Have you ever had a small, painful blister pop up on or around your lips that crusts over and takes forever to heal? If so, you’re far from alone – you’ve experienced a cold sore, also known as a fever blister.
Cold sores are incredibly common. In fact, the CDC estimates that 50-80% of American adults are infected with the virus that causes them. But just because cold sores are common doesn’t mean they aren’t annoying, uncomfortable, and sometimes downright embarrassing.
So why do some people get frequent cold sores on their lips while others seem immune? What causes them to crop up and how can you get rid of them faster? This article will cover everything you need to know about why cold sores keep returning and what you can do to treat them and prevent future outbreaks.
What Causes Cold Sores on the Lips?
Cold sores are caused by one of two strains of the herpes simplex virus (HSV): HSV-1 or HSV-2. HSV-1 is the usual culprit behind cold sores around the mouth, while HSV-2 typically causes sores on the genitals (like genital herpes).
But HSV-1 and HSV-2 can both cause sores anywhere on the body. Once a person is infected with HSV, the virus stays in the body for life and can become reactivated.
HSV-1 is usually spread in early childhood when kids put things in their mouths. It’s transmitted through contact with infected saliva, such as by kissing or sharing drinks, food, or lip products with someone who has an active cold sore. You can also get it from contact with infected objects like towels, razors, or silverware.
Once infected, most people have recurring outbreaks of cold sores triggered by certain factors. Let’s look at why cold sores keep coming back on the lips and mouth area.
Triggers for Cold Sore Outbreaks
There are several common triggers that can cause the dormant herpes simplex virus to reactivate, leading to a cold sore outbreak. These include:
Stress – Increased stress levels may weaken your immune system and trigger an outbreak. Stressful events like final exams, job loss, or the death of a loved one can be culprits.
Fatigue and lack of sleep – Not getting enough rest taxes your immune system. Burning the candle at both ends raises your risk of recurrent cold sores.
Fever or illness – Being sick with another infection like a cold or flu can enable the virus to wake back up.
Sun exposure – UV light can prompt cold sore outbreaks in some people.
Hormonal changes – Fluctuating estrogen levels in women due to menstruation, pregnancy, or taking birth control pills may lead to flare-ups.
Skin damage – Anything that causes trauma to the skin around the mouth like cuts, burns, or chapping may trigger a sore.
Immune deficiency – Conditions like HIV/AIDS or drugs that suppress the immune system (like chemotherapy) make outbreaks more likely.
If you experience frequent recurrences of cold sores, take note of any triggers that seem to spark an outbreak for you personally. Then you can take steps to avoid or minimize those triggers where possible.
Stages of a Cold Sore Outbreak
Once activated, the herpes simplex virus goes through several stages as it replicates and causes a visible cold sore lesion. Knowing the stages can help you choose the most effective treatments.
1. Prodrome Stage
This first stage happens just before the sore becomes visible. You may experience tingling, itching, burning, or pain around the lips for up to a day. The skin may redden or swell.
2. Blister Stage
Small fluid-filled blisters appear, usually along the edge of the lips. Several blisters may cluster together. The sores are contagious at this point.
3. Ulcer Stage
The blisters burst open, weep clear fluid, and then crust over into a yellowish scab. This stage is often the most painful.
4. Scabbing Stage
A firmer brownish scab forms over the ulcer. During this stage the sore may crack open and bleed if the scab gets disrupted.
5. Healing Stage
The scab sloughs off, revealing pinkish new skin that gradually blends into normal skin tone. This takes several days.
From the first tingle to complete healing, cold sores usually last 7-10 days without treatment. Certain medications can shorten this duration.
How to Treat Cold Sores
While there’s no cure for cold sores, you have many options to relieve symptoms and help them heal faster. Here are some effective remedies:
Lip balms and moisturizers – Keep lips moisturized and protected with medicated balms containing ingredients like phenol, menthol, or camphor. Sunscreen lip balms with SPF can help prevent sun-triggered outbreaks.
Cold compresses – Applying a cold compress or ice wrapped in cloth to the sore can temporarily numb pain and reduce inflammation. Do this for just 5-10 minutes at a time to avoid damaging skin.
Warm compresses – For enhanced circulation, press a warm, wet washcloth against the cold sore for about 5 minutes 2-3 times a day. This may help it heal faster.
OTC pain relievers – Nonprescription painkillers like acetaminophen, ibuprofen or naproxen can temporarily ease soreness.
Prescription antivirals – Medications like acyclovir, valacyclovir, and famciclovir stop the virus from replicating. They are most effective when taken at the very first signs of an outbreak.
OTC topicals – Anesthetic gels, creams or patches with lidocaine, benzocaine or phenol may relieve pain when applied to sores.
Alternative remedies – Some people find natural treatments like lemon balm, licorice root, and tea tree oil helpful. But clinical evidence is limited.
Avoid irritants – Don’t pick at scabs or put irritants like toothpaste on sores. This can delay healing.
See your doctor if over-the-counter treatments don’t seem to help or you experience outbreaks frequently. Prescription antiviral medication can reduce healing time and prevent recurrences.