If you have heard of cold sores, you have probably also heard a lot of myths and old wives' tales that go along with them.
So, what is the real truth behind this common condition?
Is it a cold sore actually herpes?
The short answer to this question is ‘yes’, but that would make for a pretty brief article!
This simple fact actually causes a lot of confusion, and there is much more to understand about what it means in practice.
Mouth herpes on lips
Cold sores are most commonly caused by herpes simplex virus type 1 (HSV-1).
However, in some cases, it can be caused by herpes simplex virus type 2 (HSV-2), which is the virus that usually causes genital herpes (or herpes genitalis).1
The cold sores that you see on your face (oral herpes) are also referred to as herpes labialis.
They usually come from HSV-1 and when you first experience it, you may also find that it is accompanied by a temperature and swollen lymph glands as well as the soreness and blisters around the mouth.
Herpes simplex is not a hereditary condition, so it is no good blaming mum and dad!
How are cold sores transmitted?
The herpes simplex virus is only transmitted via an affected area of a person’s skin or mucosa, when the virus is active and it makes direct contact with someone else.2
Cold sore (herpes) symptoms
It is easy to confuse a cold sore with a regular spot in the first few days, but there are some tell-tale signs to look out for.
The most obvious one is that you will feel a cold sore before you see it.
The first sign of a cold sore is a tingling or itching sensation at least a day before anything appears on the skin and is known as the prodromal phase.3
Sadly, a cold sore also lasts much longer than a spot and will eventually become a crusty scab.
Our article ‘Cold sores: Getting under the skin of what causes a cold sore’ goes into more detail about where cold sores come from.
How to prevent cold sores
Your mother probably always told you that prevention is better than cure, and she is right.
As most adults carry the virus in some form, it is best to try and avoid the triggers that bring it to the surface if you can.4
If you develop cold or herpes sores on a regular basis, your doctor may offer you antiviral medication to help keep them at bay.
Other infections, such as colds and flu can increase the risk of reactivating the virus, as can becoming run down or getting sunlight on the affected area, so looking after yourself is key to avoiding a cold sore coming back.5
How to treat cold sores
There are many myths surrounding the use of alcohol, distilled vinegar or even tea bags to treat cold sores, but these are best kept in your kitchen and away from your face!
The best cold sore remedies
The best remedy you can offer your cold sore is protection.
You need to use lip balm and gentle foods to avoid irritation whilst also protecting those around you by not sharing anything that might have come into contact with your cold sore.
Kissing is also off the menu when you have a cold sore as it is highly contagious.
You should keep in mind that herpes simplex cannot be cured as it remains in the body in dormant form.
However, the symptoms can be cleared in less than two weeks and may or may not recur at other points in your life.
Cold sore complications
Due to the type of virus that creates the cold sore, there can be some complications associated with it.
Both types of the herpes simplex virus can be spread to the fingers as herpes whitlow (or whitlow finger).6
This painful infection of the finger is often found in children who transfer the virus when they suck their thumbs.
Those who suffer from eczema are found to be at higher risk of cold sores spreading to other areas of the body.
If herpes simplex infects the eye, it can cause pain, discharge and a sensitivity to light.
If you have a cold sore, you should never kiss a new baby. You can pass on neonatal herpes in this situation and it can be extremely harmful to the child.7
If you are ever concerned about a cold sore, or any complications that you think may be related to it, you should seek medical advice from a doctor or pharmacist.
Last updated: 2 April 2021