Cold sores (herpes labialis)

What Are Cold Sores?

‘Cold sores’ is a common term used to describe blisters and scabs that form on the lips caused by the Herpes Simplex Virus.

Did you know that:

  • Herpes Labialis is the original Latin translation for herpes on the lips, more commonly known as ‘cold sores’.
  • 60% of the UK’s population carry the HSV-1 virus.
  • Children aged 1-5 are the most at risk of infection from the HSV-1 virus.
  • The HSV-1 (Herpes Simplex Virus Type 1) is the most commonly found form of Herpes and most commonly causes cold sores to appear on the lips.
  • Cold sores can appear in other locations on the face, such as the nose. Which the picture on the left displays.
  • Many people are infected with Herpes without being aware or displaying any symptoms.
  • Cold sores are most commonly passed on via kissing or physical contact with someone who is infected with HSV-1
  • Globally, the figure for those that carry Herpes under the age of 50 is close to 4 billion.

Cold Sores, Herpes Simplex Virus Type 1, Herpes Labialis:

HSV-1 goes by many different names, however the symptom and result are the same. It is safe to say that those who suffer with cold sores know they are extremely uncomfortable and irritating, especially if you have a flare up when feeling perfectly fit and healthy. There is (almost) nothing worse than feeling that tingling sensation and those familiar spots that are the telltale signs you are due an outbreak.

There are many who live with the same dreaded feeling, just waiting for the next flare up to come around! HSV-1 or cold sores are one of the most contagious and wide spread viruses to affect the human population. 3.7 billion people out of the approximate 7 billion are considered carriers of the herpes simplex virus type 1.

In the following paragraphs you will read and learn about HSV-1, how to recognise it, what symptoms to look out for, how the virus operates during an outbreak and the risk of infection.

Chart of how many people suffer with HSV-1 worldwide.

Is there any difference between Cold Sores and Herpes?

No! The name Herpes covers a range of viruses, all of which have similar features. Herpes Simplex Virus Type 1 is most commonly the virus that causes cold sores. Most people believe it is nicer and less embarrassing to call the herpes outbreak that has appeared on their lips, a cold sore. But in fact, it is a flare up of the herpes virus, appearing in the form of small fluid-filled blisters that eventually burst to produce the well-known but slightly embarrassing and unflattering cold sores.

As we touched on there are other types of the Herpes Simplex Virus, other than the two most commonly found and talked about (HSV-1 and HSV-2). Such as, Herpes Zoster, which is more commonly known as Chickenpox on first infection, but can in some cases turn out to be Shingles, or another form of the virus, Epstein-Barr Virus (EBV) frequently referred to as the ‘Kissing Disease’. EBV is different to the Herpes Simplex Virus type 1 or 2 as it is not recurring, EBV will always remain in the body but dormant. It is very unlikely a carrier of EBV would have more than one outbreak. You can read more about EBV
here.

HSV-1 infection

The HSV-1 virus acts similarly to other viruses in that it tends to live in the nerve pathways where it can remain dormant or ‘sleep’ for years without causing any outbreaks, producing those uncomfortable cold sores. Most people who carry HSV-1 become infected as children or in their adolescence. It is possible to carry the virus without knowing until your first outbreak and some lucky people will carry the virus but never suffer from an outbreak.

There are a variety of reasons that outbreaks of cold sores happen, if we are stressed or if our immune system is weakened, for example, by fighting off other types of sickness. The most highly affected area by the HSV-1 virus is on and around the mouth but it is also common to find cold sores appearing in other places around the face. Maybe you’ve found a cold sore on your nose, eye or chin, this is very normal.

Outbreaks and flare ups occurring on the lips and nose are nothing to be worried about and will disappear by themselves after time. However, those that experience cold sores around their eyes need to be extra careful and should contact their local GP. Read more about the risks and treatments for cold sores that appear on the eye.

Can Everyone Get Cold Sores?

Yes! Cold Sores or the HSV-1 virus is an extremely common viral infection and can affect all people from all different backgrounds, around the world. It was estimated by the World Health Organisation back in 2012 that approximately 3.7 billion people under the age of 50 carried the HSV-1 virus. The figure has most likely increased significantly over the years and in the UK it is believed that about 60% of people are infected with HSV type 1.

