Cold sores are caused by the herpes simplex virus (HSV-1), which is very common and relatively harmless.
Even though there isn't a cure for herpes, the infection can be treated with antiviral medication that reduces your frequency of cold sores.
To prevent the spread of cold sores and herpes, avoid sharing utensils, kissing with an active sore, or engaging in oral sex.
Cold sores appear on and around a person's lips, often looking like a blister or scab. While relatively harmless, these sores are not typical pimples, but a manifestation of herpes.
Herpes lives permanently in the body after infection and is quite contagious, especially if you have an active cold sore. As a result, herpes is a very common infection that is present in a large portion of the global population.
Widespread myths and stigma surround herpes and cold sores. And even though herpes doesn't pose a dangerous threat to your health, the cold sores can still feel painful, irritating, or embarrassing.
Here's what you need to know about limiting the spread of cold sores and herpes, and the best ways to treat your symptoms.
Yes, cold sores are herpes
While commonly referred to as cold sores, the blisters appearing around a person's mouth are a form of the herpes simplex virus (HSV). There are two main strains of herpes:
HSV-1 is most often responsible for cold sores around the mouth. In 2016, 3.7 billion people under the age of 50 worldwide had HSV-1 infections.
HSV-2 is most often responsible for genital herpes. In 2016, about 491 million people worldwide aged 15 to 49 years old had HSV-2. Almost two-thirds of those infected with HSV-2 are women. The World Health Organization says this is due to it spreading more easily from men to women than the reverse.
"Cold sores are more commonly caused by HSV-1," says Brooke Jeffy, MD, a dermatologist at Spectrum Dermatology in Phoenix, Arizona. "Genital herpes infection is usually caused by HSV-2. However, either virus can cause infection at either site."
What are the symptoms of cold sores?
Symptoms of cold sores can include:
Swollen lymph nodes
Tingling or burning around the mouth
"Cold sores can be extremely painful and can cause discomfort not only at the site of the outbreak," says Michele Green, MD, a cosmetic dermatologist in New York City.
Are cold sores contagious?
Yes, cold sores are contagious, even more so when there is an active sore.
"Herpes infections can be spread even in the absence of a sore. It is more likely to spread if there is a visible sore, particularly if it is in the blistering and crusting stage, but can be spread even with normal-appearing skin," says Jeffy.
Important: Cold sores can spread from person to person even if you or a partner does not have an active sore.
Cold sores typically last seven to ten days, moving from a small blister to a scab. However, the risk of transmitting a cold sore never diminishes altogether, as the virus is always present in a person's body, even if it's not visible.
While HSV-1 normally affects the mouth, it can also be spread to the genitals. Oral sex is a common means of transporting either form of the virus between the mouth and the genitals, says Green.
How to treat cold sores
At this time, there is no cure for HSV-1. However, proper treatment can limit the duration of symptoms and discomfort.
If you have chronic or painful cold sores, you can use prescription antiviral medicine to manage them. The three antiviral medications used in the treatment of cold sores are:
According to Annie Gonzalez, MD, FAAD, a dermatologist at Riverchase Dermatology in Miami, Florida, additional at-home treatment options for preventing and calming cold sores include:
Limiting stress when possible, as stress can trigger and exacerbate cold sore outbreaks
Using sunscreen on the lips to avoid a sunburn
Putting ice on cold sores to temporarily calm any burning sensations
Applying aloe vera gel to cold sores
Taking over the counter pain medicine, such as Tylenol
How to prevent the spread of cold sores
As there is currently no way of removing herpes from the body, preventing new cases of infection is critical. There are a few ways to prevent the spread of cold sores, says Jeffy, including:
Not sharing utensils, cups, or lip balm with anyone who has a sore
Not kissing anyone who has a sore
Frequently washing your hands as it can spread through skin contact
Practicing safe sex by using protection and regular testing
Certain medications can also help limit the spread of cold sores. "Prescription antiviral medications that reduce the duration of the sore can help to reduce spread by decreasing the amount of time someone is most infectious," says Jeffy.
Cold sores are a form of the herpes simplex virus, typically HSV-1. While there is no cure for HSV-1, antiviral medications like Acyclovir (Zovirax), Famciclovir (Famvir), and Valacyclovir (Valtrex) can limit symptoms.
Cold sores are more contagious when a sore is active but can spread at any time. You should avoid sharing utensils or lip balm and limit physical touch with someone who has a cold sore present.
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