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Herpes (oral)

Dr Roger Henderson
Reviewed by Roger HendersonReviewed on 29.04.2024 | 4 minutes read

Oral herpes, also known as cold sores, are small blisters on the face that are caused by the herpes simplex virus (HSV). These blisters pop and then get a crusting over them. Some people experience tingling or burning before the blister appears and they can be painful. They are very common, with around 1 in 5 people suffering from repeated cold sores but they usually heal by themselves a week to 10 days after they appear. Most people are infected with the virus when they are young, however may not get a cold sore until many years later. Once infected the virus stays within you and so can be reactivated and cause other cold sores at future points, and this is usually around times of stress, tiredness, menstruation, or illness. Some people also find the sun can cause outbreaks.

Genital herpes and cold sores are caused by the same virus, although there are two different strains (HSV1 and HSV2). It isn’t really important which one is causing trouble, as treatment is based on where your symptoms are happening. If you have symptoms down below, see your doctor or sexual health doctor to discuss.

Doctor’s advice

Is it contagious?

Cold sores are contagious and can be passed on through direct contact or items that have touched the cold sore. This is why it is important to avoid kissing anyone, touching your cold sore or sharing any glasses/cutlery or anything else that will have come into contact with the cold sore. It’s important to be especially careful around babies or anyone with a compromised immune system as it can become a serious condition in this group of people.

Avoid oral sex until the cold sores have completely healed. When you have no symptoms (when the virus is dormant), you are not usually infectious. Healthy people who already have cold sores cannot be re-infected. Always avoid direct contact with the sores, so wash your hands after touching your lips. Never pick at the sores as this can spread the virus to other parts of the body or result in a bacterial infection of the sores. To strengthen your immune system, eat a varied diet, exercise regularly and get enough sleep. In some people, exposure to sunlight can cause a flare-up so using a sunblock may help here.

There is a risk of infecting the eyes with the cold sore virus if your contact lenses become contaminated. You can prevent this with careful handwashing before handling your contact lenses. If you have disposable lenses and you suspect you have contaminated them, it is probably best to throw them away. If you have any concerns it may be better to wear your glasses and seek advice from your GP or optometrist.

Healthwords pharmacists' top tips

Cold sores are usually self-limiting and will usually heal up on their own within a week in most cases. One of the most important things to do is to not touch the cold sore unless dabbing on cream/gel purchased from your pharmacist and to wash your hands thoroughly after touching the area.

We recommend when you first notice a cold sore or if you have a tingling/burning sensation using an antiviral cream that you can purchase from your pharmacist. An antiviral cream helps prevent the cold sore from developing/getting worse but is less useful if the cold sore has already developed to the full. Use as recommended on the instructions, make sure to wash your hands thoroughly prior to and after applying the cream, and dab the cream on instead of rubbing it in.

When treating with an antiviral cream such as Zovirax cream (which contains Aciclovir 5%) for example, it is important that the cold sore is treated at the very earliest stage possible, (preferably at the tingling stage before the blister appears). These are effective in reducing the overall size and spread of the blister, and can also reduce the healing time of the blister. Once the blister has already appeared, there is little evidence that the antiviral activity has any significant overall benefit as opposed to just simply moisturising the lips and providing a barrier over the skin.

For those who are self-conscious or require some cosmetic covering over the cold sore, for example, attending a function, something like the Compeed cold sore patch can be used. It additionally can provide a protective moisturising barrier, and reduce the drying and cracking of the cold sore.

You can also use a pain relief or soothing gel recommended by your pharmacist or pain relief medications such as paracetamol and ibuprofen.

Pharmacist recommended products

Am I fit for work?

You are fit for work if you have a cold sore.

When should I see my doctor?

It’s important to see your doctor when you first notice a cold sore if you are pregnant or if you have a lowered immune system (due to a medical condition or medical treatment). You should also see your doctor if you have a large or extremely painful cold sore, have sores in your mouth, painful gums or if the cold sore has not healed after 10 days.

The doctor will ask you about your medical history, examine the area and may prescribe oral antiviral tablets. If you are pregnant or have a lowered immune system the doctor may refer you to a specialist service in hospital.

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Dr Roger Henderson
Reviewed by Roger Henderson
Reviewed on 29.04.2024
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