over-the-counter (OTC) antiviral ointments or prescription antiviral medications may prevent them from forming and improve the healing process.
At first, a cold sore blister appears clear, then becomes pus-filled and cloudy. These blisters become painful and redder than usual. The blisters may appear alone or as multiple blisters close together in groups or patches.
Talk to a doctor if a cold sore forms on other parts of your body such as the nose, cheeks, or genitals. You should also talk to a doctor if a cold sore affects your eyes.
Without proper treatment, cold sores that form on or near the eye can lead to an infection which can affect your eyesight. Seek immediate medical attention if the eyes become:
Cold sore blisters burst and leak, or weep, clear to yellowish-colored fluid for a few days. Sometimes blisters merge before they rupture.
Blisters tend to rupture 2 to 3 days after they develop or 48 hours after warning symptoms develop. Once they rupture, blisters leave behind shallow, red, exposed, and ulcerated sores. The skin around the sores is often painful, dry, and irritated during this period.
Cold sores are most contagious during the weeping stage. Avoid picking or touching weeping sores to prevent them from worsening, spreading, or becoming infected with bacteria.
Like other wounds, a cold sore can crust and form scabs after it bursts. Crusting and scabbing typically occur 4 to 5 days after cold sores appear. Scabs may crack or bleed a bit as they heal.
Do not try to pick or pull off scabs or crusting. Applying hydrating creams or ointments can help scabs from becoming too itchy.
After a few days, the scabs fall or flake off on their own. The skin underneath scabs tends to be redder, pinker, or more sensitive than normal.
It often takes 1 to 3 weeks for sores to heal completely. If cold sores are recurring, they are often less severe and only take a week to heal.
Most cold sores don’t leave permanent scars unless they’re severe or extensive. However, scabs are often painful and irritating during this stage.
Most cold sores don’t require medical attention. Talk to a doctor if you have:
Cold sores are contagious and spread through close contact with bodily fluids or secretions. They are most contagious when the blisters are oozing but can spread even when invisible.
The herpes simplex virus 1 (HSV-1) causes most cold sores. But the herpes simplex virus 2 (HSV-2) can also cause it. More than 50% of people in the U.S. have the cold sore virus.
After a cold sore heals, the herpes simplex virus becomes dormant (inactive) and lives in nerve cells. Certain factors can trigger the herpes virus to reactivate and cause sores, which include:
A doctor will typically diagnose a cold sore by looking at it. They may also take a swab of the sore and send it away for testing.
Unfortunately, there’s no cure for herpes. However, some medications can help reduce symptoms and speed up healing.
People with frequent cold sores or a high risk of complications can take antiviral medication routinely or before exposure to triggers. If oral antibiotics are not effective, you can take antiviral medications intravenously (IV).
Some at-home remedies can reduce cold sore symptoms and improve the healing process. At-home remedies for cold sores include:
When you have cold sores, it’s best to avoid eating acidic, salty, or spicy foods. You should also avoid exposing yourself or other people to environmental triggers to prevent contamination.
You should also avoid sharing utensils and other personal items while you have cold sores. Lastly, avoid touching the sores directly. Use a clean Q-tip or swab if you need to.
Some OTC creams and ointments can prevent cold sores if you apply them when you notice early symptoms. You can also take certain steps to reduce the risk of being infected.
There are also ways to prevent cold sores and recurrent outbreaks. Common tips include:
If you experience severe or recurring cold sores, consult with a doctor to discuss potential treatment options and preventive strategies.
In this article
