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Herpes (oral)

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 3 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 crust over them. Some people experience tingling or burning before the blister appears, which can be painful. They are very common, with around 1 in 5 people suffering from repeated cold sores. They usually heal by themselves between a week and 10 days. Most people are infected with the virus when they are young. However, they may not get a cold sore until many years later. Once infected, the virus stays within you and can be reactivated and cause other cold sores at future points. This is usually around times of stress, tiredness, menstruation, illness, or some people 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 the symptoms below, see your sexual health doctor to discuss them.

Doctor’s advice

Is it contagious?

Cold sores are contagious and can be passed on through direct contact or items touching 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 these groups of people.

Healthwords pharmacists' top tips

Cold sores are usually self-limiting and usually heal on their own within a week. 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.

When you first notice a cold sore or if you have a tingling/burning sensation, we recommend 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 in the instructions, and make sure to wash your hands thoroughly before and after applying the cream and to dab the cream on instead of rubbing it in.

When treating with an antiviral cream such as Abreva (which contains docosanol), for example, the cold sore must be treated at the very earliest stage possible (preferably at the tingling stage before the eruption of the blister). It effectively reduces the overall size and spread of the blister and can reduce the healing time of the blister. Once the blister has already erupted, there is little evidence that the antiviral activity has any significant overall benefit as opposed to simply moisturizing the lips and providing a barrier over the skin. Stronger antiviral creams are available by prescription.

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

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

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 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 any sores in your mouth, have 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 the hospital.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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