The Herpes disease is found in all varieties of life from those who live with little to no access to soap or clean water to those with well-developed hygiene and sanitary conditions. It is extremely difficult, in this day and age, to go through life without ever being infected with this virus, making HSV-1 one of the most contagious viruses known to the population.

This is not to say there are no precautions you can take to aid with the treatment and prevention of outbreaks. In fact, it is the opposite. There are many ways of avoiding outbreaks and flare ups and therefore reduce, significantly, the risk of infection. You can read more about these methods on this page and under the other tabs above.

The Risk of Infection with Cold Sores

As explained above outbreaks of cold sores affects everyone regardless of their level of hygiene. However, it is important to pay extra close attention to washing your hands whilst experiencing an outbreak and avoid kissing and other close physical contact to reduce the risk of spreading the infection around your own body and infecting others.

Have I had a Cold Sore?

If you have to ask this question the answer is most likely NO! Outbreaks of cold sores are extremely easy to recognise and roughly 60% of the adult population in the UK carry the HSV-1 virus, which occasionally rears its ugly head in the form of fluid filled blisters that once have burst create sore wounds, which are commonly referred to as ‘cold sores’. In the picture below you can see a clear example of what a cold sore, appearing on the lips would look like, but if you are ever in doubt we encourage you to seek the opinion of your doctor.

Symptoms of Cold Sores

An outbreak would usually begin with an itchy, tingling or stinging sensation in the affected area and eventually after a few hours result in blisters on the lip, nose, chin, eyes or wherever the skin is afflicted. It usually takes 3 weeks after you have first been infected for the symptoms to begin to show and on average will take 7-10 days to heal on its own without scars, unless you have repeatedly picked at the scab created by the outbreak.

What does a cold sore look like?

A cold sores will usually have the characteristics of the fluid filled blisters at first, once the blisters have burst they will form scabs. Eventually the scabs will slowly start to get smaller and finally disappear. We have demonstrated a series of pictures below that show what a cold sore on the lips will look like from first signs and symptoms to a fully healed wound.

Why is the appearance of HSV-1 called a cold sore?

The origin of the word ‘cold sore’ most likely occurred as herpes outbreaks usually occur when the immune system is weakened, for example, by a cold. Colds are a frequent cause of weakened immune systems in the majority of the population, and therefore colds and cold sores go hand in hand.

Why do I constantly get Cold Sores?

Appearances of cold sores on the face or lips are most commonly due to the HSV-1 (in 90% of cases) or HSV-2 (for the remaining 10%) and are spread through touching, kissing or other types of physical contact. After your first infection the Herpes Simplex Virus will be present at the base of the nerves and in the skin. Outbreaks can occur for any number of reasons, we know for sure that cold sores can often occur when exposed to direct sunlight (Ultraviolet light), during menstruation, when the immune system is weakened, from lack of sleep for example and when we are feeling stressed. If you suffer from frequent recurring outbreaks there is plenty you can do, we provide a wealth of prevention and treatment methods under the tab ‘Prevention & Treatment’.

Can you get cold sores anywhere on the body?

If you have experienced a herpes outbreak before then you can probably sense or feel when an outbreak is on its way. The tingling itchy area, the swelling and redness eventually followed by small fluid filled blisters which turn into uncomfortable scabs. The most commonly affected areas by the HSV-1 virus are the lips, nose, eyes and other areas on the face. If you carry the HSV-2 virus you most likely experience the same symptoms but on the genital region, thighs or near the anus. HSV-2 is commonly thought of being the most painful and uncomfortable rather than HSV-1 however, looking on the brighter side it is much easier to conceal a HSV-2 outbreak as it is not outwardly displayed and won’t ruin any Instagram selfies or family photos. You can read more about HSV-2 here.

I think I’ve got an outbreak, what should I do?

If this is the first time you suspect you have been infected with the herpes virus and believe you are about to or are having an outbreak, contact your doctor and map it on your own body for future reference. If this is not your first outbreak of HSV-1 try reading these pages before trying the treatment options available by prescription or over the counter at your local pharmacy.

