Cold Sores

What are cold sores?

Cold sores are small, painful blisters that appear on your face - usually around your lips or mouth. They're very common and most people will get them at some point. The good news is they usually heal on their own within 10 days.

What do cold sores look like?

Cold sores don't appear suddenly. They usually start with warning signs:

• A tingling, itching or burning feeling on your lip or face
• Within 2 days, small blisters filled with fluid appear
• The blisters then burst and form a crusty scab
• The whole process takes about 10 days to heal completely

The blisters are usually small but can be quite painful. They can appear anywhere on your face, not just on your lips.

What causes cold sores?

Cold sores are caused by a virus called herpes simplex. Most people catch this virus as children through close contact with someone who has a cold sore - like being kissed by a family member.

Once you have this virus, it stays in your body for life. Most of the time it's sleeping and causes no problems. But sometimes it 'wakes up' and causes a cold sore.

Common triggers include:

• Being unwell with a cold or flu
• Stress or being run down
• Strong sunlight
• Your period
• Having a weakened immune system

How do cold sores spread?

Cold sores are very contagious from the moment you feel the first tingling until they're completely healed. You can easily spread them to other people or other parts of your body.

Important: Never kiss a baby if you have a cold sore. This can cause a serious condition called neonatal herpes, which is very dangerous for newborn babies.

To stop cold sores spreading:

• Wash your hands with soap and water after touching your cold sore
• Don't kiss anyone while you have a cold sore
• Don't have oral sex until it's completely healed
• Don't share towels, cups or cutlery

Treatment and self-care

What you can do at home:

• Take paracetamol or ibuprofen for pain (never give aspirin to children under 16)
• Drink plenty of fluids
• Use sunblock lip balm (SPF 15 or higher) when outside
• Avoid foods that make it worse (acidic or salty foods)

What not to do:

• Don't touch your cold sore (except when applying cream)
• Don't rub cream in - dab it on gently
• Don't pick at the scab

Pharmacy help: Your pharmacist can recommend:

• Pain-relief creams
• Antiviral creams (work best if used as soon as you feel tingling)
• Cold sore patches to protect the area

When to see your GP

Speak to your GP if:

• Your cold sore hasn't started healing after 10 days
• The cold sore is very large or extremely painful
• You're not sure if it's actually a cold sore
• You or your child also have swollen, painful gums and mouth sores
• You have a weakened immune system (from conditions like diabetes or cancer treatment)

Your GP might prescribe antiviral tablets for severe or frequent cold sores.

Remember, cold sores are very common and nothing to be embarrassed about. With proper care, they'll heal within 10 days.

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Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.