Cold Sores Causes, Symptoms & Full Risks Explained

Despite the name, cold sores are not caused by cold. Cold sores, also known as canker sores, are small, painful blisters that usually form on the lips or skin around the mouth, nose, and on the chin. These sores appear like tiny, fluid-filled blisters on and around your lips. In most cases, the sores usually appear as clusters of tiny blisters on the lip or on the skin around the face. People who experience frequent outbreaks can use antiviral creams to alleviate symptoms.

Causes of cold sores

Generally, cold sores are caused by infection with the herpes simplex virus (HSV). Most people out there are usually infected in their childhood before they are 10 years old. Herpes simplex virus (HSV-1) is commonly picked it up when you were a kid, most likely from direct contact with someone who has it or getting kissed by an adult with the virus. You can catch HSV when you come into contact with people or things that carry the virus. For example, you can get the virus from kissing someone who is infected or when you share drinking glasses, eating utensils, towels or toothbrushes. (1)

The bad thing here is that the virus stays in the body throughout lifetime and there’s no permanent cure to get rid of them. However, the first infection does not usually cause any symptoms, the virus tends to remain inactive inside the body. Once an individual gets infected with HSV-1, the virus makes its way through the skin and into a group of nerve cells called a ganglion and remains inactive for some time. (2)

In rare cases, the herpes simplex virus (HSV-1) stays dormant (asleep) permanently without causing any problem. Well, in most cases, the virus tends to “wake up” or become active after a long period of time, leading to outbreaks of cold sores. No one knows for sure what causes this virus to wake up, but once they do, they can cause canker sores and gingivostomatitis, resulting in pain.

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Well, certain factors such as emotional or physical stress, as well as other infections, fever, excessive exposure to sunlight, exposure to windy conditions, hormonal changes during menstruation or pregnancy, tooth extractions, and certain foods and medications can possibly awake the virus.

The formation of cold sore

  • At first, the dormant herpes simplex virus-1 (HSV-1) in a person’s body becomes active, causing cold sores and canker sores. Treatment can help manage these conditions.

  • The oral herpes virus spreads through the nerve endings to the soft tissues below the lips, causing cold sores. It can also affect the genitals, nose, cheeks, or fingers. There are various treatments available for cold sores and canker sores.

  • You will start to experience tingling, itchy, or burning sensation at the area where the oral herpes sores caused by the simplex virus type wants to develop. That particular area is where the cold sore is going to appear.

  • After a day or two, a red bump appears in that area after the tingling, itching or burning sensation caused by cold sores or oral herpes, which are caused by the simplex virus.

  • Small fluid-filled blisters, also known as cold sores, caused by the oral herpes simplex virus, forms and break out along the border where the outside edge of the lips meets the skin of the face.

  • After the cold sores caused by the simplex virus have formed, you may notice that they break and ooze. A yellow crust or a scab builds up and eventually falls off, revealing new skin underneath.

Normally, cold sores caused by HSV-1 last for about 7 to 10 days. At this point, they are highly contagious and can easily spread to other people until they completely crust over. HSV-1 can also infect the eyes, fingers, and genitals. However, most genital herpes infections are caused by HSV-2, commonly known as herpes whitlow. Children who suck their thumbs may transfer the infection from their mouths to their thumbs.

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Symptoms of cold sores

Cold sores, also known as fever blisters, can show up anywhere, they most appear on the outside of the mouth, lips, on the nose, cheeks, or fingers. The signs and symptoms vary depending on certain factors. People usually experience more severe symptoms during their first outbreak. Recurrences typically appear at the same spot each time and tend to be less severe than the first outbreak.

People who are infected with HSV-1 for the first time may have severe fever, headache, nausea and vomiting. In some rare cases, cold sores may also develop inside the mouths and the lesions are commonly mistaken for canker sores. Well, when you become infected with HSV-1 for the first time, you may experience:

  • fever

  • tiredness

  • blisters (lesions) and ulcers in and around the mouth

  • a sore throat

  • pain inside the mouth and on the gums

  • swollen neck glands (lymph glands)

  • Painful eroded gums

  • Headache

  • Muscle aches

The symptoms of cold sores can last up to a week or more and may cause lots of pain and discomforts. In severe cases, the cold sore infection can actually progress to the eye and affect your vision. Eventually, it may also spread to the brain and could lead to meningitis or encephalitis.

Risk factors

According to studies, about 90 per cent of adults have herpes simplex antibodies in their bloodstream, which means that they have been infected with the virus at some time. Generally, cold sores are not serious, but the infection can progress over time and may be life-threatening for anyone who has a weakened immune system. People whose body defense against germs has been curbed by immune system disorders or medications are at higher risk of complications from the virus.

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Some medical conditions and diseases such as HIV/AIDS, eczema, cancer chemotherapy, anti-rejection drugs for organ transplants, and cold sores can increase your risk of complications.

Prevention

  • Avoid skin-to-skin contact with infected people. To help to prevent a first herpes infection in children do not let them be kissed by anyone who has cold sores, fever blisters or signs of a first herpes infection.

  • Medications. Since most people are usually infected during their childhood, there are medications to protect your children from being infected. There are special vaccines that are being developed against HSV (types 1 and 2), but these medications are mostly to protect only people who have never been infected.

  • Always wash your hands. If you do touch an active cold sore, don’t touch other parts of your body, wash your hands as soon as possible. To help avoid spreading cold sores to other people or to other parts of your body especially your eyes, always wash your hands.

  • Avoid sharing items. Avoid sharing toothbrushes, drinking glasses or bottles, cutlery, towels or other personal items. Ensure to avoid close contact such as kissing and hugging with adults or children that have burns, eczema or other symptoms of cold sores.

Learn more about cold sores here – all about cold sores.