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Why stress can = cold sores

If you get cold sores, you’ll know how frustrating it is when – despite your best efforts – one still appears. But did you know stress could be a trigger? Around 90% of adults worldwide (so, nearly all of us!) carry the virus that causes cold sores: herpes simplex 1 (HSV1).1 You can pick up HSV1 from someone else who is infected – this could be through kissing or sexual contact, but sharing make-up, cutlery, towels or razors can also spread the virus.2

What causes cold sores?

Once infected, the virus lays dormant in your nervous system until certain triggers ‘wake’ it up, and that tingling, itching feeling will start. Over the next 48 hours small, fluid-filled blisters will appear, which then burst and form scabs.3 The cold sore should clear up in about 10 days, but see your GP if yours lasts longer. What triggers the virus varies from person to person, but there are some common causes:4
  • sunlight
  • hormonal changes linked to your periods
  • too much alcohol
  • not getting enough sleep
  • injury to the mouth of face
  • stress

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How stress triggers cold sores

A review of evidence published in the journal Brain, Behaviour and Immunity in 2009 concluded there was ‘a robust relationship’ between stress and cold sore outbreaks.5 In other words, if you’re under stress you’re more likely to develop cold sores if you’re infected. But exactly how does stress have this effect? When we’re stressed, our body releases the hormone cortisol as part of the fight-or-flight response. Scientists say that cortisol curbs our non-essential functions, such as our digestive system, so we have more energy to fight off a threat.6 The trouble is, our immune system is also repressed and that’s the trigger for HSV1 to activate. When we’re stressed, we tend not to eat properly either, which can lead a lack of immune-boosting nutrients in our diet. Zinc is a known immunity-booster, but if you’re not eating enough you could be more susceptible to cold sores.7

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Use stress relief to tackle cold sores

Getting on top of stress is not just good for cold sores; your whole body and brain will benefit! Start by eating a healthy, balanced diet with plenty of fresh fruits and vegetables to plug any vitamin gaps.

Make sure you’re taking regular exercise too, as this can help reduce levels of cortisol.8 This should also help you sleep better – sleep is essential for rest and repair, helping your body fight back against HSV1.9 Practice relaxation techniques such as yoga or mindfulness,10 and try to spend at least 15 minutes a day doing something you enjoy, like reading a book.

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Advice is for information only and should not replace medical care. Please check with your GP before trying any remedies.
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  1. . Mayo Clinic. Cold sore. Available from:
  2. . Medical News Today. Everything you need to know about cold sores. Available from:
  3. . NHS Choices. Cold sores.
  4. . Herpes Viruses Association. Cold sores – questions and answers. Available from:
  5. . Chia Y and Mao X. Does psychosocial stress predict symptomatic herpes simplex virus recurrence? A meta-analytic investigation on prospective studies. Available from:
  6. . Mayo Clinic. Stress management. Available from:
  7. . Zyba SJ, et al. A moderate increase in dietary zinc reduces DNA strand breaks in leukocytes and alters plasma proteins without changing plasma zinc concentrations. Available from:
  8. . Harvard Health Publishing. Exercising to relax. Available from:
  9. . Dr Jen Tan. Is stress causing your cold sores? Available from:
  10. . As Source 6

Related Topics

Cold Sore