Everything you need to know about cold sores

Cold sores AKA “fever blisters” are ugly lesions that form around the mouth. They can be really inconvenient if you have a dance, date, wedding, or other event coming up.

If you noticed a fever blister this morning – don’t worry. The lesion will go away soon and the infection is not serious. In the meantime, read this article to learn all about fever blisters, why they happen, how to treat them, and what things can put you at an increased risk of getting one.

Oral Herpes (HSV-1)

The only people who get cold sores are people infected with HSV-1.

HSV-1 stands for herpes simplex virus type 1 (oral herpes), an incurable virus that is passed mainly through kissing. HSV-1 can be passed from one person to another even when no symptoms are present.

HSV-1 is different than but related to herpes simplex virus type 2, which is commonly known as “genital herpes.” HSV-2 is a sexually transmitted infection (STI) characterized by sores on the genitals/anus.

We will talk more about HSV-2 later.

Some good news about HSV-1:

  • You’re not alone. According to the World Health Organization (WHO), up to 66% of people under the age of 50 have oral herpes (that’s 3.7 billion people!). Click here to visit the WHO’s page on herpes.
  • HSV-1 is most common in Africa, where up to 87% of the population has it. The virus is far less common in North and South America, where between 40 and 50% of people under the age of 50 have it.
  • Most people with HSV-1 have no symptoms.
  • Fever blisters can be painful, but they are not serious.
  • Without treatment, most fever blisters will disappear within 7-10 days.

Some bad news about HSV-1:

  • Once you have HSV-1, you have it forever. There is no cure. 
  • People with HSV-1 are always at risk of developing a old sore.
  • HSV-1 can cause HSV-2 (oral to genital contact).

Risk factors

Not everyone infected with HSV-1 gets frequent cold sores. Certain behaviors that force your immune system to work harder can increase your risk of developing a fever blisters. Examples include: 

  • Not getting enough sleep
  • Stress
  • Sickness, other infections, and surgery
  • Being on your period
  • Taking any medication that suppresses your immune system
  • Sun exposure (to reduce your risk of getting a cold sore, wear sunscreen and chapstick with SPF)


Sores in and around the mouth are really the only symptom of oral herpes. Sores can look like blisters, lesions, or ulcers. When they form on a person’s lips, we call them “cold sores.”

These lesions can be painful and itchy. Infected people can also feel burning and tingling sensations.


While HSV-1 is generally harmless, there are cases when the infection causes life-threatening complications:

  • HSV keratitis, caused when the virus enters the eyes. HSV keratitis is one of the biggest causes of blindness.
  • Infant death: in rare cases, HSV-1 is passed from a mother to a child during birth. Because an infant lacks a strong immune system, exposure can lead to neurologic disability and death.
  • Eczema herpeticum, caused when HSV comes into contact with preexisting eczema. This can cause blindness, scarring, organ failure, and death.
  • Psychosocial impact: a person with frequent fever blisters can be ostracized by others and experience difficulties in sexual relationships.


There are a variety of treatment methods for cold sores. You can help relieve symptoms on your own by applying a little of your favorite essential oil to the cold sore.

Essential oils act as a moisturizer that can speed up healing and reduce inflammation. They also have antiviral properties, which can help fight the infection.

Note: essential oils can increase your risk of sunburn, so don’t apply before going outside.

Click here to read more about essential oils and cold sores (Source: Women’s Health Magazine).

Another way you can minimize the appearance of a cold sore at home is to use a cold compress. Try holding a cool, damp cloth over the area for 20 minutes. You can also purchase ointment at your local pharmacy (without a prescription).

If you experience cold sores frequently (more than 6 times per year), your best bet is to visit a doctor for an oral antiviral medication. Common antiviral medications include:

  • Acyclovir
  • Famciclovir
  • Valacyclovir

Note: treating a fever blisters as soon as symptoms appear will make it go away faster.

Avoiding transmission 

Follow these tips to avoid spreading your infection to others:

  • Do not scratch or pick at fever blisters (this can cause transmission and scarring).
  • Always wash your hands after touching or treating a fever blisters.
  • Avoid sharing products and items that come into contact with your mouth, such as utensils, drinks, makeup, toothpaste, and towels.
  • Avoid contact sports, kissing, and sexual contact

More about Herpes Simplex Virus Type 2 AKA “the bad herpes”

According to the WHO, roughly 11% of people between the ages of 15 and 49 have genital herpes (that’s 417 million people).

Just like oral herpes, most people with genital herpes have no symptoms, but can still transmit the infection. This is why so many people have it.

Symptoms of HSV-2 include genital/anal sores as well as body aches, fever, and swollen lymph nodes. In some cases, people will experience tingling or sharp pains in the hips, legs, and buttocks before sores are visible. Flare-ups generally become less common and less severe after the first outbreak.

Women and uncircumcised males have a higher risk of acquiring an HSV-2 infection. People infected with HSV-2 are 3 times more likely to be infected with HIV (human immunodeficiency virus).

To avoid transmitting HSV-2, avoid having sex when symptoms are present. When they are present, use a condom (use of a condom has been shown to decrease the risk of transmission by up to 50%).

Click here to read my article about Vitamin B12 and how you can tell if you have a deficiency. 

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