Outbreaks! Oh No, Not Now!

It’s safe to say there is never a good time for an outbreak of cold sores. Many of those who suffer with frequent outbreaks may feel like the virus knows when you are trying to avoid a flare up, if you are looking forward to something (where you want to look your best) such as a family photo, wedding, a date or a job interview. When you start to feel that first sensation, an itch, a tickle, swiftly followed by the well-known fluid filled blisters and then the painful scabs, which ruin any look. There is an explanation as to why when you are most excited and looking forward to something cold sores rear their ugly heads, it is probably because the joy and excitement that builds closer to the anticipated event can trigger a form of stress that weakens the immune system, giving the HSV-1 virus the perfect opportunity to flare up.

How to catch a cold sore outbreak early

Sometimes carriers can be lucky and catch an outbreak at the first signs, if you are able to react at the very first signs of stinging or itching in the affected area you may be able to ‘nip it in the bud’ before it turns into a full blown cold sore. If you feel an outbreak coming it is best to take a break and boost your immune system, if you are stressed then try to slow down as much as possible to give your body and head a break. To help boost the immune system ensure you are getting enough sleep, eat healthily, include lots of green and give your body an extra vitamin C boost either through supplements or freshly squeezed fruit and vegetable juices. A delicious cocktail of ginger, turmeric and lemon should do the trick, or try some of the other recommended treatments you can buy from our shop.

Read more about prevention and treatment here.

How to get fewer cold sores

Once you have read these pages and have confirmation that the sore on your lip, nose, face or elsewhere is herpes or a cold sore, then pop over to our ‘Prevention & Treatment’ tab where we provide loads of information on how to treat outbreaks and reduce the number of outbreaks in the future. The general opinion is that there is little to nothing that can be done to reduce the frequency of outbreaks of cold sores, however, the truth is that there is plenty that can be done to prevent outbreaks.

Children and Cold Sores

It is particularly common for children aged 1-5 to be infected with HSV-1 as at this early age everything they can get hold of is touched or put in the mouth, which makes it extremely difficult to avoid infections in general, but particularly HSV-1. Become more aware of the risk of infection, symptoms and measures to be taken to avoid outbreaks of cold sores in children here.

TRUE or FALSE

Cold Sores are caused by Bacteria!

Wrong! This is a common misconception that cold sores thrive where bacteria thrives on the skin, but this is nonsense. Cold sores are only ever caused by a virus called Herpes Simplex Virus which has nothing to do with bacteria.

It is however, true that a virus can be transmitted between people in the same way as bacteria, but does not behave in the same way.

Are cold sores only contagious during an outbreak?

No! It is still possible to infect others with HSV-1 if you are not having an outbreak. Many do not realise they are carriers of HSV-1 as they do not have regular outbreaks. Some researchers believe during the days leading up to an outbreak it is possible to infect others, but of course the risk of infection is greatest during an active outbreak.

Cold Sores should be cleaned with Alcohol!

False! Do not put alcohol on the wound. Not only will this sting very much but could also extend the length of time you are experiencing an outbreak. Alcohol dries out the affected area and can cause those already painful scabs to crack, which will interfere with the skin’s natural healing mechanism. This is not to say the body can do everything on its own, sometimes providing a helping hand can benefit the healing process. Instead of alcohol, try pure aloe vera, lemon balm oil or CBD oil for some relief.

Cold Sore & Fluorine – Can toothpaste help ease a cold sore?

No! The same as alcohol this will only sting and looks ridiculous, there is no benefit to it, it can in-fact burn the area and cause the wound to become more painful. The toothpaste will dry out the wound and can cause cracking which will make the cold sore more painful and slow down the healing process. Conventional toothpastes contain Fluoride which is bad for your immune system, the most important tool when fighting a cold sore outbreak is a strong immune system. Fluorine is not only found in toothpaste but also in our drinking water and food. It has never been proven that Fluoride benefits your teeth for example protecting enamel and prevent tooth decay. On the other hand, it is known that in taking fluoride can negatively affect and weaken the immune system. Instead, of using conventional toothpaste during an outbreak you could try coconut oil or a toothpaste that does not contain fluoride in-fact integrating these into your daily life regardless of outbreaks will help strengthen your immune system.

