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How to Get Rid of a Cold Sore

US News & World Report - Health logo US News & World Report - Health 12/14/2019 Vanessa Caceres
a close up of a man: Young man with a cold sore on his lip © (Getty Images) Young man with a cold sore on his lip

If you've ever had a cold sore – a painful, reddish blister on the lip or around the mouth – there's probably only one question you're wondering: How do I get rid of this cold sore fast?

Fortunately, there are some ways you can decrease the amount of time you're living with a cold sore. There even are some ways to lessen your chance of developing cold sores in the future.

Read on to learn what cold sores are, why they develop and how to treat them.

What Is a Cold Sore?

Also called a fever blister or herpes simplex labialis, a cold sore is a sore (also called a vesicle) that looks like a blister or a cluster of blisters with a red base, says Dr. Christina Gasbarro, a primary care physician with Mercy Personal Physicians at Overlea near Baltimore. "Eventually they start to dry and can look a little yellow and crusty," she explains.

Cold sores are caused by the herpes simplex virus. However, this isn't the same as the sexually transmitted herpes virus. In fact, more than half of adults ages 14 to 49 have the herpes simplex virus that causes cold sores, according to the American Academy of Dermatology. That's because we were likely exposed to it as children or young adults. Many of us have the virus, but it stays dormant, or quiet, in our bodies. Sometimes, the virus reactivates, leading to the development of a cold sore.

"Most people have been exposed (to the herpes simplex virus), but only a fraction develop cold sores," says Dr. Sonoa Au, a dermatologist with Advanced Dermatology PC and the Center for Laser & Cosmetic Surgery in New York and New Jersey.

It's not always clear why some people with the virus get cold sore outbreaks and other people with the virus never develop them.

There are several reasons why the herpes simplex virus may lead to a cold sore outbreak:

  • Contact with someone who has a contagious cold sore.
  • Stress.
  • Surgery or minor trauma near the lip area.
  • Cold weather.
  • Direct, intense sun exposure.
  • Getting sick. "I joke with patients that it's Mother Nature kicking you when you're down," says Dr. Esther Freeman, an assistant professor of dermatology at Harvard Medical School in Boston and director of the Massachusetts General Hospital Global Health Dermatology.
  • For women, being on your period.
  • Not getting enough sleep.

It could even be a combination of these factors that reactivates the virus that causes cold sores.

Cold sores are nothing to be ashamed of, and they usually aren't serious. However, there is a three- to seven-day period during which they are contagious.

If you're in contact with someone who has a cold sore, there are a few ways that you can get the virus from them:

  • Kissing. It doesn’t have to be an intimate kiss; it could even just be a short kiss to greet a relative.
  • Sharing utensils or cups.
  • Sharing personal hygiene items like lip balm, a razor or a towel.

Cold sores frequently are confused with a few other skin problems, including:

  • A bacterial infection.
  • Acne.
  • Chapped lips.
  • Mouth ulcers. These are small ulcers inside the mouth, but they're not infectious.
  • Skin cancer.

However, some symptoms can help distinguish a cold sore from these other health problems. In addition to the common look of a cold sore, other symptoms you may experience are itching and a tingling or zinging sensation right before the cold sore emerges. That's actually the time when you should start treatment.

How to Treat a Cold Sore Quickly

Without treatment, a cold sore may last a week to three weeks, Gasbarro says. The best ways to get rid of a cold sore quickly are to:

  • Start treatment as soon as you feel the tingling or zinging sensation before the cold sore even erupts.
  • Use two doses of an oral antiviral prescription medicine called valacyclovir for a day. (Your doctor may prescribe other oral medications that are similar to valacyclovir, including acyclovir, penciclovir and famciclovir.) On average, use of an oral antiviral medication can shorten the time of having a cold sore from a week to three days, Freeman says. She's even seen patients who have cold sores frequently and have the medication on hand. By starting treatment promptly, they were able to prevent full development of a cold sore. Of course, everyone's case is a little different. Even if you start antivirals after the cold sore emerges, the treatment can still help shorten the length of time that you'll have it.

Another option is the prescription topical cream acyclovir. This can be used if you can't or don't want to take oral medications, Freeman says. Oral antivirals are still more effective.

Another possible treatment is topical over-the-counter medications. One popular cream is called docosanol 10%, sold under the brand name Abreva. Using this as soon as a cold sore emerges can shorten the amount of time you have it, but it's not as effective as the oral prescription medications. If using a cream, you can apply it with a clean cotton-tip swab, the AAD recommends.

Applying petroleum jelly to your cold sore and the surrounding skin can help the skin from becoming too dry, which may help it heal faster, the AAD explains.

If you have pain or a fever from a cold sore, you can use common pain relievers such as ibuprofen or acetaminophen. Getting a fever is more common with your first outbreak of cold sores. These types of medicines only help control pain or fever; they won't help the cold sore go away. Putting a cold compress on the cold sore area also may help with pain.

There are some home remedies that some people try when they get a cold sore. These include aloe vera gel, lemon balm or witch hazel. These might help with any discomfort, but they're not going to get rid of your cold sore quickly, Freeman says.

While you have a cold sore, you'll still be contagious until it crusts over, the AAD reports. Make sure to take precautions when you have a cold sore:

  • Don't touch or pop your cold sore.
  • Avoid close facial contact with others, especially babies.
  • Don't share personal hygiene items, food, utensils or cups.
  • Wash your hands frequently, including after you apply medicine.

When to See a Doctor for Cold Sores

Cold sores aren't usually serious. You typically don’t need to see a doctor for them unless you need to obtain prescription medicine. Otherwise, there are a few occasions when you'll want to see your primary care doctor or a dermatologist for a cold sore:

  • It's lasted more than two or three weeks.
  • There's extensive blistering.
  • You have recurrent cold sores that bother you. "Doctors can prescribe a suppressive dose of an antiviral medication for people with frequent recurrences," Au says. In this situation, you may fill a prescription for oral valacyclovir and keep it on hand for the next time a cold sore erupts. Or, if you get them very frequently, you may even use a preventive daily dose of medicine.
  • You have sores that spread near the eyes or eye irritation caused by the sores. See an eye doctor immediately if this occurs because herpes simplex virus that affects the eyes has the potential to cause permanent damage, Au cautions.

Although there's no foolproof way to avoid a future outbreak, there are a few things you can do to reduce your chances:

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