Cold Sores: What You Need to Know About Oral Herpes

Have you ever had itchy, tingly blisters on your lips or the skin around your mouth when you were sick or on your period? These could be cold sores, which are a common condition caused by the herpes simplex virus (HSV). Although they usually heal on their own, understanding the condition can help you manage it more effectively.

What is a cold sore?

A cold sore, also known as oral herpes, is a small, fluid-filled blister that usually appears around the lips but can also develop near the mouth, nose, or chin. These blisters often appear in groups, and after they burst, they leave a scab that can last for days.

Cold sores can be spread by direct contact with skin or saliva, like when you kiss someone or share utensils. While the virus is mostly spread through non-sexual contact, it can also be spread sexually, especially through oral intercourse.

Cold sore causes

Most cases of oral herpes are caused by herpes simplex virus type 1 (HSV-1). However, HSV-2, which is usually associated with genital herpes, can also cause cold sores around the mouth.

Some people are infected with the virus but don't know it because it stays dormant and doesn’t cause any symptoms. However, for others, certain triggers can cause the virus to be active again and cause cold sores to appear. These triggers include:

• Fever

• Stress

• Fatigue

• Sun exposure

• Weakened immune system

• Dental work or injury to the lips

• Hormonal changes, such as during menstruation

Are cold sores contagious?

Oral herpes is highly contagious, so if you come into contact with a cold sore, you too can develop the infection. Where the infection appears on your body depends on which part touches the cold sore.

Cold sores are most contagious during the first 24 to 48 hours after the appearance of blisters, meaning the virus can easily spread through kissing, sharing utensils or other close contact. However, it's important to know that HSV can still be spread when there are no visible symptoms, although this is less common.

Cold sore symptoms

Although not everyone who has HSV will show symptoms, when they do occur, here's what you can expect:

• Tingling, itching, or burning sensation on or around the lips

• Redness and swelling in the affected area

• Small, fluid-filled blisters that often appear in clusters on or near the lips

• Pain or discomfort around the sore

These symptoms may vary depending on whether it is your first outbreak or a recurrence. The first time you have a cold sore, it is usually the most severe and may also cause:

• Headache

• Sore throat

• Muscle aches

• Swollen lymph nodes

• Painful gums (especially in children)

When to see a doctor?

Cold sores generally heal on their own within two weeks. However, you should seek medical advice if:

• You have a weakened immune system

• The cold sores don't heal within two weeks

• You experience severe pain or particularly large sores

• The sores keep returning frequently

• You develop gritty or painful eyes

If cold sores are affecting your daily life or you're concerned about frequent outbreaks, our specialists at Thomson Medical can help. Schedule a consultation with us for personalised care and support.

How is oral herpes diagnosed?

To diagnose oral herpes, your doctor usually begins by examining the blisters and asking about your symptoms. They may ask how often you have outbreaks and if you've been in contact with someone who has HSV. To confirm the diagnosis, your doctor may also perform:

• Blood test to detect HSV antibodies in your system

• PCR (polymerase chain reaction) test to detect viral DNA from the sore sample

• A viral culture test to see whether the herpes virus is present in the fluid taken from the sores

What are the available treatments for oral herpes?

Currently, there is no definitive cure for cold sores because the virus remains inside the body once contracted. However, this does not mean that treatment is ineffective; it can help reduce the duration and the severity of outbreaks. Treatment options for oral herpes include:

• Antiviral medications:

  • Topical (cream) antiviral medication, such as aciclovir cream, can be applied directly to the cold sore and is available without prescription at pharmacies in Singapore.

  • However, if you have severe conditions or if topical treatments haven't been effective, your doctor may prescribe oral antiviral medications. Common oral antivirals include aciclovir, valaciclovir, and famciclovir tablets.

• Pain relief:

  • Topical creams containing lidocaine or benzocaine can help numb the pain

  • Oral pain relievers such as ibuprofen or paracetamol

To help provide comfort and support healing, there are a few home care remedies that you can try:

• Keep the area clean and dry

• Apply ice or a cold compress to reduce swelling and pain

• Use lip balms with SPF to protect against sun exposure (a common trigger)

• Avoid picking or touching the sore, which can delay healing and spread the virus

• Wash your hands frequently, especially after touching the affected area

To help you manage cold sores, schedule a consultation with Thomson Medical. Our specialists can assist you in determining the best treatment option for your specific needs.

Can cold sores be prevented?

Although oral herpes cannot be fully cured, there are steps you can take to prevent spreading or catching this condition.

• If you have cold sores, protect others by:

  • Avoiding kissing and close physical contact

  • Not sharing cups, cutlery, towels, or toothbrushes

  • Washing your hands often, especially after you touch the area that is affected

  • Covering the cold sore whenever you can

• If you've had a cold sore:

  • Use lip balm with SPF to protect against sun exposure

  • Use relaxation techniques or regular exercise to deal with stress

  • Get adequate sleep and maintain a healthy immune system

  • Find out what triggers you (like stress or being in the sun) and stay away from them

FAQ

Are cold sores contagious?

How do you quickly get rid of a cold sore?

Is oral herpes a sexually transmitted infection (STI)?

Can I still kiss someone if I have oral herpes?

How long does a cold sore last?

Typically, a cold sore lasts from the first tingling sensation to full healing for 7 to 10 days. However, an initial outbreak may last up to two weeks.

Would it be possible to get cold sores on the tongue?

Yes, although they are less common than cold sores on the lips. HSV-1 can cause blisters or ulcers on your tongue, gums, inner cheeks, or throat, especially during your first outbreak. This condition is called herpetic gingivostomatitis and is more common in children. The symptoms include painful mouth ulcers, a fever, swollen gums, and difficulty eating or drinking.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations based on your specific conditions or needs, schedule a consultation with our specialists at Thomson Medical.