You can only get an outbreak of cold sores if you have a cold!

Wrong! Outbreaks can occur at any time. But it is true that there is a connection between an outbreak of cold sores and having a cold (hence the name). However, it is not due to the cold as such. Rather that the immune system is battling another illness so cannot use all its defences to fight the residing HSV virus.

For example, if you often feel stressed, tired, depressed or exhausted you will find that this often triggers an outbreak of cold sores. This is due to your immune system being on overtime, trying to battle the other ailments you are experiencing. Therefore, if not definitely a cold that fuels a flare up, any other illness can cause the immune system to disregard the HSV-1 virus to target the other affliction, which results in those familiar blisters.

Can you get a Cold Sore from too much sun?

Yes and No. You must be infected with HSV-1 initially to get a cold sore. However, many of those that carry the virus experience more frequent outbreaks when the sun is stronger. In the Spring or Summer time or if in a different country where the climate is warmer and sunnier. Long periods of time spent in the sun or under ultraviolet light can stimulate the virus and cause outbreaks. There is uncertainty about the link between sunlight or UV light and cold sore outbreaks but it is most likely due to a form of UV radiation.

Some carriers enjoy using a UV or SPF lip balm, but unfortunately this does not work for everyone. You could try taking the supplement L-Lysine for a period of 1-2 weeks before going on your next sunbathing or skiing holiday and notice if you get any outbreaks this time around.

Can Exercise Cause Cold Sores?

Moderate exercise is positive and will benefit the immune system which in turn will help prevent cold sores. On the other hand, hard exercise can affect the body and immune system which can in turn provoke the HSV-1 virus and stimulate outbreaks.

This is not a suggestion to stop or change your exercise routine, rather it is to inform and raise awareness, that those who participate in hard physical exercise will be more susceptible to outbreaks of cold sores, you could see this as a sign that your body needs you to slow down as your immune system has started to become affected.

You must not drink from the same glass as someone with a cold sore!

It is common knowledge that kissing must be avoided if your partner is experiencing an outbreak, but there is a risk of transferring the virus by sharing drinking glasses, forks or spoons. However, this risk is small, but it is always good to be careful just in case. If one of your friends or family is presenting with cold sores, as far as possible avoid sharing water or wine glasses, water bottles, cutlery and towels and always wash everything thoroughly after use.

You get more outbreaks if you talk about it!

Maybe! This has not been scientifically proven, but from our experience, talking about herpes and cold sores can trigger symptoms to appear 24 hours after. And then it’s all about putting our good advice and remedies to use to put the virus back to sleep.

The theory is if you are worried or afraid about having an outbreak, this can trigger stress hormones to be produced, which the HSV virus will pick up on and stimulate an outbreak. However, this is just an assumption and based on personal experience.

If Cold Sores are the Herpes virus, do I have a sexual transmitted disease?

No! Cold sores come from the HSV-1 herpes virus and most carriers are infected as children but do not present symptoms or have outbreaks until later life. HSV-2 also known as Genital Herpes, is most commonly found in the genital area and is therefore more often transmitted through sexual acts. HSV-1 and HSV-2 are recognizably different variations of the Herpes Simplex Virus. A person can easily suffer from one version of HSV and not the other, but there are also those who are unlucky enough to suffer from both variants of the Herpes virus.

Can I infect myself with Cold Sores?

Yes, it is possible to spread the HSV virus around your own body. For example, if you suffer with cold sores on your mouth or lips and you have touched the cold sore without being vigilant and washing your hands you can in-fact spread HSV-1 to other areas of the face or body. Therefore, always be conscious of washing your hands if you are touching the wound. You should also pay extra close attention to children suffering from outbreaks and their hand and face hygiene, particularly as small hands may pick at scabs and then rub their eyes. Contact your local GP immediately if redness or swelling occurs around the eyes or if any similar symptoms of cold sores appear around the eye.