- Cold sores typically go away within 2-4 weeks on their own.
- But you can speed up the healing process with over-the-counter (OTC) creams containing docosanol.
- You can also reduce inflammation with OTC pain relievers that contain lidocaine or benzocaine.
- Visit Insider's Health Reference library for more stories.
A day or two before these blisters appear you may feel a subtle tingling, itching, or burning sensation on your lips. Soon after, tiny hard, red blisters will appear, which may feel swollen and painful. Eventually, the blisters break and release fluid, and after a few days, the sores begin to scab over and heal.
While cold sores typically go away on their own within two to four weeks, there are measures you can take to ease your symptoms in the interim. Below, doctors share guidance on what to do when you have a cold sore.
What causes cold sores on the lip?
Cold sores are caused by the contagious herpes simplex virus (HSV), of which there are two types.
HSV-1 is a common and highly contagious virus typically transmitted through skin-to-skin contact involving the mouth — like kissing and oral sex — while HSV-2 is mostly transmitted through genital-to-genital contact.
It's important to note, however, that you can contract herpes and not have cold sores. In fact, many people don't know they have HSV-1 because they're asymptomatic.
You may experience recurring outbreaks of cold sores when you first contract the virus. This is when you're most contagious, especially when blisters are oozing fluid. However, these outbreaks often decrease over time.
After a while, cold sores typically only show up when triggered. Here are some common triggers for cold sore outbreaks, according to Purdy:
- Hormonal changes, like those related to menstruation
- Viral infection, like the common cold or flu
- Sunburn on the lips, or exposure to strong sunlight
- Chapped, cracked skin on or around the lips
- Using harsh, irritating skin or cosmetic products around the lips that disrupt the skin barrier
Everyone who has the herpes virus is different, and some people may simply be more prone to frequent outbreaks, says Purdy.
"I've had patients often get cold sores during exam weeks, life crisis, or relationship troubles," says Purdy. "These types of circumstances may lower someone's immune system and increase the chance that the virus will express itself in the form of cold sores."
How to treat cold sores fast
There are a wide variety of treatments to help manage cold sore symptoms and shorten the amount of time they're visible. They range from home remedies to prescription medications. The right one for you will depend on the severity and frequency of your outbreaks.
Here are some of your best home treatment options, according to Purdy:
- Over-the-counter creams: The only FDA-approved non-prescription medicine to treat cold sores is Abreva, which contains the active ingredient docosanol to decrease symptoms and possibly speed up healing. Topical zinc oxide treatments may also be beneficial.
- Over-the-counter pain relievers: Try taking ibuprofen or acetaminophen to reduce inflammation, and thus ease the pain that comes with cold sores. Alternatively, you can apply an over-the-counter topical pain reliever with numbing agents like lidocaine or benzocaine, directly onto the cold sore.
- Cool compresses or ice: Applying a cold, damp washcloth to a cold sore intermittently throughout the day may help reduce swelling and pain. You may also use ice, but don't apply it directly to the skin — instead, wrap it in a paper towel or washcloth.
Cold sores should clear up within 10 days or so of when you start treating them. If symptoms don't go away within two weeks, Purdy advises seeing your healthcare practitioner
When to see a doctor
A doctor can prescribe an oral antiviral medication to help cold sores heal faster. Examples of these medications include acyclovir, valacyclovir, and penciclovir.
You should see a noticeable improvement after using these medications for three to five days, says Purdy.
Purdy says you should also see a doctor if:
- Cold sores are severely painful or widespread
- You experience a headache with a high fever, which suggests you may have herpes meningitis, a more serious infection that can affect the brain and even be fatal when left untreated
- You're immunocompromised
- Symptoms spread to the eyes, causing redness, pain, swelling, or discharge
Knowing and avoiding your triggers can help minimize herpes outbreaks. For example, if you notice that you tend to experience outbreaks when you're overwhelmed at work or school, you may need to work on developing some strategies for managing stress.
Overall, Purdy says supporting your immune system by maintaining a healthy diet and getting plenty of sleep is one of the best ways to keep cold sores at bay.
You can also wear a hydrating lip balm with SPF to protect yourself from getting sunburned, which may trigger an outbreak.
Don't forget to replace your toothbrush, lipstick, and lip balm after an outbreak, as Purdy notes the virus can live on its surface for several days and cause an immediate re-infection.
Although there is no known cure for cold sores, there are a number of different treatment options that can help to reduce symptoms while also enabling the sore to heal faster.
As long as symptoms aren't too severe, the sores aren't widespread, and you aren't immunocompromised, you can usually treat cold sores at home with over-the-counter creams, pain relievers, and cool compresses.
If the sores don't clear up within a couple of weeks, experts strongly recommend talking with your doctor about whether prescription medication is a viable option for you.
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